Flu, RSV & COVID-19: How to Prepare for This Year's Triple Threat of Respiratory Viruses

The threats will be all around this respiratory season — which typically begins in the fall and continues through early spring.

"The COVID-19 pandemic altered the typical seasonality of influenza and especially respiratory syncytial virus (RSV) over the last few years," says Dr. Wesley Long, medical director of diagnostic microbiology at Houston Methodist. "Flu came early last year, but after a quiet summer, all signs point to flu and RSV likely returning to their typical winter seasonality this year."

In other words, flu and RSV look like they're getting back in sync. And COVID-19 hasn't gone away either — in fact, cases are currently rising.

"Even if COVID-19 cases crest and taper down soon, there's always the chance of another winter wave," adds Dr. Long.

It's why some experts are warning of a "tripledemic," a situation where all three — flu, RSV and COVID-19 — surge at the same time.

"It's reasonable to assume that we'll see some level of all of these viruses this respiratory season," says Dr. Long. "Whether that happens in isolated waves or all at once, that's hard to predict. But it's why everyone should take steps to be as protected as they can be."

Here's everything you need to know as you prepare for the 2023 respiratory season.

What's the best way to protect yourself? Get vaccinated

"Everyone should get their annual flu shot," says Dr. Long. "It's best to try to get that done by mid-October, but it's never too late in the season to get vaccinated."

He adds that you should ask your doctor about getting vaccinated with the new COVID-19 vaccine.

"The COVID strains circulating right now are a little different than the ones covered in the last bivalent boosters," explains Dr. Long. "To reduce your risk of symptomatic infection, you should get the new COVID vaccine once it's available to you. Think of it just like you would think of getting your annual flu shot."

New this respiratory season are RSV vaccines, though the shots are only available to those who are most vulnerable to developing serious illness: older adults and infants.

Adults over the age of 60 are eligible for the RSV vaccine and should consider getting inoculated heading into respiratory season. Additionally, the vaccine soon is expected to be offered to pregnant individuals late during pregnancy to help protect newborns from RSV.

If you're unsure which vaccines you're eligible for this respiratory season, ask your doctor for guidance.

Is it the flu, COVID-19 or RSV? There's a test (and potentially a treatment) for that

If you do get sick, it's likely going to be hard for you to tell whether it's the flu, RSV or COVID-19 since they all share similar symptoms — including fever and dry cough. It's why Dr. Long says testing will be critical this season.

"Tests are available for all of these respiratory viruses," says Dr. Long. "At Houston Methodist, we actually have a single test that tests for the four viruses at the same time — flu A, flu B, RSV, and COVID-19."

Knowing whether it's the flu, COVID-19 or a cold can help make sure you get the right treatment.

"We have medications to treat flu and COVID-19, but the treatments don't overlap," explains Dr. Long. "Getting tested is important since it will help guide prompt, effective treatment."

For those who have the flu, almost anyone qualifies to receive a prescription oral antiviral treatments. There are even pediatric doses for young kids.

"If you have COVID-19, your doctor may prescribe oral medications," says Dr. Long. "There are specific criteria, but I think a lot more people qualify than they probably realize."

And while the options for treating a cold aren't great, Dr. Long points out that we don't want someone with RSV to be taking a flu antiviral or antibiotics they don't need.

The bottom line: If you're feeling under the weather, call your doctor. He or she can help advise you on which test is most applicable for you based on your symptoms and which viruses are circulating most predominantly at that point in time.

If I'm sick and it's not one of these respiratory viruses, should I still stay home? Yes

If you're experiencing respiratory symptoms, don't think that just because you're negative for the flu, COVID-19 and RSV, it's OK to go to work, school, church or some other crowded, public place.

You likely have some type of common cold, and you could be contagious.

"Viruses that spread during respiratory season are basically transmitted the same way — from person to person through droplets we release as we cough, sneeze and even speak," says Dr. Long. "If your tests are negative but you still have symptoms, stay home."

Why? Because certain individuals are more vulnerable to respiratory illnesses, including that run-of-the-mill cold that doesn't seem like a big deal to you. These vulnerable individuals have a higher risk of getting very sick, potentially being hospitalized and developing life-threatening complications.

Staying home when you're sick — no matter what the cause — helps reduce the chance of inadvertently passing a respiratory bug along to someone who's more vulnerable. Plus, the rest of us don't want to catch something avoidable and have a vacation or holiday ruined either.

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