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Flu, COVID, and RSV are on the rise. How worried should you be?


Five questions about the “Tripledemic” of 2022-23.

Just when you thought it was (sort of) safe to breathe again, news reports are warning us of a nasty flu season, a surge in something called respiratory syncytial virus (RSV), and “scrabble variants” of COVID-19.

And it wouldn’t be a thing without a name—step aside, Sharknado and snowmageddon, the so-called Tripledemic is coming to town.

A tripledemic is a lot to worry about. Let’s break down this multi-pronged attack of the bugs.

How bad will flu season be this year?

Here in 2022, we’re coming off two abnormally light flu seasons in 2020-21. But the data on our current flu season (which officially began the week ending October 8) is nothing short of alarming. According to the Centers for Disease Control’s (CDC) “Fluview” page, where stats are updated on an ongoing basis, the flu infection rate is high and continues to increase across the country. According to CDC estimates, there have been at least 8.7 million illnesses, 78,000 hospitalizations, and 4,500 deaths from flu so far this season.

For many, the big question is “why”? For the last two years Americans have been social distancing, working from home, and wearing masks indoors.  These precautions have prevented many of us from catching the flu and other respiratory infections. 

This winter, the use of masks has relaxed and we’re gathering indoors and traveling more.  The good news: this year’s flu shot appears to be “very good match” to the circulating strains of the virus, according to the CDC. That said, fewer people are getting the vaccination compared to previous years.

Do I need to be worried about RSV?

Anyone can catch RSV, but it’s most severe for small children. This is primarily because it generates a lot of mucus—snot—that adults can deal with more easily. Our passageways are bigger, and we know how and when to blow our noses. A baby or small child has tighter nasal passageways, which get tighter still when they become inflamed, and the really little ones haven’t learned to blow their noses.

RSV is surging, possibly because of our behavioral changes during the ongoing pandemic. Yes, it’s a similar explanation to the surge in flu numbers, mentioned above. For babies and small children, reduced interaction with the outside world has resulted in less exposure to various viruses, and therefore lower naturally acquired immunity. The weaker defense against RSV in 2022 has been called an “immunity gap.”

For an older child or adult, RSV often looks like the common cold—so you may have had it and not even known you did. But for the immunocompromised, those with asthma, and the elderly, RSV can be serious (as can any respiratory virus). For adults over 65, RSV can lead to pneumonia, worsen heart failure or exacerbate lung disease, all of which can result in death.

Most adults don’t need to worry about RSV. But babies with congestion may eat less and risk dehydration. Nasal suctioning or flushing is recommended, as is maintaining fluid intake. Consult a doctor immediately if your baby or child has:

  • Labored breathing marked by wheezing or grunting
  • Extreme lethargy
  • Tinges of blue around the mouth

Aren’t we done with COVID?

Unfortunately, no. We’re not done with “classic” COVID-19, though vaccination has blunted its impact to some extent. The rub is that COVID-19 mutates rapidly, spinning off variants as fast as we can name them. Get ready for a new cast of characters descended from the omicron variant that don’t sound terribly friendly: BQ.1, BQ.1.1, BF.7, BA.4.6, BA.2.75, BA.2.75.2, and XBB. Those are the variants—dubbed “Scrabble variants” by one expert—that are making inroads in the U.S.

For those with a strong immune system, the latest bivalent COVID vaccine booster shot and antiviral drugs like Paxlovid are good options to prevent serious illness and the lingering effect known as “long COVID.” But the new variants pose increased risk for those with compromised immune systems.

The bottom line here?

With simultaneous surges in three contagious viruses, the winter of 2022-23 is most definitely going to be a bumpy ride.

But we’re here to help. The 2022-23 flu shot and any COVID-19 vaccine, including booster shots, are covered without any cost-sharing under your Horizon health plan.

Both the booster and flu shot will be available in similar places as previous vaccinations. Your doctor or local pharmacy are the best places to start. You can also check where the updated booster is available by visiting New Jersey’s Covid-19 vaccine appointment finder.  If you need both the COVID-19 booster and a flu shot, don’t worry – you can get them at the same time.

If you have any questions about the vaccines, please contact your primary care physician.

Horizon Health News is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Paxlovid™ is a registered mark of Pfizer Inc.