TRIPLEDEMIC?

Q: I've heard about really high rates of respiratory viruses this year. How concerning is this and is there a way to protect the vulnerable people in our life?


A: You heard right! We are currently seeing a surge in RSV cases, and it is extremely concerning. In fact, you may have heard the term “tripledemic” circulating in the media as there are high levels of three respiratory viruses circulating right now: respiratory syncytial virus (RSV), COVID-19, and influenza (flu). The CDC actually issued a Health Alert to health care providers on November 4th about how the co-circulation of these three viruses together is causing unseasonably early, elevated respiratory disease rates especially among young children, and that this is also placing strain on healthcare systems.


SITUATION


Currently, outpatient medical visits for respiratory illnesses are occurring at a frequency above the national baseline (based on the last 5 years of data), visits continue to rise week over week with a steep trajectory, and the greatest percentage of people seeking medical attention for respiratory illness is children 0-4 years. We are seeing respiratory virus activity in every state, but it is extremely high in the south/southeastern United States.


WHY IS THIS HAPPENING?


Throughout most of the COVID-19 pandemic, the population has practiced mitigation measures such as masking, telecommuting, social distancing, hand washing, etc. Due to these prevention measures, we had two years of low respiratory virus activity. The same practices that kept us safe from COVID-19 also prevented other respiratory viruses like RSV and the flu. The dropping of all mitigations in 2022, plus the lack of any exposure/immunity to these viruses in very young children born just before or during the pandemic is causing an unseasonal onslaught. This sharp increase in cases is causing emergency rooms and pediatric intensive care units (PICUs) to be at capacity.


How you can best protect yourself and vulnerable members of your community:


Moving into the holidays, it is very important to take precautions to protect yourself and vulnerable family and community members against respiratory viruses, and to celebrate safely in groups.


1) Get vaccinated against COVID-19 and the flu

If you get the flu shot and the bivalent COVID-19 vaccine now, you will be protected by Thanksgiving. This is the best way to avoid severe illness, hospitalization, and death. The CDC recommends that all individuals 6 months and older get the flu vaccine every year. The updated COVID-19 booster protects against both the original virus that causes COVID-19 and multiple Omicron sub-variants. The website https://www.vaccines.gov/can help you find a place near you to get both vaccines.


2) Do not attend gatherings if you are sick or have cold symptoms, no matter how mild! The best way you can protect your loved ones from illness is to stay home if you have cold symptoms! If in doubt, don’t attend. All three viruses have similar symptoms, and you cannot tell the difference between them by symptoms alone.


3) Use a rapid test for COVID-19 before gathering

If you are symptom-free, Use a rapid antigen test right before you leave for the gathering (especially with vulnerable family members) to be sure you are COVID-free.


4) Practice multiple prevention measures! While we know no one mitigation is 100% effective, using multiple layers of protection helps avoid the spread of respiratory viruses, particularly in crowded, indoor spaces. RSV, COVID-19 and the flu are all respiratory viruses, and they spread in similar ways. In large indoor groups you can always wear a mask. You can gather outdoors, if weather permits, or ventilate your space well by opening windows. Wash your hands often and avoid touching your face or mouth, and cover coughs or sneezes. Also disinfect surfaces often, especially on kitchen counters or other areas where many people tend to gather.