The Triple Threat of Influenza, Covid and RSV

CNN
–

The United States faces a triple threat, a combination of RSV, Influenza and Covid-19. Children’s numbers surge and multiple children’s hospitals are overwhelmed with RSV, even though flu levels are the highest in more than a decade. After a cooling-off period for the problem, a new coronavirus infection is on the rise across the country, too.

This is all happening with the holiday season, and more people traveling and congregating indoors, who may be taking fewer precautions than they have in years past.

How worried should people be? Who should be more careful? Can people be infected with all three viruses at the same time? What steps can be taken to reduce risk and stay safe? Should states like cover-ups and social distancing make a comeback?

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

CNN: Why should people worry about the close relationship of RSV, flu and Covid-19?

Dr. Lina Wen: There are several reasons for concern about so-called triple bloodlines.

The first is the social impact. Children’s hospitals across the United States are already overwhelmed with children infected with viruses, including respiratory syncytial virus and the flu. Some experts speculate that this is due to the immunity gap due to mitigation measures taken in the past two years. Things are so bad, children’s health leaders I’m asking for an official declaration of emergency from the Biden administration to better help these 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 to assist you with resources, supplies and personnel.”)

When hospitals have excess 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 several days for a bed to open. Some patients, especially in rural areas, may need to be transported for hours to get the care they need.

These delays can be harmful, even fatal. This doesn’t just affect patients with respiratory ailments; it delays care for broken bones, asthma attacks and appendicitis, among other medical emergencies.

Another is due to particularly vulnerable individuals. While most people infected with RSV, flu, Covid-19 and other respiratory illnesses experience mild symptoms, the most vulnerable can become very ill, requiring intensive care or even dying. The higher the rate of infection in their community, the greater the risk to high-risk groups.

Of course, no one wants to be sick. Even minor viral illnesses can cause inconveniences such as absenteeism from work and school. Even if a person does not need to be hospitalized, they may still feel unwell and pass it on to others. Therefore, the high infection rate of these viruses is a concern for all of us.

CNN: Who are the people who should be most careful during this time?

temperature: The people who must be most careful are the ones most at risk of serious illness. This includes older adults, newborns, and people with multiple chronic medical conditions. These are the people who are most at risk of contracting the virus, and for an otherwise healthy adult, a mild infection could land them in the hospital.

Another group you should consider alerting is those who have had direct contact with at-risk individuals. Spouses of immunocompromised individuals, family members who live with an elderly person, parents or caregivers of newborns—these are all individuals who should reduce their own risk of infection to prevent transmission to vulnerable people close to them.

CNN: Can humans be infected with these three viruses?

temperature: In theory, yes. Over the course of a year, anyone is guaranteed to be infected with all three viruses. Generally, though, they don’t get all the information at the same time. The term “tripling” refers to an increase in all three viruses in a population at the same time, but not necessarily (and usually not) in the same person at the same time.

CNN: What steps can you take to reduce your risk and keep yourself safe?

temperature: There are vaccines against Covid-19 and flu that can prevent serious illness and death. People should follow the Centers for Disease Control and Prevention’s guidance on staying up-to-date on COVID-19 and flu vaccines.

Coronavirus is airborne. Good ventilation helps reduce transmission, so gathering with others outside is safer than indoors. Indoor environments can be less dangerous if ventilation is enhanced, for example by opening doors and windows and using HEPA filters.

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

Other tools are also important, including testing and shielding. Taking a Covid-19 test before collection can reduce the risk. A good quality N95 mask or equivalent (KN95 or KF94) can also be used.

CNN: Are cloth masks or regular medical masks enough?

temperature: No, the virus that causes Covid-19 spreads through tiny droplets that can travel through cloth and common medical masks. N95 masks are the gold standard and will provide the best protection against respiratory viruses.

There will be some people who cannot afford an N95. These individuals may wear two medical masks or a cloth mask over a medical mask. But these options still don’t offer as much protection as a proper N95 or equivalent.

CNN: Should states be returning to measures like masking and social distancing?

temperature: I think it’s hard to ask everyone to re-disguise themselves, 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 contagious variant emerges that is more dangerous and less effective for the current There are vaccines for resistance. This is not currently the case.

However, just because the mandate is comprehensive may not mean that people shouldn’t take care of themselves. Individuals—especially those at risk of severe illness and their household contacts—should choose to wear an N95 or similar item in crowded indoor settings. 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.