Nov. 8, 2023 – Getting COVID-19: No enjoyable. The identical is true of flu or RSV. However getting a couple of of them on the similar time? Now you’re speaking about what could possibly be a extremely harmful scenario.
Because the colder months creep up on us, so does the unfold of the massive three respiratory viruses: COVID, influenza, and respiratory syncytial virus. The excellent news is we now have an up to date COVID vaccine, flu pictures that defend in opposition to a number of strains of the virus, and RSV vaccines for older people, pregnant folks, and infants. But regardless of our prevention efforts, some unfortunate few could contract not simply one among these viruses, however two directly or in shut succession through the winter season.
Whereas we will’t predict what the season will appear to be this yr, final yr’s information from the CDC confirmed that RSV, COVID, and flu didn’t all peak directly – which is nice information for each sufferers and well being care techniques.
Right here’s why that’s excellent news: Final winter was the primary time Panagis Galiatsatos, MD, a pulmonary and demanding care physician at Johns Hopkins, noticed sufferers coming in with each COVID and flu. Far as a rule, he stated, sufferers had solely one among these viruses; nonetheless, the variety of these with each flu and COVID he noticed final yr was “alarming.”
“Sufferers that had co-infections had been by far our sickest sufferers,” Galiatsatos stated. “That is additionally a scientific bias as a result of I’m a crucial care doctor, however the entire sufferers I met with co-infections had been within the intensive care unit.”
How Do You Know If You Have Extra Than One Virus?
In terms of simply how many individuals expertise co-infections like this, it’s arduous to inform. Most of those diagnoses come from being hospitalized, the place docs will usually check for all three viruses. For many who don’t find yourself in a hospital, they won’t know they’ve a couple of an infection, particularly as a result of the signs are related. A runny nostril, cough, fever, and physique aches can occur with all three viruses.
Due to the accessibility of COVID assessments, it’s extra probably that in the event you get sick and check optimistic for COVID, you in all probability received’t search out a flu or RSV check at a medical facility in case your an infection isn’t dire sufficient to immediate a hospital go to.
Testing for all three isn’t a necessity for everybody, stated Peter Chin-Hong, MD, an infectious illness knowledgeable on the College of California, San Francisco. The aged, very younger, and other people with weakened immune techniques ought to undoubtedly search additional testing as quickly as they’re capable of.
Nonetheless, those that don’t fall into these classes can nonetheless get examined for all three viruses. Primarily based on what docs have seen previously, there’s a better probability that if in case you have two viruses, it’s in all probability COVID and flu, not RSV. And early testing in these circumstances can save sufferers a variety of grief as a result of we’ve antiviral therapies for flu and COVID that we don’t have for RSV.
What to Do If You Have Flu and COVID
“Very first thing is, don’t panic,” says Chin-Hong. When you check optimistic for COVID at residence and you’ve got signs, search out the drug Paxlovid inside 5 days of being sick. If it seems you’ve got the flu in addition to COVID, you may get antivirals like Tamiflu inside the first 48 hours of signs, which can shorten the sickness by a day or extra.
There’s been some confusion round who precisely qualifies for Paxlovid. The FDA has stated that it’s accredited for the therapy of “delicate to reasonable COVID-19 in adults who’re at excessive danger of progressing to extreme COVID-19,” however some could assume they aren’t within the high-risk class and don’t search it out.
There may be nonetheless a reluctance to take Paxlovid, from sufferers who’re nervous in regards to the “rebound” and from docs who’re hesitant to prescribe it, stated Bernard Camins, MD, an infectious illness knowledgeable at Mount Sinai in New York Metropolis.
“We have to be extra prepared to prescribe Paxlovid as physicians,” Camins stated. “Typically docs will say, ‘Oh, you’re not feeling too unhealthy, let’s not do it.’ The issue is it is likely to be too late by the point [the patient] does get sick sufficient.”
Relating to the notorious COVID rebound — the place sufferers develop COVID once more shortly after recovering — that many have related to Paxlovid use, docs like Chin-Hong and Camins need sufferers to know that this rebound is fairly typical, with or with out Paxlovid.
And within the respiratory virus season specifically, Chin-Hong stated, what you may suppose is a rebound of COVID signs could very nicely be one other virus, like influenza or RSV.
Does One Virus Make You Extra Prone to Getting One other?
The quick reply: It is determined by who you’re, what actions you do, and the timing of your an infection.
Research on COVID have proven that there might be long-term injury to immune techniques after recovering from an an infection. Typically having two viruses directly could make you sicker, as was the case for Galiatsatos’s sufferers. Researchers have additionally discovered that sufferers who examined optimistic for influenza had a decreased danger of testing optimistic for COVID; however for many who did have co-infections, the illness was rather more extreme and left much more long-term injury to the lungs.
Having COVID is the commonest denominator relating to folks with a number of infections, Galiatsatos stated, as a consequence of its potential to invade the immune cells, weakening sufferers and making them extra weak to catching different viruses.
However there’s nonetheless quite a bit we don’t find out about co-infections with COVID, flu, and RSV. Based on William Schaffner, MD, an knowledgeable in preventative medication and infectious ailments at Vanderbilt College in Nashville, a non-immunocompromised individual isn’t extra prone to get contaminated with one other virus in the event that they have already got one.
“That’s, until their behaviors cause them to larger publicity,” Schaffner stated. “If folks aren’t vaccinated, don’t put on masks, or have a private behavioral disposition to consistently expose themselves to vociferous crowds, nicely, they’re extra prone to decide up a number of of those infections through the course of the winter.
“That’s just because they’re exposing themselves. It would not have something to do with their immune techniques.”
