This winter season has seen an alarming surge in respiratory viruses. Notably, certain hospitalized patients are recording dual infections—testing positive simultaneously for COVID-19, influenza (flu), and RSV. While symptoms mimic those visible in a single illness—like a severe cough, fever, body aches, fatigue, and in severe cases, difficulty breathing—it is however uncertain whether double infections result in an exacerbation of the discomfort.
Dr. Michelle Barron, the Senior Medical Director of Infection Prevention and Control for UCHealth, candidly stated, ‘They feel pretty terrible.’ Mirroring this trend, some individuals first contract COVID-19 and are almost immediately further plagued with either influenza or RSV or vice versa. Simultaneous contraction of two respiratory viruses is categorized as a co-infection, whereas sequential contraction is referred to as sequential infection.
Hospitalization is required for less than 5% of patients who are severely ill with flu, COVID-19, or RSV, however in such cases, dual infections were detected. Importantly, individuals feeling significantly ill should seek the assistance of a medical professional who could prescribe treatments like Tamiflu or Paxlovid that might prove beneficial.
Early into the global pandemic in 2020, medical practitioners were deeply concerned about the concurrent circulation of multiple viruses during the fall and winter respiratory virus season. Initially, flu cases declined drastically, thus the medical community’s focus primarily revolved around addressing COVID-19 cases, but over time, both flu and RSV have made a strong comeback.
Cases of flu, COVID-19, and RSV are now steeply rising. Concurrently, a severe stomach bug, called norovirus, is also prevalent. It is essential for immunocompromised individuals to take necessary precautions to avoid contracting these illnesses. Moreover, it is a critical protective measure for all eligible individuals to consider vaccination to prevent annual respiratory diseases. ‘It’s not too late to get your vaccines,’ advised Barron.
As per trends observed in previous respiratory virus seasons, the first wave of flu A typically hits in the early stages, followed by a secondary wave of flu B. Timely vaccination could therefore still offer individuals protection against a potential flu B infection in the upcoming weeks.
On the COVID-19 front, hospitalizations have been spiking since the summer lows. Encouragingly, the number of COVID-19-related hospitalizations this winter appears to be the lowest compared to the initial stages of the pandemic. This trend suggests that a new normal pattern is now unfolding for the winter respiratory season.
Similarly to the flu, COVID-19 infections seem to surge most during the fall and winter respiratory virus season. This pattern has been recently corroborated by the U.S. Centers for Disease Control and Prevention (CDC). A descriptor for this pattern, a ‘tripledemic’, has emerged which means that COVID-19, RSV, and the flu are all circulating at the same time. However, as of now, COVID-19 accounts for a larger percentage of hospitalizations and a higher mortality rate than the flu and RSV combined.
Owing to reduced testing rates, an overwhelming number of sick individuals are unaware of their specific illness. Hospital visits become necessary when some individuals fall gravely ill, and in such situations, co-infections are being discovered. Consequently, dual infections, including rhinovirus—responsible for the common cold, are being detected in some patients.
Historical trends show that older individuals and those who are immunocompromised are most susceptible to severe illness if they contract the flu or COVID-19. But with the increased inoculation and subsequent immunity to SARS-CoV-2, fewer critically ill people now need hospitalization.
As we navigate this tripledemic, it’s essential to update our vaccination status where possible and seek immediate medical help, particularly if you belong to a high-risk group, or if symptoms like difficulty breathing occur. Now more than ever, it’s crucial to stay vigilant, proactive, and committed to preventative measures to safeguard our health and well-being.