The Tridemic Triple Threat

Covid-19, flu and RSV (or respiratory syncytial virus) are colliding and filling up hospital systems around the world. That this ‘tripledemic’ or ‘tridemic’ is making headlines, despite the collective fatigue of pandemic news.

FTR Health TridemicWhile most people recover from these respiratory infections, some people, mostly infants and older adults, can become very ill and require hospital care. And even people with strong immune systems can have terrible symptoms that require urgent medical care – especially if they’re unlucky enough to get one, two or three of the viruses at the same time.

Influenza, which normally peaks in February, has driven up hospitalisation rates across Europe and the US to the highest level for this time of year in more than a decade, surpassing those from Covid-19. In Scotland, for example, the situation is so bad that officials are advising people to stock up on paracetamol and ibuprofen so they do not run out over the Christmas period. Spain is uniquely prepared for influenza, with vaccine uptake for at-risk groups (over 60s, pregnant women or people with underlying health conditions) over 60% in 2022. However, the holiday period on the Costa del Sol brings together people from all over the world, who are unlikely to have the same level of protection.

Meanwhile, RSV made so many young children ill this autumn, that paediatric hospitalisations in the US reached their highest record ever. RSV is a common winter virus similar to the flu – in other words, it is intense, highly contagious and can lead to death, especially in children. Worse, unlike the flu, no vaccine exists for RSV. Further, while Covid-19 infections are lower than the last two Decembers, they are also climbing.

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How can you tell the difference between these various viruses, and how do you know when to seek treatment? This chart is a good starting point when it comes to comparing different symptoms, though these can of course vary person-to-person. If you are experiencing any of these symptoms and are in an at-risk group, I highly recommend seeking medical treatment. In particular, no matter your age group, isolate and seek treatment if you are experiencing shortness of breath, high fever, diarrhoea or vomiting.

When patients come to me with symptoms of a respiratory illness, the first thing I do is run a ‘c-reactive protein (CRP) test.’ This is an easy finger-prick blood test that gives results in minutes, and can tell me whether or not an illness is bacterial or viral. Bacterial infections are far less likely, making up just 1 in 10 of most respiratory illnesses, but if you are that unlucky one, then I will know whether or not to consider prescribing antibiotics. (The inappropriate use of antibiotics, and the resulting untreatable ‘superbugs.’ is a discussion I’ll leave for another time!)

This CRP test also gives me an indicator of the strength of your virus, as it measures how much inflammation you have in your body. Depending on your symptoms, I might then run an instant Covid-19 and/or influenza test. I have had patients test positive for both influenza A and B, and cases where patients have both Covid-19 and influenza. Knowing the type of virus lets me adjust the treatment protocol, and whether or not to consider hospitalisation.

Of course, prevention is the best treatment! Get vaccinated for the flu and get a Covid-19 booster, wear a mask in crowded places, and consider instant testing before large gatherings. These small efforts on your part will help keep you and your loved ones safe in 2023.

(News/Feature/Health: Tridemic/Paula Anthony)

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