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 identical time? Now you’re speaking about what could possibly be a extremely harmful state of affairs.
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 shield towards 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 might contract not simply one in every of these viruses, however two without delay or in shut succession in the course of the winter season.
Whereas we will’t predict what the season will appear like this yr, final yr’s data from the CDC confirmed that RSV, COVID, and flu didn’t all peak without delay – which is nice information for each sufferers and well being care methods.
Right here’s why that’s excellent news: Final winter was the primary time Panagis Galiatsatos, MD, a pulmonary and important care physician at Johns Hopkins, noticed sufferers coming in with each COVID and flu. Far as a rule, he stated, sufferers had solely one in every of 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 medical bias as a result of I’m a vital 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 relation to simply how many individuals expertise co-infections like this, it’s laborious to inform. Most of those diagnoses come from being hospitalized, the place docs will sometimes take a look at for all three viruses. For individuals who don’t find yourself in a hospital, they may not 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 checks, it’s extra seemingly that in the event you get sick and take a look at constructive for COVID, you in all probability received’t hunt down a flu or RSV take a look at 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 methods ought to undoubtedly search additional testing as quickly as they’re in a position to.
Nonetheless, those that don’t fall into these classes can nonetheless get examined for all three viruses. Based mostly on what docs have seen previously, there’s the next probability that 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 plenty of grief as a result of we’ve got antiviral remedies 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. If you happen to take a look at constructive for COVID at house and you’ve got signs, hunt down the drug Paxlovid inside 5 days of being sick. If it seems you have got the flu in addition to COVID, you will get antivirals like Tamiflu inside the first 48 hours of signs, which can shorten the illness by a day or extra.
There’s been some confusion round who precisely qualifies for Paxlovid. The FDA has said that it’s permitted for the therapy of “delicate to reasonable COVID-19 in adults who’re at excessive threat of progressing to extreme COVID-19,” however some might assume they aren’t within the high-risk class and don’t search it out.
There’s nonetheless a reluctance to take Paxlovid, from sufferers who’re anxious concerning 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 must be extra prepared to prescribe Paxlovid as physicians,” Camins stated. “Generally 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 would possibly suppose is a rebound of COVID signs might very effectively be one other virus, like influenza or RSV.
Does One Virus Make You Extra Prone to Getting One other?
The brief reply: It is determined by who you might be, what actions you do, and the timing of your an infection.
Research on COVID have proven that there will be long-term damage to immune methods after recovering from an an infection. Generally having two viruses without delay could make you sicker, as was the case for Galiatsatos’s sufferers. Researchers have additionally found that sufferers who examined constructive for influenza had a decreased threat of testing constructive for COVID; however for individuals 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 most typical denominator on the subject of folks with a number of infections, Galiatsatos stated, because of its capability to invade the immune cells, weakening sufferers and making them extra weak to catching different viruses.
However there may be nonetheless rather a lot we don’t find out about co-infections with COVID, flu, and RSV. In response to William Schaffner, MD, an knowledgeable in preventative drugs and infectious illnesses at Vanderbilt College in Nashville, a non-immunocompromised individual isn’t extra more likely to get contaminated with one other virus in the event that they have already got one.
“That’s, except their behaviors cause them to higher 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, effectively, they’re extra more likely to decide up a number of of those infections in the course of the course of the winter.
“That’s just because they’re exposing themselves. It does not have something to do with their immune methods.”