A steady increase in respiratory illnesses across the United States as winter approaches is leading health experts at West Virginia University and elsewhere to warn of a possible “tridemic,” widespread occurrences of influenza, COVID-19 and respiratory syncytial virus or RSV.
Following two mild flu seasons, due in part to COVID-19 safety guidelines such as masking and social distancing, experts are predicting more widespread infection this year. The Centers for Disease Control and Prevention Influenza Hospitalization Surveillance Network is currently reporting the highest laboratory-confirmed flu hospitalization rate since 2010-2011.
Two WVU experts said that’s why it’s important for everyone, including those in low-risk populations, to practice prevention to keep vulnerable individuals and communities safe and healthy.
When a cold is more than a cold
Symptoms of flu, COVID-19 and RSV typically mimic the common cold but can cause severe infection in some individuals. The three respiratory illnesses also share many of the same symptoms, including fever, cough and runny nose.
Flu and COVID-19 are not distinguishable by the symptoms alone, which also include sore throat, muscle or body aches, headache and fatigue. Both also can cause mild to severe illness, including death in vulnerable individuals. Individuals who experience flu- or COVID-19-like symptoms should confirm diagnosis with a home COVID-19 test as soon as possible to begin treatment and isolation to help reduce the severity of disease and to prevent community spread. If symptoms are mild, symptoms can often be controlled with home management and over-the-counter medications.
“Rapid COVID-19 testing is available over the counter and is recommended when symptoms develop,” said Dr. Carmen Burrell, medical director of WVU Medicine Student Health and Urgent Care. “If symptoms are severe, you should be evaluated by a physician for testing and symptomatic management.”
There is also concern about two new COVID-19 variants, BQ.1 and BQ.1.1, both of which are variants of Omicron. These variants have been growing rapidly, accounting for one in four new COVID-19 infections after being attributed to only 2.6% of cases at the beginning of October. These variants evolve around immunity from vaccines and past infections, making them more likely to lead to illness.
RSV can often cause wheezing and difficulty breathing. Affecting the lungs and breathing passages, RSV can lead to serious illness especially in infants and older adults, including bronchiolitis and pneumonia. Most RSV cases in healthy adults clear up after one to two weeks.
WVU Medicine Children’s is currently experiencing heavy volumes due to the surge of RSV infection among the state’s youngest residents.
“Symptoms of RSV that we are seeing in children are secretion, a lot of congestion and some may have a fever,” said Dr. Lisa Costello, a WVU Medicine pediatrician and assistant professor in the School of Medicine Department of Pediatrics. “For young children with RSV, they will often have increased breathing rates.
“If children are having a hard time breathing, they need to be seen by a health care provider. Signs of increased breathing difficulties can include really fast breathing, flaring nostrils, head bobbing while breathing, grunting when breathing and the rib cage caving in with each breath.”
Protecting yourself and your community
Flu, COVID-19 and RSV can be transmitted through droplets in the air. Flu and RSV are mainly spread when a person coughs or sneezes, but could also be spread by touching a surface that has the virus on it and then touching your face before washing your hands.
The best way to prevent flu and COVID-19 and their potentially serious complications is to get vaccinated.
“Getting vaccinated helps decrease the spread and impact of seasonal infections,” said Dr. Burrell. “This assists with herd immunity and will prevent more severe infections or complications when one is exposed to COVID-19 or influenza. Through herd immunity, we can also help prevent more vulnerable individuals who may not be able to be immunized.”
“It is important to use the tools in our toolbox to prevent each of these viruses,” Dr. Costello added. “The strongest tool in our toolbox is getting vaccinated to prevent and reduce severity of the flu and COVID-19. The COVID-19 and flu vaccines are good at preventing severe disease. Even if you do get the virus, you are less likely to end up in the hospital or even worse. By getting vaccinated, you are reducing the strain on the health care system and helping yourself and those around you who may be at higher risk.”
The CDC recommends an annual flu vaccine for everyone six months and older. This includes individuals with conditions that could put them at higher risk for flu complications as well as pregnant women.
Individuals ages six months and older are eligible for COVID-19 vaccination. West Virginians are encouraged to use the free, online WV COVID-19 Vaccination Due Date Calculator to determine when they are eligible and due for any COVID-19 shot.
WVU Medicine Urgent Care clinics and WVU Student Health offer flu and COVID-19 vaccination opportunities on a walk-in basis. First, second and booster doses of the Pfizer and Moderna vaccines are available at these clinics, and individuals may choose to get their flu shot at the same time as their COVID-19 vaccine.
There is no vaccine for RSV.
Individuals should follow best practices to prevent all three respiratory illness.
Best practices to protect yourself from contracting illness are:
- Wash your hands often with soap and water for 20 seconds or use alcohol-based hand rub. Make sure to clean between your fingers and around your wrists. Sing the chorus of “Country Roads” as you wash your hands.
- Avoid touching your eyes, nose or mouth. Germs are often spread when a person touches something that is contaminated with germs and then touches the eyes, nose or mouth.
- Cover coughs and sneezes with a tissue, or the bend of your elbow, not your hands. Use the nearest waste receptacle to dispose of the tissue after use.
- Avoid contact with individuals who are sick, when possible.
Additionally, sick individuals are urged to stay home.
“The spread of any respiratory illness can lead to absences from school and work,” added Burrell. “In addition to the items listed above, a healthy diet and regular sleep and exercise can help maintain a strong immune system to help prevent any infection.”
The latest WVU Medicine Health Reports on flu/COVID-19 and RSV, available on the WVU Medicine YouTube channel, share additional information about early infection rates and how to keep yourself and your community safe from flu, COVID-19 and RSV.
Individuals with questions or concerns should contact their primary health provider. WVU students can reach out to WVU Medicine Student Health at 304-285-7200.