Tridemic:
A Triple Threat

COVID-19, the flu, and RSV overwhelm healthcare systems

As Americans prepare to gather for the holidays, they face simultaneous surges in COVID-19, influenza, and respiratory syncytial virus (RSV). The World Health Organization reported almost 450,000 new COVID-19 cases in the United States during the past week, and the CDC has classified most U.S. states as having “high” or “very high” rates of flu. Although RSV cases have likely peaked for the season, they remain elevated after reaching alarming highs earlier this fall. The resulting “tridemic,” as healthcare experts call it, has created a perfect storm of outbreaks for hospitals to contend with, said Katherine Prihoda, a pediatric nurse practitioner and clinical associate professor at the School of Nursing–Camden. 

“The flu, COVID-19, and RSV are all highly contagious respiratory infections caused by viruses,” Prihoda said. “It is possible for a person to be infected with two or more of the viruses at the same time.”

Katherine Prihoda, pediatric nurse practitioner and clinical associate professor at the School of Nursing–Camden

Katherine Prihoda, pediatric nurse practitioner and clinical associate professor at the School of Nursing–Camden

In early fall, Prihoda recalled, more and more RSV patients had to be admitted to South Jersey hospitals for IV therapy, respiratory support, and careful monitoring. With months still left in the RSV season, she knew the predicament would only worsen.

In response to the tridemic, health officials across the nation have sprung into action once more. New York City, Los Angeles, and Washington state are among city and state governments that have issued new recommendations for indoor masking in anticipation of holiday gatherings.

“While none of these orders are mandated, it seems to be a good recommendation,” Prihoda said. “It not only serves as a barrier to transmission for those who are considered healthy, but it also prevents transmission from those who are mildly ill with one of the viruses but remain out in public.”

Prihoda believes the trifecta of surging viruses has made it more difficult to treat each illness separately, but the lessons of the COVID-19 pandemic can help to curb transmission and inform effective medical intervention.

“Much was learned from the COVID pandemic, so medical facilities can respond more effectively to this triple threat,” said Prihoda, who advised continued vigilance in staying home when sick and seeking medical care when symptoms arise. “The COVID-19, flu, and RSV combined test is an option to determine what type of infection a person has. It determines if a patient is currently infected with SARS-CoV-2, influenza A/B, or RSV and is available through medical providers.”

Experts warn that the simultaneous presence of COVID-19, flu, and RSV could become the new normal during U.S. winters for years to come. Vaccines, testing, antiviral treatments, and everyday hygiene measures remain the best tools to slow transmission of the viruses and limit the severity of infections. Additional best practices include proper hand hygiene, refraining from sharing utensils, and maintaining a balanced diet with plenty of vitamins and minerals.

“Everyone needs to continue to be cautious and institute disease-prevention protocols to control some of the spread,” Prihoda said. 

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