As we enter the cold and flu illness season, Texas physicians warn there are three viruses lurking in the air – the influenza virus that causes the flu, respiratory syncytial virus (RSV), and SARS-CoV-2, the virus that causes COVID-19. Physicians say the best way to say safe – especially for those at greatest risk of severe illness – is to vaccinate against all three.
“These are the respiratory viruses we see seasonally, usually in the fall and winter, that can cause serious illness in young children, the elderly, and people who are immunocompromised,” said Trish Perl, MD, chair of the Texas Medical Association’s (TMA’s) Committee on Infectious Diseases.
“RSV is the single most important cause of hospitalizations in children,” for example, she said. Many children were hospitalized because of serious RSV cases last year.
Another factor that makes the interplay of the three viruses challenging is that they are very difficult to differentiate, with all three presenting similar symptoms. Dr. Perl said knowing which virus is making someone severely sick is important for physicians treating serious cases because “we approach these differently in different patient populations.”
The Dallas physician – an infectious diseases specialist – warns that while people have become accustomed to using COVID-19 test kits at home, they are not always accurate and cannot test for the flu or RSV. Even if the COVID-19 test shows a negative result, she says it is important for patients at risk to get tested at a physician’s office, clinic, or hospital, which can test for all three viruses so patients can get the care they need.
In addition to considering testing for other viruses, it is important for someone with symptoms but testing negative for COVID-19 to still take everyday preventive actions, such as staying home, to prevent spreading an illness to others.
“Doctors are worried because all three viruses can lead to hospitalization, lost work, and missing school, and all have economic consequences,” said Dr. Perl.
The U.S. Food and Drug Administration (FDA) recently approved COVID-19 booster shots that target the strains of the coronavirus that are most prevalent now – XBB and XBB.1.5 – both subvariants of the omicron variant. Hospitalizations of people with these subvariants have spiked over the past few weeks. The omicron variant caused record hospitalizations during the height of the pandemic, though the situation is not as dire now.
“A lot of us think that’s because people have some immunity, either from the vaccines, or from getting COVID-19,” said Dr. Perl. But she said it is still important to get the booster shot because “like the flu, the coronavirus is evolving, and it could become a seasonal virus.”
The current recommendation is to get the COVID vaccine and the flu shot at the same time. “I got mine yesterday – got one in the right arm, one in the left arm,” she said.
She said in addition to preventing hospitalizations from serious illness, the flu shot is effective in preventing pneumonia, and even potential heart attacks and strokes among patients with cardiovascular disease who catch severe cases of the flu.
The recently FDA-approved RSV vaccine is a third vaccine available this season. This is recommended – with consultation with their doctor – for people who are 60 years of age and older, since they are at higher risk for severe disease. The vaccine also is recommended for pregnant women seasonally in the eighth month of their pregnancy. The purpose of the vaccine for this group is to prevent RSV in infants after they are born.
Now – the start of the season when we see more cold, flu, and viral illnesses – is the time to get these shots to build up protection from getting severely ill, Dr. Perl said.
