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 may very well be a very 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 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 certainly one of these viruses, however two without delay or in shut succession through the winter season.
Whereas we will’t predict what the season will appear like this 12 months, final 12 months’s information 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 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 most of the time, he stated, sufferers had solely certainly one 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 stated. “That is additionally a medical bias as a result of I’m a vital care doctor, however all the sufferers I met with co-infections have been within the intensive care unit.”
How Do You Know If You Have Extra Than One Virus?
In the case of simply how many individuals expertise co-infections like this, it’s onerous to inform. Most of those diagnoses come from being hospitalized, the place medical doctors 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 exams, it’s extra seemingly that when you get sick and take a look at optimistic for COVID, you most likely 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 folks with weakened immune techniques ought to positively search additional testing as quickly as they’re capable of.
Nevertheless, 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 a better likelihood that when you have two viruses, it’s most likely COVID and flu, not RSV. And early testing in these instances can save sufferers numerous grief as a result of we now have 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 case you take a look at optimistic for COVID at residence and you’ve got signs, hunt down the drug Paxlovid inside 5 days of being sick. If it seems you will have the flu in addition to COVID, you will 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 authorized for the remedy of “gentle to average COVID-19 in adults who’re at excessive threat 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’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, 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. “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.”
Relating to 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 specifically, Chin-Hong stated, what you may assume is a rebound of COVID signs could very properly be one other virus, like influenza or RSV.
Does One Virus Make You Extra Vulnerable to Getting One other?
The brief reply: It depends upon who you might be, what actions you do, and the timing of your an infection.
Research on COVID have proven that there could be long-term injury to immune techniques 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 discovered that sufferers who examined optimistic for influenza had a decreased threat of testing optimistic for COVID; however for individuals who did have co-infections, the illness was far 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, because of its means to invade the immune cells, weakening sufferers and making them extra susceptible to catching different viruses.
However there’s nonetheless lots we don’t learn about co-infections with COVID, flu, and RSV. In keeping with William Schaffner, MD, an knowledgeable in preventative drugs 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, except their behaviors cause them to better publicity,” Schaffner stated. “If folks aren’t vaccinated, don’t put on masks, or have a private behavioral disposition to continuously expose themselves to vociferous crowds, properly, 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 does not have something to do with their immune techniques.”
