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

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

It’s a triple threat.

After years of isolation and masking, influenza, COVID-19 and respiratory syncytial virus (RSV) are hitting harder at the start of this cold season in a phenomenon dubbed the “triple epidemic.”

During Thanksgiving week, approximately 20,000 Americans were hospitalized for the flu, the most for that week in more than 10 years. according to Washington Post analysis. Meanwhile, the number of people infected with COVID is increasing. New York State has seen more than 141,000 cases in the past monthand the Center for Disease Control over the weekend housed five New York counties – Bronx, Kings (Brooklyn), Queens, Nassau and Suffolk – in the “orange zone”, indicating a high risk of COVID and recommending masking indoors. The lesser-known but fairly common RSV is at its worst since 2012, according to Dr. Juanita Mora of the American Lung Association.

Respiratory diseases are on the rise as winter approaches.
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“Usually 100% of children will have it [RSV] up to two years. But over the last two years, these kids who are now two to four years old have never seen RSV,” Mora told The Post. “So you have a whole new group of little ones—plus the bigger ones, too—that have never seen RSV.”

dr. David Hirschwerk, medical director of North Shore University Hospital in Manhasset and an infectious disease specialist for Northwell Health, told The Post that fewer precautions are simply leading to an increase in cases.

“[Last year and 2020] many people still masked to a greater extent than this year,” he said. “And there just weren’t that many people getting the flu shot.”

As cold weather approaches, doctors are seeing an increase in viral infections.
As cold weather approaches, doctors are seeing an increase in viral infections.
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Another culprit is the cold weather. New research published in the Journal of Allergy and Clinical Immunology on Tuesday found that even a temperature drop of 9 degrees Fahrenheit is enough to kill nearly half of the billion cells that keep viruses and bacteria at bay in a person’s nostrils.

“You basically lose half your immunity just because of that little drop in temperature,” rhinologist Dr. Benjamin Bleier, an associate professor at Harvard Medical School in Boston he told CNN.

Respiratory viruses are out with a vengeance this month.
Respiratory viruses are out with a vengeance this month.
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If you’re not feeling well, testing is the best way to determine what illness you’ve been suffering from. Single smear tests can be tested for any of the three viruses in urgent care settings or in a primary care physician’s office. They are there home equipment too.

While it’s technically possible to contract multiple “triple” viruses at once, Hirschwerk said it’s incredibly uncommon. Each of the three viruses usually lasts five to seven days, so plan on a few days of Netflix bingeing and tea drinking. For more details on each disease, read on.

Symptoms to watch out for in any disease.


A common respiratory virus usually rears its ugly head during the winter and mutates year after year. Influenza can also lead to further respiratory illnesses such as bronchopneumonia and bronchitis.

It most often occurs through cold-like symptoms and postnasal drip. It can also cause gastrointestinal problems, high fever, mucus cough, sore throat and fatigue.

According to Hirschwerk, the flu shot is the optimal solution to fight the virus. The prescription drug Tamiflu can be used in treatment with an albuterol inhaler.


Keeping up to date with Covid vaccines is key this winter, doctors say.
Staying up-to-date on COVID vaccines is key this winter, doctors say.
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As if we all needed a reminder, COVID-19 is a respiratory virus that emerged in late 2019. It primarily affects the respiratory tract, but it can also affect the heart. Long-term effects include myocarditis and brain clots.

Key symptoms are difficulty breathing, dry cough, sore throat, pain, fatigue and loss of taste and smell.

As with the flu, staying up-to-date on vaccinations is key. The prescription drug Paxlovid can be used to treat Covid, and some cases may merit prescribed oral steroids. An albuterol inhaler can also be used to treat more severe cases that do not require hospitalization.

To prevent the spread, Mora also recommends practicing a “little quarantine” and hiding from crowded places for a few days before meeting loved ones this holiday season.

respiratory syncytial virus

Individual smears can be made for Covid, flu and RSV.
Individual smears can be made for Covid, flu and RSV.
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In healthy adults, RSV can be no more troublesome than a mild cold, but it can be quite serious for very young children and the elderly. Along with bronchopneumonia, bronchiolitis can also cause a lung infection.

It first manifests with cold-like symptoms, but becomes most severe in young children when it reaches their lungs. Warning signs include a dry cough, high fever, difficulty breathing, dehydration, runny nose, wheezing and shortness of breath.

Apart from Synagis — a special vaccine exclusively for immunocompromised patients — there is currently no vaccine for RSV. Pfizer is awaiting FDA approval to give the drug to mothers in the third trimester, according to Mora.

Basic hygiene measures at home and at school are the best preventive measure.

Symptomatic therapy — such as taking Motrin or Tylenol and staying hydrated — may be taken to help recover from RSV, and oral steroids may be prescribed if needed. Severe cases of wheezing and dry cough may also require an inhaler prescribed with albuterol.

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