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 state of affairs.
Because the colder months creep up on us, so does the unfold of the large three respiratory viruses: COVID, influenza, and respiratory syncytial virus. The excellent news is we now have an up to date COVID vaccine, flu photographs that defend in opposition to a number of strains of the virus, and RSV vaccines for older people, pregnant individuals, 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 seem like this 12 months, final 12 months’s data from the CDC confirmed that RSV, COVID, and flu didn’t all peak without delay – which is sweet 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 significant care physician at Johns Hopkins, noticed sufferers coming in with each COVID and flu. Far most of the time, he mentioned, sufferers had solely one in every of these viruses; nonetheless, the variety of these with each flu and COVID he noticed final 12 months was “alarming.”
“Sufferers that had co-infections have been by far our sickest sufferers,” Galiatsatos mentioned. “That is additionally a medical bias as a result of I’m a essential care doctor, however the entire sufferers I met with co-infections have been within the intensive care unit.”
How Do You Know If You Have Extra Than One Virus?
With regards 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 medical doctors will sometimes check for all three viruses. For individuals 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 exams, it’s extra doubtless that for those who get sick and check optimistic for COVID, you in all probability gained’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, mentioned 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. Primarily based on what medical doctors have seen prior to now, there’s the next likelihood that if in case you have two viruses, it’s in all probability COVID and flu, not RSV. And early testing in these instances can save sufferers a number of grief as a result of we’ve got 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. In the event you check optimistic for COVID at house and you’ve got signs, search out the drug Paxlovid inside 5 days of being sick. If it seems you may have the flu in addition to COVID, you may 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 authorized for the therapy of “delicate to average COVID-19 in adults who’re at excessive danger 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 fearful concerning the “rebound” and from medical doctors who’re hesitant to prescribe it, mentioned Bernard Camins, MD, an infectious illness knowledgeable at Mount Sinai in New York Metropolis.
“We should be extra keen to prescribe Paxlovid as physicians,” Camins mentioned. “Typically medical doctors will say, ‘Oh, you’re not feeling too dangerous, let’s not do it.’ The issue is it is perhaps too late by the point [the patient] does get sick sufficient.”
Concerning the notorious COVID rebound — the place sufferers develop COVID once more shortly after recovering — that many have related to Paxlovid use, medical doctors 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 particularly, Chin-Hong mentioned, what you may suppose is a rebound of COVID signs might very nicely be one other virus, like influenza or RSV.
Does One Virus Make You Extra Vulnerable to Getting One other?
The brief reply: It is dependent upon 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 damage to immune methods after recovering from an an infection. Typically 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 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 harm to the lungs.
Having COVID is the commonest denominator on the subject of individuals with a number of infections, Galiatsatos mentioned, because of its means to invade the immune cells, weakening sufferers and making them extra susceptible to catching different viruses.
However there’s nonetheless so much we don’t find out about co-infections with COVID, flu, and RSV. In response to William Schaffner, MD, an knowledgeable in preventative medication and infectious illnesses at Vanderbilt College in Nashville, a non-immunocompromised particular person isn’t extra more likely to get contaminated with one other virus in the event that they have already got one.
“That’s, until their behaviors cause them to better publicity,” Schaffner mentioned. “If individuals aren’t vaccinated, don’t put on masks, or have a private behavioral disposition to continually expose themselves to vociferous crowds, nicely, they’re extra more likely to choose 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 would not have something to do with their immune methods.”
