The Triple Threat of Influenza, Covid and RSV


The United States is facing a triple threat of respiratory syncytial virus, influenza, and viral infections caused by Covid-19. Many children’s hospitals have been overwhelmed by the RSV surge, while flu levels are the highest in more than a decade. New coronavirus infections are also on the rise nationwide after a lull in cases.

All of this comes as the holiday season kicks off, with more people traveling and congregating indoors, perhaps with fewer precautions than in the previous two years.

How much should people care? Who should be most cautious? Can people be infected with all three viruses at the same time? What steps can be taken to reduce risk and stay safe? Should rules like wearing masks and social distancing return?

To guide us through these questions, I interviewed CNN Medical Analyst Dr. Leana Wen, emergency physician, public health expert, and professor of health policy and management at the Milken Institute School of Public Health at George Washington University. She is also the author of “Lifeline: A Physician’s Journey in the Fight for Public Health.”

CDC Influenza Virus

Seasonal Flu: What You Need to Know


– Source: CNN

CNN: Why should people care about the confluence of RSV, influenza and Covid-19?

Dr. Lianna wins: There are several reasons to be concerned about this so-called triple epidemic.

One is the social impact. Children’s hospitals across the United States are already overwhelmed with children infected with viruses, including RSV and the flu. Some experts speculate this is due to an immunity gap caused by mitigation measures taken over the past two years. The situation is so bad that the head of children’s health has asked the Biden administration to formally declare a state of emergency to better help the hospitals. (The government has not yet declared a state of emergency, but the U.S. Department of Health and Human Services wrote to state governors last week saying it “stands ready to continue assisting you with resources, supplies and personnel.”)

When hospitals exceed capacity, patient care suffers. People who come to emergency rooms end up waiting longer because there are not enough staff to care for them. Patients who need to be hospitalized may have to wait days for a bed. Some patients, especially in rural areas, may need to be moved for hours to get the care they need.

These delays can be harmful, even fatal. This doesn’t just affect patients with respiratory illnesses; it can also cause delays in care for fractures, asthma attacks and appendicitis, among other medical emergencies.

Another is the consequences for particularly vulnerable individuals. While most people infected with RSV, flu, Covid-19 and other respiratory illnesses experience mild symptoms, the most vulnerable can become seriously ill, requiring intensive care or even dying. The higher the infection rate in their community, the more dangerous it is for vulnerable groups.

Of course, no one wants to be sick. Even mild viral illness can cause inconveniences such as missing work and school. Even if someone doesn’t need to be hospitalized, they can still get sick and infect others. So high levels of infection with these viruses is a concern for all of us.

CNN: Who should be most cautious during this time?

win: Those who should be most cautious are those at highest risk of serious illness. This includes older adults, newborns, and people with multiple chronic medical conditions. These are the people most at risk of contracting the virus, and in healthy young adults, mild infections can lead to hospitalization.

Another group that should consider caution is those who have direct contact with high-risk individuals. Spouses of immunocompromised individuals, family members living with older adults, parents or caregivers of newborns—these are all individuals who should reduce their own risk of infection to prevent transmission to vulnerable members of their immediate family.

CNN: Can people be infected with all three viruses at the same time?

win: In theory, yes. Over the course of a year, someone is guaranteed to be infected with all three viruses. Generally, though, they don’t get them both. The term “triple disease” refers to three viral surges in a population at the same time, not necessarily (and often not) in the same person at the same time.

CNN: What steps can be taken to reduce risk and stay safe?

win: Vaccines are available against Covid-19 and flu to prevent serious illness and death. People should follow CDC guidance on getting timely coronavirus and flu vaccines.

Coronavirus is airborne. Good ventilation helps reduce transmission, so gathering with others outside is safer than indoors. Risks to indoor environments may be reduced if ventilation is improved, such as by opening doors and windows and using HEPA filters.

Coronavirus testing remains an important tool in the fight against the pandemic.

Influenza and RSV are mainly spread by droplets. People should stay away from people who are coughing and sneezing (symptomatic people should avoid public places). Everyone should wash their hands often — and wash their hands. This is especially important for young children who often put their hands in their mouths.

There are other important tools, including testing and shielding. Taking a Covid-19 test before gathering can reduce the risk, as can wearing a high-quality N95 or equivalent mask (KN95 or KF94).

CNN: Are cloth masks or regular medical masks enough?

win: Do not. The virus that causes Covid-19 spreads through tiny droplets that can pass through cloth and common medical masks. N95 masks are the gold standard and offer the best protection against respiratory viruses.

There will be some people who cannot tolerate N95. These people can wear two medical masks or one cloth mask over one medical mask. But these options are still not as protective as a fitted N95 or equivalent.

CNN: Should mandates like masks and social distancing return?

win: I think it’s hard to ask everyone to wear masks, keep their distance, and avoid indoor gatherings with loved ones — especially during the holidays. My point is that top-down mandates at any level of government should be reserved for truly dire situations where there is no other option – for example, if a new highly transmissible variant emerges that is more dangerous and less effective for existing vaccines Drug resistant. This is not currently the case.

That said, just because full enforcement is unlikely doesn’t mean people shouldn’t be taking care of themselves. In crowded indoor spaces, individuals—especially those at risk of severe illness and their household contacts—should choose to wear a fitted N95 or similar. They can choose additional protective measures, including staying outdoors or in well-ventilated areas as much as possible. Everyone should again make sure they have the currently available vaccines against Covid-19 and flu.

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