THE COLD AND FLU SEASONS HAVE HIT my household, and I know I am not alone. This is a year in which common viruses that stayed in the background during the COVID-19 pandemic return. The tripledemic is here.
My hospital in the Seattle area has no available beds, with influenza and COVID-19 running rampant. According to the US Centers for Disease Control and Prevention, one in four flu tests returned positive in the United States, compared with eight percent at the same time of year in 2019.
Moreover, respiratory syncytial virus (RSV) has pushed many children’s hospitals to capacity. And we are getting slammed with COVID-19 hospital admissions.
And Covid-19-related hospitalizations are rising again. Putting it all together — influenza, COVID-19, and respiratory syncytial virus — we get the so-called tripledemic that epidemiologists have feared. No wonder, so many in my hospital are sniffling.
Tripledemic: Covid-19, flu, and RSV
Tripledemic has no scientific definition; the term refers to a collision of COVID-19, RSV (respiratory syncytial virus), and flu such that we may see hospital emergency departments overwhelmed.
While all three viruses are present, they aren’t each peaking simultaneously. Still, we are seeing record levels of RSV in young children. Yale infectious diseases specialist Scott Roberts, MD, explains that we usually see a spike in December or January, but RSV has arrived earlier this season.
RSV is decreasing, but flu and COVID-19 are rising
RSV typically causes mild illness, but it can be very dangerous for young children whose small lungs cannot cough forcefully enough to clear mucus. Nearly all children contract the virus before age two.
Fortunately, as of early December 2022, RSV cases reported by Yale are decreasing. On the other hand, COVID-19 and flu cases are on the rise. Dr. Roberts believes the flu rise may be partly due to our lack of immunity from not being exposed to the virus over the last several seasons. Kudos to all who practiced appropriate social distancing and mask-wearing in 2020 and 2021.
United States Centers for Disease Control (CDC) director Dr. Rochelle Walensky adds that the RSV, flu, and Covid are stressing American hospital systems. It’s the unintended consequence of measures that sought to save lives — social distancing and mask-wearing curbed the spread of flu and RSV in 2020 and 2021.
Influenza numbers
The year-to-date numbers in the USA are disturbing: We have had 78,000 hospitalizations and 4,500 people flu-related deaths, according to the CDC. In the winter to spring 2020 flu season, we had 25,000 flu-associated deaths. In that season, influenza hospitalizations rates were low, with less than one person for every 100,000 hospitalized. This number compared with 66 per 100,000 the prior year.
The flu threat is elsewhere, too. According to the World Health Organization, there has been an early start in Europe. In England, one in four influenza tests returned positive. Respiratory syncytial virus hospitalization rates there are rising. German hospitals are struggling with RSV infections.
Scrabble variants
Have you heard of the newest COVID-19 variants? Some call them the “scrabble variants,” given their various letters and numbers. The good news? None of the newer variants appears to increase hospitalization rates. Still, BA.5 variants BQ 1.1 and BQ 1 are rising faster, and mutations remain a concern. Some of our treatments (including monoclonal antibodies) appear less effective against these variants. According to Yale’s Dr. Roberts, the current bivalent booster appears to give a spike in protection.
Tripledemic — What you can do
With fewer masking and social distancing requirements, virus mitigation efforts are left largely in the hands of individuals like you and me. Still, while the flu, COVID-19, and RSV are all respiratory viruses, there are differences in how they spread. Here are some of the ways that I reduce my risk of contracting an infectious disease:
- Contaminated surfaces. We have appropriately focused on air quality for COVID-19 transmission, but don’t forget that many other viruses can spread via contaminated surfaces. Wash your hands and clean contaminated surfaces. While bleaching everything may not be a primary means of stopping COVID, appropriate surface wiping may reduce your risk of suffering from RSV or the flu.
- Stay home. Think about others: If you are sick, stay home.
- Vaccinate appropriately.
- Get adequate sleep.
- Practice respiratory etiquette. Flu can spread from respiratory droplets, aerosols, and through contaminated surfaces. If you cough, do so into a tissue and immediately dispose of it in the trash.
- I wear a mask, not obsessively (you won’t find me walking outdoors with one on) but in higher-risk places. For now, you also won’t find me in very crowded environments.
- Children. While I do not have young children, if you have them, please reach out to a pediatrician if your child has a cough and fever. With babies, Yale’s Thomas Murray, MD, Ph.D. explains that “with babies, if you see really fast breathing or any blueness around the lips or what we call the use of accessory muscles, which is if you start to see the shoulder blades when they’re breathing or see the belly going up and down fast, or if the baby looks uncomfortable, those are reasons to come to the emergency room.”
Some final thoughts
Our mitigation efforts can have a collective effect. I care about myself, but I care about those around me, too. We have learned to approach COVID-19 as a community, but isn’t it time we did so for other transmissible viral illnesses, too?
Thank you for joining me in this look at seasonal viruses and the tripledemic (COVID-19, the flu, and RSV). We are all beginning to let our guard down as the acute COVID-19 pandemic phase seems to be passing. Please be safe.
The information I provided in this blog is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you seek medical advice, diagnoses, or treatment. I am not liable for risks or issues associated with using or acting upon the information in this blog.
