Feeling sick? How to know if you have COVID, RSV or the flu

It’s a triple threat.

After years of isolating and masking, influenza, COVID-19 and respiratory syncytial virus (RSV) are all hitting harder and earlier this cold season in a phenomenon that’s been dubbed a “tripledemic.”

During Thanksgiving week, roughly 20,000 Americans were hospitalized with the flu, the most for that week in more than 10 years, according to a Washington Post analysis. Meanwhile, COVID numbers are creeping higher. New York State has seen over 141,000 cases in the last month, and, over the weekend, the Centers for Disease Control placed five New York counties — Bronx, Kings (Brooklyn), Queens, Nassau and Suffolk — in the “orange zone,” signaling a high risk of COVID and a recommendation to mask indoors. The lesser known but quite common RSV is at its worst since 2012, according to Dr. Juanita Mora of the American Lung Association.

“Usually 100% of kids will have had [RSV] by age two. But over the last two years, these kids who are now two- to four-year-olds have never seen RSV,” Mora told The Post. “So you have a whole new crop of little ones — plus bigger ones as well too — that have never seen RSV.”

Dr. David Hirschwerk, medical director of Manhasset’s North Shore University Hospital and infectious disease specialist for Northwell Health told The Post that fewer precautions are simply making for an uptick in cases.

“[Last year and 2020] many people still were masking to a greater extent than this year,” he said. “And there just also have not been as many people to get the influenza vaccine.”

Another culprit is the cold weather. New research published in the Journal of Allergy and Clinical Immunology Tuesday found that even a 9-degree Fahrenheit temperature drop is enough to kill almost half of the billions of virus- and bacteria-preventing cells in a person’s nostrils.

“You’ve essentially lost half of your immunity just by that small drop in temperature,” rhinologist Dr. Benjamin Bleier, an associate professor at Harvard Medical School in Boston told CNN.

If you’re not feeling well, getting a test is the best way to determine which illness you’ve contracted. Single swab tests can be run for any of the three viruses at urgent care facilities or a primary care physician’s office. There are home kits as well.

While it is technically possible to contract multiple of the “tripledemic” virus at once, Hirschwerk said that is is incredibly uncommon. Each of the three viruses tend to last five to seven days, so plan on several days of Netflix binges and tea drinking. For more details on each illness, read on.

Influenza

The common respiratory virus typically rears its aching head during winter time, and it mutates from year to year. The flu can also lead to further respiratory diseases such as bronchopneumonia and bronchitis.

It most commonly appears through cold-like symptoms and a post nasal drip. It can also cause gastrointestinal issues, a high fever, mucusy cough, sore throat and fatigue.

Getting a flu shot is the optimal solution to combatting the virus, according to Hirschwerk. The prescription medication Tamiflu can be used in treatment in addition to an albuterol inhaler.

COVID-19

As if we all need a reminder, COVID-19 is a respiratory virus that originated in late 2019. It primarily affects the respiratory tract but can also impact the heart. Long haul impacts include myocarditis and brain clots.

Key symptoms are difficulty breathing, a dry cough, sore throat, aches and pains, fatigue and the loss of taste and smell.

As with the flu, staying up-to-date on vaccines is crucial. The prescription drug Paxlovid can be used to treat Covid and certain cases may merit prescribed oral steroids. An albuterol inhaler can also be used to treat more severe cases that don’t require hospitalization.

To prevent the spread, Mora also recommends doing a “mini quarantine” and laying low from crowded places a few days prior to seeing loved ones this holiday season.

Respiratory syncytial virus

In healthy adults, RSV can be no more troublesome than a mild cold, but it can be quite severe for very young children and the elderly. It can also cause the lung infection bronchiolitis in addition to bronchopneumonia.

It first presents itself with cold-like symptoms but becomes most severe in toddlers when reaching their lungs. Warning signs include a dry cough, high fever, trouble breathing, dehydration, runny nose, wheezing and shortness of breath.

Aside from Synagis — a special vaccine solely for immunocompromised patients — there is no current vaccine for RSV. Pfizer is awaiting FDA approval for one to be given to mothers in their third trimester of pregnancy, according to Mora.

Basic sanitary measures at home and school are the best preventative measure.

Symptomatic therapy — such as taking Motrin or Tylenol and staying hydrated — can be taken to recoup from RSV and oral steroids may be prescribed if needed. Severe cases of wheezing and a dry cough might also warrant an inhaler prescribed with albuterol.