Illnesses due to circulating respiratory viruses are increasing rapidly across the nation. Prevention measures practiced at the beginning of the COVID-19 pandemic limited seasonal respiratory illnesses. Now that safety measures are more relaxed, health care systems have seen an early start for some of these viruses. There are worries in the health care community about a potential "tripledemic."
"The real concern in this term ‘tripledemic’ comes from the idea that they all may hit about the same time," says Andrew Pavia, MD, chief of the Division of Pediatric Infectious Diseases at University of Utah Health. "This could overwhelm many of our health systems." These systems are already struggling with staff shortages and exhaustion after almost three years of COVID-19.
The combination of a surge in sickness and staff shortages can cause a crippling impact on health systems. This has already happened in some areas of the country. That’s why it’s important to take steps to protect ourselves and others in the months ahead. Here are three respiratory viruses that are increasing across the country.
1. RSV (respiratory syncytial virus)
RSV is a common infection that causes cold-like symptoms in most people. Cases of RSV typically increase from late fall to early spring. Both adults and children can get infected with RSV, but the virus can be more serious for young children and older adults. RSV can cause bronchiolitis and pneumonia in children younger than one. About 50,000 kids are hospitalized for RSV each year.
"Most of us get RSV many times during our life," Pavia says. "But when you get it the first two to three years of life, it can cause a nasty infection with wheezing, profuse secretions, and difficulty breathing and eating."
RSV is also threatening to older adults. About 177,000 older adults (age 70 and older) are hospitalized for RSV each year. While RSV is a mild cold for most people, it can cause very serious disease for people with weakened immune systems, including pregnant women.
Flu or Influenza is an infection of the nose, throat, and lungs. It causes 20,000 to 50,000 deaths each year in the US, with the exception of the last two years due to the COVID-19 pandemic. Flu was largely absent in the winter of 2020-21 and relatively mild last winter.
The flu can cause severe illness, hospitalization, and death in people of all ages—but children under age two, adults older than 65, pregnant women, people with conditions such as heart disease, lung disease and diabetes, and people with weakened immune systems are more vulnerable and more likely to get severely ill.
The good news is there is a vaccine. "While the vaccine isn’t perfect, it’s a good tool," Pavia says. "We’ve been recommending the flu vaccine to all children for almost two decades to prevent serious illness and hospitalization." According to Pavia, you become more vulnerable to flu as you age—your risk of severe flu goes up substantially in your 50s and even more so in your 60s and on. The CDC recommends that everyone six months and older get a flu shot every year.
COVID-19 is a respiratory illness that causes a wide-range of symptoms ranging from mild to severe and often deadly infection. Cases of COVID-19 have typically increased in the fall and peak in the winter, although this can depend on new emerging variants of the COVID-19 virus. Infectious disease experts like Pavia expect an upcoming surge due to the emergence of several subvariants of Omicron.
Everyone can get COVID-19, but older adults, people with certain medical conditions, pregnant women, and young babies are at high risk of developing severe disease. While children aren’t as likely to get severely ill with COVID-19 as adults, some children can still get seriously ill.
"Most kids who get COVID-19 won’t likely end up in the hospital or the intensive care unit," Pavia says. "But at any given time, we have about a dozen kids in the hospital with COVID-19, so it’s not mild or trivial."
The COVID-19 vaccine is available to anyone age six months and older. And anyone five years and older can get an updated booster. Similar to the flu vaccine, COVID-19 vaccines don’t prevent you from getting the virus but help prevent severe illness, hospitalization, and death.
How can you tell the difference between RSV, flu, and COVID-19?
The three respiratory viruses all can cause cold-like symptoms as well as fever, cough, and difficulty breathing. While differences exist between all three viruses, it’s hard to tell from their symptoms alone. The best way to determine which infection you have is by seeing a doctor and getting tested.
It’s possible to get infected with more than one virus at a single time. Having a virus can lower immunity and increase the risk of getting another infection. If infections occur together, symptoms can worsen.
"Last year, we saw a bit of RSV combined with COVID-19 infection," Pavia says. Some data shows that if children get two viruses at the same time, they’re sicker than if they get either one of them alone. Pavia says many of the children that were admitted to the pediatric ICU at Intermountain Primary Children’s Hospital last year had both RSV and COVID-19.
Can masks help prevent the spread of respiratory viruses?
Wearing a face mask became widely common during the COVID-19 pandemic. But Pavia says masks are even more effective at preventing the spread of flu. "Flu almost completely disappeared the first year of the pandemic," Pavia says. "That’s because flu is not as transmissible as COVID-19, so masks have proven to work really well." Masks also help prevent RSV because they can contain highly infectious snot, which can spread when you sneeze.
It’s always good to be considerate of who is next to you. "You never know whether the person you’re standing next to is the parent of a child with cancer or someone who is immunocompromised," Pavia says. "You might be putting them at tremendous risk."
What else can someone do to protect themselves?
Prevention measures such as wearing a high-quality mask in crowded areas, physical distancing, frequent hand washing, and staying home when sick are all good ways to help protect yourself and others. But the best way to protect yourself is by getting vaccinated.