Published on January 01, 2022

woman with flu blowing nose with germ illustrations

COVID, Flu and RSV: What to Know About the Tridemic

Respiratory illnesses pose serious health threats.

Three in particular should serve as reminders to take risk-reducing steps, including getting vaccinated. Those bugs include:

  • Respiratory Syncytial Virus (RSV), which often affects babies and children
  • COVID-19, which continues to cause hospitalizations and serious illness
  • Influenza, or the flu, which is common but dangerous, especially for the very young and old

While flu season falls often in autumn, and RSV case numbers are higher in winter, COVID-19 is a newer, year-long threat.

“RSV is really contagious, and hits the little ones really hard,” said Kara Bruning, MD, Clinical Vice President of Avera’s Pediatric Service Line. "We see kids with serious flu and COVID-19, too.”

Stop the Spread of Winter Sickness

RSV and flu rates can fluctuate from year to year, but cases usually begin showing up in the fall. To stop the spread, use proven methods, such as:

  • Good, regular handwashing
  • Social distancing and mask use, to avoid possible spread from others
  • Staying home when you’re sick and keeping sick kids home when they’re ill, too

“We need to do everything we can to stop these viruses before they start,” Bruning said. “Everyone should take preventive steps: especially when it comes to getting your vaccinations.”

Symptoms of Respiratory Viruses

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RSV, flu and COVID all have similar symptoms:

  • Fever
  • Sneezing and congestion
  • Coughing
  • Decreased appetite
  • Headache and muscle aches
  • Sore throat
  • Fatigue

Since they share symptoms, it’s quite important to call your provider to get tested and diagnosed, as treatment will vary. Bruning said it’s possible to get more than one virus at once.

Warning signs of respiratory viruses include a high fever and trouble breathing. Bruning said children, including infants, who struggle with breathing use extra muscles to help. Their tummies will start to “suck in” below and between their ribs. “If you see this sort of thing, call your provider,” Bruning said.

Blueish lips or fingertips are other signs of a baby’s breathing issues. Most babies that need oxygen due to RSV recover, well after treatment. While less common, RSV can affect adults as well as kids.

Flu Shots and COVID-19 Vaccinations

“Getting vaccinated is the safest way to protect yourself from getting seriously ill,” said Jawad Nazir, MD, Avera Medical Group infectious disease and internal medicine specialist. Vaccinations can help stop the spread of viruses, especially to vulnerable people, such as the very young, old or folks with underlying medical conditions

While vaccines won’t prevent all cases of viral illnesses, their valuable protection against serious cases and hospitalization makes them the gold standard in preventive medicine. There is no vaccine for RSV.

The Centers for Disease Control and Prevention (CDC) recommend everyone get the flu shot annually, as the inoculation is tailored to stop the most common flu strains in existence. High-dose vaccines for people 65 and older are recommended, too.

Bruning and other providers recommend vaccines for COVID-19. They are available to all people ages 6 months and older. “Everyone should stay up-to-date with shots and boosters,” she added.

Treatment for Respiratory Illnesses

Hydration and oxygen therapies are sometimes used for flu and RSV patients who are admitted to hospitals. Severe infections of the virus can lower oxygen levels. A patient can develop pneumonia and sometimes require supplemental oxygen.

“In some cases we have to intubate young children and let the machines help them breathe,” Bruning said. “This temporary step can help them until they recover.”

You can learn how you can get your flu or COVID-19 vaccinations. If you are 65 or older or have medical problems that can increase risk of bacterial pneumonia, you should ask your provider about a pneumococcal vaccine.


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