This winter—the first in three years without widespread mask wearing and social distancing—public health authorities have their eye on a potential perfect storm due to three viral causes of acute respiratory illness: Respiratory Syncytial Virus (RSV), Influenza (flu), and COVID-19. Here’s what you need to know about these three viruses:
RSV is a relatively common respiratory virus that causes manageable cough and congestion in most people. However, it can cause more severe symptoms in adults over age 65 and children under age 2, including bronchiolitis (asthma-like symptoms) and pneumonia. This year, there is a large number of young children in the highest-risk age group who lack immunity to RSV and may be susceptible to more severe infection, and this has led to a rapid rise in cases and hospitalizations. While there is no antiviral treatment for RSV (except for a monoclonal antibody treatment used only in high-risk premature infants), the good news is that most children and adults with severe RSV recover fully with supportive care. Although in development, there is currently no vaccine against RSV.
Influenza virus or flu, which has more acute symptoms such as high fever, muscle aches, and upper or lower respiratory symptoms, usually peaks in January or February, but there is an unusually rapid rise in cases this year, with more than 6 million cases already (compared with approximately 9 million over the entire 2021-22 season) and the highest rate of hospitalization in over 10 years. This may also be due to a more susceptible population that is traveling and gathering more now than at any time over the past two years. For Influenza, we have an effective prevention strategy–the yearly flu shot–which can be very effective not only for preventing cases but also for keeping cases milder. We also have Tamiflu (Oseltamivir), an oral antiviral that if started within the first 48 hours can lessen the effects and shorten the course of Influenza.
For COVID-19, the population has higher levels of immunity than at any time during the pandemic because of vaccines or infection, and the recently released bivalent COVID booster vaccine, now available for everyone 5 years of age or older, targets the now-dominant Omicron variant. While COVID-19 continues to evolve, with new subvariants that may partially bypass immunity induced by previous infection or the bivalent booster, that immunity still helps to keep symptoms milder and reduce severe illness and hospitalization. There are effective outpatient treatments for COVID-19 that can be used within the first week of infection, including oral Paxlovid (Nirmatrelvir / Ritonavir) and IV Remdesivir, both readily available through local health systems.
To help you steer clear of the “triple-demic” this year, doctors and public health authorities recommend the following:
• Avoid crowded indoor spaces, and when you need to be in those spaces, consider wearing a mask.
• Wash your hands often with soap and water or use hand sanitizer.
• Clean contaminated surfaces (especially important for preventing spread of RSV, which is more readily spread via surfaces than flu or COVID-19).
• Avoid contact with others who are sick.
• If you or a family member are sick with respiratory symptoms, stay home, avoid family gatherings, and contact your primary care doctor for further instructions– including how to treat your symptoms, get tested, and access antiviral treatment for Influenza or COVID-19 if necessary.
• Get vaccinated with this year’s flu vaccine and the COVID bivalent booster—both readily available at your doctor’s office and local pharmacies.
• If you have any questions, please reach out to your medical provider or clinic to receive the latest guidelines and advice.
Please take care and stay safe!