As in two previous fall seasons, Americans needed to be concerned about the spread of COVID in the workplace and school while potentially battling influenza strains. Unfortunately, now they have more reasons to be concerned. This year is shaping up to be more problematic in that another disease called Respiratory Syncytial Virus or RSV is having record occurrences. The three diseases are poised to grow in scope concurrently and set the stage for a huge number of hospitalizations and unprecedented problems. These three diseases infiltrating society concurrently have been coined the “tripledemic.”
Early reviews for the flu season are not good as this fall, the number of influenza cases has already been noted to be especially high. Hospitalization and ventilator rates for the flu have already increased this year in some locales. Complacency from low flu numbers during the pandemic (which occurred from now absent masking and distancing), has led to low flu vaccine recipients this year.
Meanwhile, RSV is a very contagious disease that gives most of its morbidity in very young children and older adults. The disease is one of the main causes of hospitalizations in babies and can even prove fatal. Adults over 65 also appear to be especially vulnerable. In previous years up to 300 babies die a year and 14 thousand older adults from RSV. There is no vaccine right now but there may be one soon for pregnant women and older adults. Recently, a major influx of RSV cases was noted in North America and Southern California appears to be especially hard hit.
Sadly, COVID has also not gone away. In fact, with new variants BQ.1, XBB, and others, the number of cases is going back up in many regions of the country as the weather cools and people spend more time indoors. The return-to-office initiatives have created more exposure during in-person work and commuting. Waning vaccine effectiveness is being underappreciated and boosters have become marginalized in many places. While the new bivalent vaccines have been shown to be valuable, poor early uptake of their use has already hurt the protection they could offer to society.
The confluence of these diseases poses major ramifications. The number of work and school absences could be staggering. Companies that rely on in-person workforces will be most vulnerable to productivity challenges with high numbers of absences. Confusion about which disease someone has may lead to improper care and diagnosis which would magnify the spread of the illnesses. Hospitalizations could soar and create inpatient bed shortages. The combined mortality rates could challenge some of the deadliest times of the last several years.
However, mitigation of this dangerous scenario is possible. Understand how these three diseases differ and to whom they can occur. Aggressive surveillance testing should be performed to exposed individuals and during periods of high infections for COVID and influenza to limit the number of cases. Everyone should be receiving a seasonal flu vaccine if they have not received one. Attention should be noted as to when individuals received their last COVID vaccination or booster. If the COVID shot was not in the last six months or the individual has never been vaccinated, strong consideration should be made for receiving the COVID vaccine as soon as possible. Parents should contact their pediatricians if their children are starting to act ill.
The tripledemic has already started but a window to prepare is still here. Don’t wait until it is too late!