YES, three different viruses, not only the Three Kings, are expected to visit us this coming Christmas season. This is predicted to be a winter of tripledemic.
The three viruses include our old annual nemesis, influenza, the current COVID-19, and the returning visitor, RSV (Respiratory Syncytial Virus).
All these three are highly contagious and it is possible for people to get infected with these three viruses at the same time.
The flu virus spreads rapidly during the winter months as individuals gather closer together indoors. The same is true with the SARS-CoV2 virus of COVID-19 and the RSV. In general, respiratory tract infections are common all year round, but greater number of cases are noted during the fall-winter season. The flu virus can be of different variety each year, the very reason why one should get a flu vaccine each year. Vaccines are tailored to target the “viruses of the year.”
RSV is caused by the virus with that name, respiratory syncytial virus, which infects adults and more especially children, with milder symptoms for adults and older children but more severe symptoms for infants and seniors.
The symptoms of the flu and COVID-19 could be very similar, sometimes hard to distinguish one from the other, but one unique with COVID-19 is the loss of taste or smell. Also, it takes longer for people infected with COVID-19 to show symptoms (incubation period is between 2 to 5.6 days, or up to 14 days among some people) and the infection lingering longer for COVID-19 compared to the flu.
‘All these three are highly contagious and it is possible for people to get infected with these three viruses at the same time.’
RSV, for emphasis, is more dangerous to infants and old people, where symptoms, including fever and wheezing, shortness of breath, are more severe. Hospitalization may be required, though most RSV infections run their usual course of 1-2 weeks. Babies with RSV must be watched and monitor closely for hypoxemia (low blood oxygen level), which could kill. Signs of this are rapid breathing, bluish fingernail or lips, abdomen is sucking in, trying to breathe for air hunger. When any of these are noted, call 911. Rapid emergency hospitalization is required.
There is now a COVID-19, Flu, RSV combined test, to determine which the viral infection is, which is available through physicians and hospitals. One could be exposed to COVID-19, still without symptoms, but could already be infectious to others. That’s why persons exposed to a known infected individual should test themselves with the rapid antigen home kit. This test has a 50 percent false negative yield but when positive (showing two lines on the Test Card) it is 100 percent accurate. If in doubt, a PCR test is recommended for confirmation.
From about 5-14 days after exposure, the body releases cytokines to fight the infection, and the first symptoms start to manifest: fever of 100.5 F (38 C) or higher, dry cough (the first sign in many cases), sore throat, fatigue, headache, runny nose, muscle aches, diarrhea, and in some people, loss of taste or smell, which is not typical in cases of flu or RSV. An oximeter is helpful. The normal SPO2 (blood oxygen level) is 95-100, and below 90 is too low. If shortness of breath occurs, go to the nearest emergency room. If using an inhaler, use it as you leave for the ER. This could be pneumonia developing.
COVID-19 patients could be infectious up to 10 days from first symptom, but the severe ones could be as long as 20 days. Those who are immunocompromised should be isolated for at least 20 days.
Let us face these three winter invisible enemies with wisdom and humility, not recklessness and arrogance.
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Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, a Health Advocate, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. Websites: FUN8888.com and philipSchua.com Email: scalpelpen@gmail.com
