The Pettis Report: Protecting Yourself From the “Tridemic” – Here’s How to Reduce Your Risk of Flu This Winter

Sore throat, runny nose, body aches, chills – like every previous winter, many of us will experience these common and seemingly unavoidable symptoms this season. However, the winter of 2022 is different – we are entering what’s been called a “Tridemic,” consisting of three increasingly prevalent viruses at the same time. These three viruses are COVID-19 (coronavirus), influenza, and RSV.

While flu season is typically between October and May, reaching its peak severity in December and January, it began six weeks earlier this year with unusually widespread and intense illness. By the end of October, there had already been at least 880,000 cases of influenza illness, 6,900 hospitalizations and 360 flu-related deaths nationally according to the CDC. This is the highest number of cases and hospitalizations since the 2009 H1N1 swine flu pandemic.

The cold and dry weather, along with limited travel and social restrictions, have resulted in a resurgent influenza season and other circulating respiratory viruses to coincide with the winter rise in COVID-19 cases. Though each virus is distinctly different, they can cause a similar clinical syndrome. And if you’re experiencing the common symptoms this season, how do you know which virus is responsible?

In today’s blog post, we’ll discuss each of these viruses, their symptoms and importance, and how to reduce your risk of getting sick this season.

Understanding the Tridemic Viruses

First let’s look at the three widespread viruses this season and how they vary from one another.

RSV (which stands for respiratory syncytial virus) is a common respiratory virus that usually causes mild symptoms. While most people recover within a week or two, RSV can be serious especially for infants and older adults. In the US, RSV causes about 14,000 deaths among adults 65 and older and up to 300 deaths among children under 5 each year.

RSV is the most common cause of bronchiolitis (inflammation of the small airways and lung), and pneumonia (infection in the lungs) in children younger than one year old in the United States. There is currently no vaccine available for RSV, but at least two candidates are in late-stage clinical trials and show high effectiveness in older adults.

Influenza (flu) is also a respiratory virus, though generally less prevalent than the “common cold.” By comparison, it tends to be more severe and can be distinguished by high, persistent fever and chills, an abrupt onset of symptoms, frequent coughing, and moderate to severe headache.

People who are infected with influenza will generally recover in less than two weeks, usually within a few days. However, unlike a common cold, the flu can potentially progress to a life-threatening illness. Even after someone recovers from the flu, the inflammatory response from the virus continues to affect middle-aged or older individuals for another four to six weeks, increasing the rate of heart attacks and strokes.

One of the most notable severe complications of flu is pneumonia, which can cause respiratory difficulty, particularly in those over age 65 and those with chronic diseases like asthma and COPD, diabetes, and heart disease.

COVID-19 (SARS-CoV-2) is a virus causing symptoms ranging from mild to severe illness. The symptoms can appear as many as 2 to 14 days after exposure. The clinical symptoms can be similar to the other viruses, but it can often uniquely cause loss of sense of taste or smell.

As you may know, COVID-19 has developed multiple variants over the course of the now three-year pandemic. Each of these variants tend to be more easily spread in the population and now account for 27% of cases, but fortunately tend to cause less severe disease.

As new variants develop a greater ability to resist immune defenses, these variants have made vaccination particularly challenging; however, those who have been vaccinated and boosted with the latest updated “bivalent” version of the vaccine are at significantly lower risk of infection and the development of severe disease.

Reduce Your Risk of Getting Sick

Though it is possible to get the flu and COVID at the same time, the good news is that the same prevention strategies work for both viruses. Measures like masking, social distancing, getting vaccinated, and frequently washing your hands work for COVID-19, as well as other respiratory viruses like the flu and RSV. So let’s look at how to prevent the spread of all three.

Get Vaccinated

Staying up-to-date with available vaccines is our most effective and widely available tool to keep the “tridemic” under control. The CDC recommends a yearly flu vaccine as the first and most important step in protecting against the four most commonly circulating flu viruses.

Everyone 6 months and older should get an annual flu vaccine, especially people at higher risk of serious flu complications such as young children, people 65 years and older, pregnant women, and people with certain chronic health conditions (like asthma, diabetes or heart and lung disease).

It is also important for parents of infants to get vaccinated, as children younger than 6 months are at higher risk of serious flu illness but are too young to be vaccinated.

In addition to the flu vaccine, remember to stay updated with your COVID-19 boosters. COVID-19 vaccines are now recommended for everyone 5 years and older; if you haven’t received a COVID vaccine or booster in the last 4 to 6 months, please get vaccinated as soon as possible.

While vaccines for COVID-19 and flu may not necessarily prevent infection, they still offer the best protection against illness and death.

Antiviral Drug Prescriptions

If you have the flu, your doctor may prescribe antiviral drugs to treat it. Antiviral drugs are prescription medicines which are different from antibiotics.

They can make flu illness milder, shorten the time you are sick, and may also prevent serious flu complications – for people with higher risk factors, treatment with an antiviral drug can mean the difference between a mild flu versus a very serious illness that could result in a hospital stay.

If you are at higher risk from flu and get flu symptoms, call your healthcare provider early so you can be treated with flu antivirals if needed.

Take Everyday Precautions

We can also take everyday preventative actions to stop the spread of germs.

Though social distancing regulations have relaxed this year, try to avoid large or crowded indoor gatherings. Masking regulations have also become less common than at the height of the pandemic, but remain an effective and necessary measure when it is necessary or desirable to gather in groups. We must all show special care and extra precaution particularly when such gatherings include older adults and anyone who has an underlying illness.

Avoid close contact with people who are sick. If you are sick yourself, limit contact from others as much as possible. Make sure to cover your nose and mouth when coughing and sneezing – the best way is to use a tissue and throw it in the trash after.

Lastly, frequent hand washing is always a good idea. If soap and water are not available, use an alcohol-based hand sanitizer. In general, avoid touching your eyes, nose, and mouth. It is also helpful to routinely disinfect common surfaces and objects that are frequently touched.

Staying Protected This Season

While we’re looking at a tough winter this year, it is absolutely possible to minimize the risk of exposure and infection. We all have to do our part in reducing the spread of flu, by following the measures outlined today. Most importantly, get your annual flu vaccine as well as the COVID-19 vaccine or booster.

Taken together, many of the same prevention techniques can be very effective in protecting you against COVID-19, influenza, and RSV this season.

Wishing you continued health,

Karlton S. Pettis, M.D.