November 8, 2023 – Infection with COVID-19: No fun. The same goes for flu or RSV. But getting greater than one among these at the identical time? Now you're talking a few situation that could possibly be really dangerous.
As the colder months approach, so does the spread of the three major respiratory viruses: COVID, influenza and respiratory syncytial virus. The excellent news is that we now have an updated COVID vaccine, flu shots that protect against multiple strains of the virus, and RSV vaccines for the elderly, pregnant women and young children. But despite our prevention efforts, some unlucky people may turn into infected with not only one among these viruses, but two directly or in quick succession in the course of the winter.
While we are able to't predict what this yr's season will appear like, we are able to't predict what last yr's season will appear like Data CDC research showed that RSV, COVID and flu didn't all peak at the identical time – which is nice news for each patients and healthcare systems.
Here's why this is nice news: Last winter, Panagis Galiatsatos, MD, a pulmonary and significant care physician at Johns Hopkins, saw patients infected with each COVID and flu for the primary time. Far more often, he said, patients have only one among these viruses; Still, the number of individuals sickened by each flu and COVID was “alarming” last yr.
“Patients with co-infections were by far our sickest patients,” Galiatsatos said. “This is also a clinical bias because I am an intensive care doctor, but all the patients with co-infections that I met were in the intensive care unit.”
How do you already know if you could have a couple of virus?
When it involves how many individuals experience such co-infections, it's difficult to say. Most of those diagnoses come from a hospital stay, where doctors typically test for all three viruses. Those who don't find yourself within the hospital may not know they've a couple of infection, especially since the symptoms are similar. All three viruses may cause a runny nose, cough, fever and body aches.
Due to the accessibility of COVID testing, it's more likely that when you turn into ailing and test positive for COVID, you'll likely not seek a flu or RSV test at a medical facility unless you usually are not infected serious enough to require a hospital visit.
Testing for all three shouldn't be a necessity for everybody, Dr. Peter Chin-Hong, an infectious disease expert on the University of California, San Francisco. Older people, the very young, and people with weakened immune systems should definitely seek further testing as soon as they're able.
However, when you don't fall into these categories, you'll be able to still get tested for all three viruses. Based on what doctors have seen prior to now, the 2 viruses usually tend to be COVID and flu, not RSV. And in these cases, early testing can save patients quite a lot of heartache, since now we have antiviral treatments for flu and COVID that we don't have for RSV.
What to do if you could have the flu and COVID?
“The first thing is: don’t panic,” says Chin-Hong. If you test positive for COVID at home and have symptoms, search for the drug Paxlovid inside 5 days of becoming ailing. If it seems you could have each the flu and COVID, it's possible you'll be given antivirals reminiscent of Tamiflu inside the first 48 hours of symptoms appearing, which often is the case shorten the illness by a day or more.
There has been some confusion about who exactly qualifies for Paxlovid. The FDA has said that it's approved for the treatment of “mild to moderate COVID-19 disease in adults who are at high risk of progressing to severe COVID-19 disease,” but some may consider it shouldn't be to be used belong to the high-risk category and don't search for it.
There remains to be a reluctance to take paxlovid, each amongst patients who're frightened in regards to the “backlash” and amongst doctors who're hesitant to prescribe it, Dr. Bernard Camins, an infectious disease expert at Mount Sinai in New York City.
“We as physicians need to be more willing to prescribe Paxlovid,” Camins said. “Sometimes doctors say, 'Oh, you're not feeling too bad, let's leave it alone.' The problem is that it might be too late [the patient] gets sick enough.”
Regarding the infamous COVID rebound – where patients get sick again with COVID shortly after recovery – that many have linked to taking Paxlovid, doctors like Chin-Hong and Camins want to make it clear to patients that this rebound is quite is typical, with or without Paxlovid.
And especially during respiratory virus season, Chin-Hong said, what one might think is a resurgence in COVID symptoms could very well be another virus, like influenza or RSV.
Does one virus make you more vulnerable to infection from another?
The short answer: It depends on who you are, what activities you do, and when your infection occurs.
Studies on COVID have shown that this often is the case Long-term damage on the immune system after recovery from an infection. Sometimes two viruses can make you sick at the same time, as was the case with Galiatsatos' patients. Researchers have too found that patients who tested positive for influenza had a lower risk of testing positive for COVID; but in those who had co-infections, the disease was much more severe and left even more long-term damage to the lungs.
According to Galiatsatos, COVID is the most common reason in people with multiple infections because it has the ability to invade immune cells, weakening patients and making them more susceptible to infection with other viruses.
But there's still a lot we don't know about co-infections with COVID, flu, and RSV. According to William Schaffner, MD, an expert in preventative medicine and infectious diseases at Vanderbilt University in Nashville, a non-immunocompromised person is no more likely to become infected with another virus if they already have one.
“That is, unless their behavior results in them being more exposed,” Schaffner said. “If people are not vaccinated, do not wear masks, or have a personal behavioral predisposition to constantly expose themselves to loud crowds, they are more likely to acquire one or more of these infections over the course of the winter.”
“It’s simply because they expose themselves. It has nothing to do with their immune system.”