During late 2021/early 2022 we were warned about a “twindemic” of COVID-19 and flu. This winter, medical experts are warning of a potential “tripledemic” with three major respiratory viruses — the flu, COVID-19 and RSV (respiratory syncytial virus) — converging at the same time.

RSV started unusually early in 2022, with babies and young children getting sick as early as summer. The flu also began earlier than usual, with hospitalization rates the highest in a decade. Now, COVID-19 cases are starting to rise again as well. Hospitals are filling up across the country.

As people spend more time indoors with less ventilation, more relaxed safety protocols, and lower immunity due to lack of exposure from pandemic precautions, it’s a recipe for sickness this holiday season.

What does a “tripledemic” mean for holiday plans and the winter ahead, and how can we protect ourselves? Let’s review some facts.

What are the symptoms of each virus?

The symptoms of the three respiratory infections are quite similar.

COVID-19 symptoms

• Fever, chills
• Cough, sore throat, runny nose
• Loss of taste and smell
• Headache
• Fatigue
• Sore throat
• Muscle/body aches
• Stomachache, vomiting, diarrhea

Influenza (flu) symptoms

• Sudden onset of fever, chills
• Cough, sore throat, runny nose
• Muscle aches, pains
• Headaches
• Stomachache, vomiting, diarrhea

RSV symptoms

• Cough, runny nose, sneezing
• Fever
• Wheezing
• Decreased appetite

What happens if you get sick?

If you suspect you have the flu or COVID-19, contact your doctor as soon as you start noticing symptoms. In most situations, you will need a COVID-19 test to determine how long you need to isolate and to let others know if they were exposed. Testing for influenza or other viruses is only needed for those who have risk factors for severe illness and may benefit from antiviral treatments, such as oseltamivir.

For COVID-19, antiviral treatments Paxlovid and molnupervir have been shown to decrease risk of hospitalization and death for older adults and those with risk factors for severe disease.

RSV is a common respiratory virus that mostly affects children, but adults are getting it, too. While it usually causes mild, cold-like symptoms, some people with RSV need to be admitted to the hospital. The most vulnerable are the very young (under age 3), very old and immunocompromised. Currently, there are no proven effective antiviral treatments for RSV.

Infants who were born premature or are at high risk can receive a monoclonal antibody (palivizumab) to protect against infection. If your child has a fever or cough, start with their primary care physician. Go to the emergency room if you notice them having trouble breathing or any other concerning symptoms.

How can you and your family prevent illness this winter?

The flu, COVID-19 and RSV are all contagious respiratory viruses that can spread through coughing and sneezing and, for RSV mainly, by touching contaminated surfaces. The viruses can be especially dangerous for infants, older adults and immunocompromised people, so prevention is key.

With holidays gatherings and colder weather keeping us inside, take these precautions:

1. Be vigilant about symptoms and stay home when sick – The best prevention for all three illnesses is to avoid close contact with people who are sick. Also, pay attention to your own symptoms and stay home when ill. If you have a newborn, be careful about who visits.
   
   
2. Get vaccinated– It's the best way to protect yourself, your loved ones and your community. Get your annual flu shot and the updated bivalent COVID-19 booster which targets omicron subvariants. Getting vaccinated can lower your risk of severe illness, hospitalization and death. There is no vaccine for RSV but there are several in development.
   
   
3. Take precautions – Masks protect against all of three infections, so wear a mask when traveling or spending time indoors with others outside of your household. Cover coughs and sneezes with a tissue and throw it away. Wash your hands often and thoroughly and clean frequently touched surfaces. Open windows to let air flow through rooms.
   
   
4. Be extra careful during the holidays – If you’re going to a holiday gathering, be careful in the week leading up to it, especially if you’re considered high risk. Unventilated crowded indoor settings with a group of people are most risky for contracting any of the three viruses. Take a rapid COVID-19 test before getting together with others to protect each other.

Did you get your flu shot? Don't wait! Flu shots are available through your primary care physician's office and at our walk-in care locations.

Edward-Elmhurst Health has COVID-19 vaccine appointments available to ages 6 months and older, including booster doses for those eligible. Schedule your COVID-19 vaccine now or learn more.