Opinion: How to approach the trio of viral illnesses that are battering us
Now that elections are overcome, the headlines are filled with relevant material. You've likely heard about the increased cases of RSV, flu and COVID-19. They're real. Recently, Blank Children's Hospital recorded a record 185 visits in one day. Emergency departments in Des Moines and throughout the nation are overflowing.
Three viruses now circulating account for much of the misery both in the community and emergency room waiting areas: RSV, influenzas, COVID. In general, these viral illnesses are not harmful to most people. On the other hand, if you're not “most people,“ these viruses can be quite a bit of harm.
We've been here for the past couple of years with COVID. It is still here and doing what coronaviruses do, infecting and reinfecting. There were four of them before COVID; now there are five. They will continue to reinfect us. It's our new normal.
RSV is an old friend: respiratory syncytial virus. When you see a child who has a nose running clear, eyes that are red-rimmed and a cough, that's likely RSV. RSV usually occurs in the late fall and winter, when people start to huddle together, sharing their illnesses. Most people get RSV early in life and carry some level of immunity to it. Just like COVID, however, you can get RSV over and over. Typically, for the healthy adult, this means a few days of a running nose and a cough. During that time, you don't infect other people by doing what we learned to do last year and last decade, keeping a distance and not sharing germs. That activity will come back to bite us. Keep reading.
Influenza is also an old friend. Flu has been around for a long time. This year, we're sharing the H3 influenza thus far; this can change. (No one besides infectious disease doctors, geeks and virologists care about the name of what’s making us miserable. And I can rarely tell them apart, the flus or the geeks.) Influenza makes you just miserable. Your muscles ache and it even hurts to move your eyeballs. Fevers can be alarmingly high. It's very transmissible, particularly by droplets and contact.
That's all well and good. If you're healthy, you'll likely do OK with any of these. The trick is not to spread them to people who are ill already, such as the very young, the very old, the ill and the immunocompromised. We learned how to do this during COVID. And that's part of the problem.
More:Opinion: How does the COVID-19 pandemic end? History and biology help provide the answer.
While protecting others from getting ill from COVID (which Iowans did great at!), we didn't have the usual waves of influenza and RSV over the past two to three years. Depending on your point of view, that is fortunate or unfortunate. It means that the infants did not get exposed to RSV. The adults did not get their immunity renewed by being exposed to RSV and flu. The elderly and immunocompromised may well have survived because of this. RSV has not forgotten. It is coming back earlier and has a larger pool of people to infect because it didn't get them last year and the year before. Thus, RSV and influenza are likely to become more prominent in the next few months.
All is not hopeless, however. These diseases are, in general, preventable. And, if you catch them, there are a few things you could do.
PREVENTION: Prevention is obviously the simplest, cheapest and safest thing to do for all three (like with other diseases.) Unfortunately, we don't have a good immunization yet for RSV, so you'll have to take your chances there. Meanwhile, you have pretty good shots against influenza and very good shots against COVID. (I love the English term “jab.”) Get these updated.
INFECTION CONTROL: If you get sick, show the common courtesies everybody in Iowa knows about; don't spread your diseases to others.
MEDICAL ATTENTION: If you're feeling like you're seriously ill, contact your family doctor. Your family doctor can tell the difference between a viral and bacterial illness and knows your history and thus your vulnerability to becoming more ill. This is especially true for COVID and influenza.
We have very good antiviral medications for COVID, pretty good antiviral medications for influenza and pretty much nothing that helps with RSV. Antibiotics do not help these; these are viral illnesses and they scoff at bacterial treatment. Your family doctor, who knows you best, will advise you.
Although I work in an emergency department, there’s not a whole lot the emergency department can offer you for general relief beyond what your mother advised. And given the crowding, you’re likely to pick up something you don’t already have!
A frequent question, then, is when to seek emergency care. The most important thing, again, is to contact your family doctor for advice. “Just go to the ER” is not an appropriate response; don’t accept it. You have a right to better advice from someone with 24-plus years of education. If you're having trouble breathing, vomiting excessively (“excessively” is defined differently by everybody, especially males) or chest pain.
We’ll get through this winter together, like always, walking over the ice and snow hand-in-hand. Clean hand in clean hand, I’ll add.
Dr. Tom Benzoni is an emergency physician, practicing locally.
This article originally appeared on Des Moines Register: Opinion: How to approach the trio of viral illnesses battering us
