Triple-demic of 2022: RSV, COVID, and flu

During the height of the COVID-19 pandemic, it seemed other illnesses such as the flu and colds "disappeared" at times. They were still present, but the COVID virus certainly took center stage.

Now that the pandemic has lessened to a certain degree, influenza and RSV (respiratory syncytial virus) are making themselves known, creating what some experts are referring to as the "triple-demic of 2022."

How can individuals keep themselves and their family members safe? An important strategy is to recognize symptoms as soon as possible — especially in very young children who have no way to express what they're feeling. Look for a runny nose, congestion, cough, wheezing, fever, loss of appetite, and generally being more fussy than usual.

"Those are the most common things you'll see. It should be remembered most children will do fine, but those are the symptoms you're going to see initially," said Samuel Iden, MD, Medical Director of Emergency Medicine at Reid Health.

Where to get care?

Most people with RSV, COVID, or flu experience mild symptoms, but it's important to be mindful of serious symptoms that require additional emergency care.

In non-emergent situations, the best place to start in getting treatment for your illness is with your primary care physician. An emergency room visit should be reserved for those who are experiencing severe symptoms such as fast or troubled breathing, chest pain or pressure, severe muscle weakness, or worsening of chronic medical conditions.

Treatment protocols for COVID, RSV, and influenza

Because COVID, RSV, and influenza have many symptoms in common, it can be difficult to determine the appropriate course of action, but Dr. Iden says upfront management of all three is similar for both children and adults.

"It's mainly supportive care - grandma's chicken noodle soup, pushing fluids, controlling fevers," he said.

It's crucial those feeling ill stay hydrated, no matter the age. Fever-reducing medications such as Tylenol or Motrin can provide some relief.

"More challenging though, regardless of the disease, is the question of how sick this particular child is going to be," Dr. Iden said. "That's the real challenge - whether it's COVID or influenza or RSV - looking at a patient and trying to figure out is this one of the patients who is going to do great and fly through this without any trouble or is this a child who 48 hours from now is going to be struggling."

Children who were born prematurely are at significant risk for RSV complications because of the underdevelopment of their lungs. If a child has known lung disease or heart disease - or if they're a transplant patient or undergoing chemotherapy - they automatically go into a different categorization of concern.

"I would encourage folks if you have a very young infant, less than a couple months old who is premature, talk to your pediatrician about whether your baby is one who would be a candidate for a medication that can help prevent the disease. It hasn't been cleared for use in everybody, but it's something to talk about to your pediatrician," Dr. Iden said.

Virus prevention tips

When it comes to trying to prevent getting sick in the first place, Dr. Iden reminds everyone simple actions such as proper hand hygiene, masking, and staying home from work if you don't feel well work — and they work well.

Parents can also try to mitigate spread within the household by making sure their sick 3-year-old doesn't overly expose an infant by giving the baby a "big sloppy kiss." Try to avoid sharing utensils or sippy cups. And if you have a brand-new baby, decide carefully where you'll introduce them to friends and family members.

Someone might be carrying a virus at a baby shower, church, or holiday party and you don't know it. Little precautions such as these are simple to perform and can make a world of difference.

Dr. Iden's biggest piece of advice? "Wash your hands."

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