Experts are warning about a tripledemic of respiratory viruses. Here’s what could be ahead, and how to stay safe.
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| Public health experts are warning about a tripledemic of RSV, COVID-19, and flu. What experts say about why there’s a surge and what you can do to stay safe. |
By Korin Miller, Prevention
Late fall heading into winter is known as respiratory virus season, but this year things are a little different. Three respiratory viruses are surging—RSV, COVID-19, and the flu—in what plenty of people are now calling a “tripledemic” of infectious diseases.
Here’s a breakdown of what it’s like out there right now: Flu cases are higher than they typically are this time of year, per data from the Centers for Disease Control and Prevention (CDC), RSV cases are soaring, and COVID-19 cases are starting to creep upward again—and things are expected to get worse before they get better.
“There isn’t any doubt that there are going to be three active respiratory viruses this season,” says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine. “COVID is out there, RSV started unseasonably early and is giving pediatric hospitals a hard time in the sense that there are many children that need care.” An uptick in cases of the flu also “started early” and is “very active” in the southeast, working its way up the east coast, Dr. Schaffner says.
Ultimately, “we’re going to be seeing a busy respiratory virus season. And, if they all come together at once, it will be a big strain,” Dr. Schaffner says.
Here’s what you need to know about what’s ahead.
What’s causing the surge in RSV cases?
Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security, points out that it’s not unusual for several respiratory viruses to pick up this time of year. But what is unusual is the large number of RSV cases and the severity of them.
“The concern is that the RSV season has started earlier—as it did last year—and many children are sick all at once with RSV,” Dr. Adalja says. “Pediatric hospitals have less capacity than adult hospitals, so they have a low threshold to be under strain.”
OK, but…why are cases surging right now? It’s not entirely clear, but there are some theories. “It’s a puzzle, but the favorite explanation is that, during the period of relative social distancing and lockdown, many children didn’t attend schools or go to daycare—and this is a virus that affects children and older persons,” Dr. Schaffner says. RSV is a common childhood illness and, because many children weren’t interacting with each other, they didn’t get infected, he says. “Now, a group of susceptible children has been built up and they’re getting the virus,” Dr. Schaffner says.
It’s also thought that the population’s overall immunity to RSV may have waned, Dr. Adalja says. And, with that, RSV has been allowed to thrive.
What can happen in a tripledemic?
The major concern is hospital capacity, says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. While many people can get any of these three illnesses and do fine, there is also a risk of developing serious complications with each of them, he says. “It’s not good” if the healthcare systems get overwhelmed, Dr. Russo says. “If we have three infectious diseases together, we run the risk of overwhelming our healthcare system,” he explains. “This has been an ongoing issue since the pandemic began—there are staffing issues and not enough people to care for patients.”
And, of course, there’s a chance you could get three different respiratory viruses in a season. “People can definitely get all three—there’s no question about that,” Dr. Russo says. While all three viruses cause respiratory illnesses, they’re three “completely independent viruses and very different from each other,” Dr. Schaffner says.
A big question, Dr. Russo says, is if cases of all three will peak at the same time or if there will be waves of one and then another. “We’re quite concerned about coincidental waves or overlapping waves to put us at risk for all of them,” he says.
How to protect yourself from the tripledemic
Experts stress the importance of getting vaccinated against the flu and being up to date with your COVID-19 vaccines. “This can reduce your risk of getting sick,” Dr. Russo says. Unfortunately, there is no vaccine to protect against RSV.
All three viruses spread through respiratory droplets, so Dr. Russo recommends trying to be in places with good air circulation when you need to be indoors and, if you’re high risk for serious complications of any of these viruses, he says it’s not a bad idea to wear a mask inside.
Hand hygiene is also important, Dr. Schaffner says, since RSV in particular can be spread via secretions that get on surfaces.
But, if you’ve taken all the precautions, Dr. Adalja says you shouldn’t panic about the idea of a tripledemic. “People routinely got multiple respiratory viruses in one season,” he points out.
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