What you need to know about the triple threat of influenza, Covid and RSV | CNN

CNN
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The United States faces a triple threat, with a confluence of viral infections from respiratory syncytial virus, influenza and Covid-19. Many children’s hospitals are overwhelmed after outbreaks of RSV, as the level of flu is the highest it has been at this point in the year in more than a decade. And after a lull in cases, new coronavirus infections are also on the rise across the country.

This is all happening at the start of the holiday season, with more people traveling and congregating indoors, likely with fewer precautions than in the previous two years.

How worried should people be? Which individuals should be the most cautious? Can people catch all three viruses at the same time? What steps can be taken to reduce risk and stay safe? And should mandates such as masking and social distancing return?

To guide us through these questions, I spoke with Dr. Leana Wen, CNN medical analyst, emergency physician, public health expert, and professor of health policy and management at George Washington University Milken Institute School of Public Health. She is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health”.

– Source: CNN
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Seasonal flu: what you need to know

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– Source: CNN

CNN: Why should people worry about the convergence of RSV, influenza and Covid-19?

Dr AS Leana Wen: There are several reasons to be concerned about this so-called tripledemic.

One is the impact at the societal level. Already, children’s hospitals across the United States are filled with children infected with viruses, including RSV and influenza. Some experts believe this is due to an immunity deficit resulting from the mitigation measures taken over the past two years. The situation is so bad that children’s health officials have requested a formal declaration of emergency from the Biden administration to better help these hospitals. (The administration hasn’t declared an emergency, but the US Department of Health and Human Services sent a letter to governors last week saying it “stands ready to continue to assist you with resources, supplies and personnel”.)

When hospitals exceed capacity, patient care suffers. People who come to the emergency room wait much longer because there are not enough staff to take care of them. Patients who need to be hospitalized can wait days for a bed to become available. Some patients, especially in rural areas, may need to be transferred for hours to receive the care they need.

These delays could be detrimental or even fatal. And it doesn’t just affect patients with respiratory conditions; this leads to delays in care for broken bones, asthma attacks and appendicitis, among other medical emergencies.

Another is the consequence for particularly vulnerable people. While most people who contract RSV, influenza, Covid-19 and other respiratory illnesses will have mild symptoms, the most vulnerable could become seriously ill, require intensive care and even die. The higher the infection rates in their community, the more dangerous it becomes for vulnerable people.

Of course, no one wants to be sick. Even a minor viral illness can cause inconvenience, such as missing work and school. And even if someone doesn’t need to be hospitalized, they can still feel unwell and be contagious to others. Thus, a high level of infection of these viruses is something that affects all of us.

CNN: Which people should be most cautious during this time?

Magnifying glass: The people who should be the most careful are those who are at the greatest risk of serious illness. This includes the elderly, newborns, and people with multiple chronic conditions. These are the people most susceptible to viruses, and what is a mild infection for someone who is a healthy young adult could result in hospitalization for them.

Another group that should consider being cautious is those in direct contact with high-risk individuals. A spouse of an immunocompromised person, family members who live with the elderly, parents or caregivers of a newborn – these are all individuals who should reduce the risk of infection for themselves in order to prevent transmission to a vulnerable person in their immediate household.

CNN: Can people get all three viruses?

Magnifying glass: In theory, yes. Someone can certainly, in the course of a year, contract all three viruses. In general, however, they do not receive them all at the same time. The term “tripledemic” refers to all three viruses that appear simultaneously in the population, not necessarily (and usually not) in the same person simultaneously.

CNN: What steps can be taken to reduce risk and stay safe?

Magnifying glass: Vaccines exist against Covid-19 and against the flu to prevent serious illness and death. People should follow the advice of the US Centers for Disease Control and Prevention to stay up to date with their coronavirus and flu vaccine.

The coronavirus is airborne. Good ventilation helps reduce the spread, so gathering with others outdoors will be safer than indoors. Indoor environments may pose a lower risk if there is better ventilation, for example, through open doors and windows and the use of HEPA filters.

Influenza and RSV are mainly transmitted by droplets. People should stay away from those who are coughing and sneezing (and people with symptoms should avoid public places). Everyone should wash their hands frequently – and well. This is especially important for young children who often put their hands in their mouths.

There are other important tools as well, including testing and masking. Taking a Covid-19 test before the gathering can reduce risk, as can wearing a high-quality N95 mask or equivalent (KN95 or KF94).

CNN: Is a cloth mask or a regular medical mask enough?

Magnifying glass: No. The virus that causes Covid-19 is spread by microscopic droplets that can pass through fabrics and ordinary medical masks. The N95 mask is the reference and will offer the best protection against respiratory viruses.

There will be people who will not tolerate an N95. These people can wear two medical masks or a cloth mask on top of a medical mask. But these options are still not as protective as a well-fitting N95 or equivalent.

CNN: Should mandates like masking and social distancing come back?

Magnifying glass: I think it will be very difficult to ask everyone to return to masking, distancing and avoiding indoor gatherings with loved ones, especially during the holidays. My view is that top-down mandates from any level of government should be reserved for truly dire situations for which there are no other options – for example, if a new highly transmissible variant emerges that is far more dangerous and resistant to existing vaccines. This is not the situation at the moment.

That said, just because mandates at all levels probably aren’t that people shouldn’t take care of themselves. People – especially those vulnerable to serious illness and their household contacts – should choose to wear tight-fitting N95s or equivalent when in crowded indoor spaces. They can choose additional protective measures, including staying outdoors or in well-ventilated spaces when possible. And everyone must make sure, once again, to be vaccinated with the vaccines currently available against Covid-19 and the flu.