Twindemic Turns into Tripledemic: Flu, Coronavirus, and RSV
Just as we were starting to wonder whether the world is finally nearing the end of the COVID-19 pandemic, the experts are warning against the threat of a “tripledemic” for the upcoming winter. Indeed, with new SARS-CoV-2 variants and subvariants emerging every season, the unusual upsurge in the number of RSV (respiratory syncytial virus) infections, and the influenza season right around the corner, experts increasingly suggest that the world may shortly face a “tripledemic” of SARS-COV-2, RSV, and influenza. Moreover, with many hospitals around the world are already reporting surges in these respiratory infections, there is growing concern about whether a spike in respiratory viruses could overwhelm the healthcare systems by increasing hospitalizations, overcrowding facilities, burdening healthcare workers, and exhausting supplies. Read along to find out more about the threat of “tripledemic”, symptoms to watch out for, along with the best ways to protect yourself.
What is a “Tripledemic” and how concerned should we be?
While it is not uncommon for different viruses to circulate simultaneously, the experts are concerned that if SARS-CoV-2, influenza, and RSV surge and peak around the same time, it may result in a “tripledemic” which may significantly increase hospitalizations and burden the healthcare system. While respiratory viruses tend to rise during colder months, flu and RSV cases appear to be increasing earlier than usual this year. Alongside the disruption of seasonal patterns, experts also emphasize that many people, including children, likely have little or waning immunity against influenza and RSV following pandemic precautions.
As for COVID-19, although SARS-CoV-2 is known to upsurge during the colder months, cases remain low for now. However, several countries including France, Germany, and the UK is reporting uptick in rates of hospitalization and death, which generates concern regarding whether other parts of the world could follow suit. The emergence and circulation of novel and more transmissive Omicron variants with seemingly enhanced ability to evade immunity such as BQ.1 and BQ.1.1 further reinforces such concerns.
Still, given that all of these infections are mild and treatable for the majority of people, the primary concern regarding a potentially impending “tripledemic” is whether coincidental or overlapping waves of COVID-19, influenza, and COVID-19 could overwhelm the healthcare system, cause capacity issues, and disrupt service for those who need treatment at hospitals or healthcare facilities.
Which symptoms should you look out for?
Although these are completely independent infections, clinical presentations of COVID-19, influenza, and RSV may be largely similar. Therefore, their differentiation usually requires the use of diagnostic tests. Still, there are several differences that is worth to mention which can help you determine the virus you are most likely infected with. Appearing 2-14 days after the initial exposure to the virus, most common symptoms of COVID-19 include fever, chills, cough, sore throat, runny/congested nose, loss of taste and smell, fatigue, headache, and body aches. Influenza, on the other hand, is typically characterized by a much more rapid onset. Symptoms of influenza may appear 1-2 days after infection, and may include fever, chills, dry cough, sore throat, runny nose, muscle pains, fatigue, and headache. Children infected with influenza may more commonly experience gastrointestinal symptoms such as stomachache, vomiting, and diarrhea. While it may cause more serious infections in children and immunocompromised individuals, RSV is generally a milder infection relative to influenza and COVID-19. Common symptoms of RSV include sneezing, runny nose, cough, fever, wheezing, and lack of appetite.
Who is most at risk?
In general, immunocompromised individuals, young children, pregnant women, older adults, and people with certain health conditions are most at risk for respiratory infections such as COVID-19, influenza, and RSV. Young children are especially susceptible to influenza and R.S.V. Many children infected with these viruses develop severe disease due to their insufficient or waning immunity against the infections and their lack of exposure to these viruses before the pandemic. In fact, according to Centers for Disease Control and Prevention (CDC), RSV is the most common cause of lower respiratory tract infections in children younger than 5 years old and it is estimated that 58,000 children under 5 years old are hospitalized from RSV every year.
What can you do to protect yourself against the “tripledemic”?
Especially for those who are at higher risk of developing serious disease and complications from COVID-19 and influenza, vaccination is important. With regards to COVID-19, keeping up to date with vaccines and boosters is strongly advised to ensure the highest possible level of protection against severe disease. Bivalent vaccines containing both the original strain and the Omicron strain are also in use in many countries around the world. Influenza vaccines, on the other hand, are updated each influenza season based on the estimations of the dominant influenza subtype in circulation. Particularly when the updated vaccines match the subtype in circulation, influenza vaccines have demonstrated significant efficacy in preventing infection and severe disease. As for RSV, there is currently no vaccine available. Fortunately, there is a monoclonal antibody preventative injection, palivizumab, available for use in children most susceptible to severe disease, and several RSV vaccines are currently under development. Apart from vaccination, people who are at higher risk of developing severe disease or those who want to decrease their risk of infection with these viruses can also continue to use masks.
Should you get tested?
As the differentiation of SARS-CoV-2, influenza, and RSV can otherwise be challenging due to their similar clinical presentations, testing is also a critical strategy against these infections. Our RapidFor™ SARS-CoV-2 Rapid Antigen Test Kits, Influenza A/B Rapid Test Kit, and RSV Rapid Test Kit quickly check for these infections and deliver highly accurate results in minutes. Our RapidFor™ SARS-CoV-2 Rapid IgG/IgM Test Kit and RapidFor™ SARS-CoV-2 Neutralizing Antibody Test Kit, on the other hand, help determine the level of vaccine-induced or infection-induced immunity against COVID-19. Finally, our RapidFor™ SARS-CoV-2 & FLU A/B Antigen Combo Test Kit and SARS-CoV-2 + Flu A/B + RSV Combo Rapid Test Kit enable the rapid differential differentiation of infections with COVID-19, influenza, and RSV.
References
Asri, A. K., Pan, W. C., Lee, H. Y., Su, H. J., Wu, C. D., & Spengler, J. D. (2021b). Spatial patterns of lower respiratory tract infections and their association with fine particulate matter. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-021-84435-y
