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RSV, flu and COVID-19? Northeast Ohio doctors say they're worried about a 'tripledemic'

A picture of a doctor in their lab coat.
Rainbow Babies and Children's Hospital is preparing a contingency plan if the hospital becomes overwhelmed with RSV patients.

Influenza and respiratory syncytial virus, also known as RSV, thrive in colder weather because people move indoors where droplets from sneezing or coughing can spread more easily. But it's been relatively warm recently in Northeast Ohio, and those viruses are spreading more than normal, doctors said.

That spread combined with the threat of a resurgent COVID-19 virus should serve as a warning, said Dr. Christine Alexander, the department chair of family medicine at MetroHealth Medical Center.

“The fact that it’s happening while there’s good weather, while we’re still out and about, when we’re not shut in doors, is a concern,” she said. “I think we really should view this as a warning, ‘please pay attention.’”

Surging RSV cases have filled some Northeast Ohio hospitals earlier than anticipated this year. Meanwhile, the CDC reports early spread of the flu continues across the U.S., with the southeast and south-central parts of the country reporting the most cases. Doctors say it’s possible RSV, influenza and COVID-19 could spread around the same time making for one very sick winter.

Dr. Claudia Hoyen, the director of pediatric infection control at Rainbow Babies and Children's Hospital, said there continues to be a large number of RSV cases at the hospital.

“At least in [the Cleveland area], we have not had that trajectory where we're going straight up every week in terms of numbers, which is good,” said Hoyen. “So that hopefully will be plateauing and perhaps really seeing a little bit of a slowdown in terms of new patients that are coming in.”

The number of children coming in with RSV is high enough that the hospital has instituted a hospital incident command (HIC) structure in order to prepare in case things get worse, she said. Concerned families should reach out to their insurance company nurse helpline, pediatrician or family practice physician to get their advice before accessing already stretched hospital resources.

“Fortunately, in Ohio we’re doing OK for now,” Hoyen said. “I've been on the phone with colleagues throughout the country. And I know that in places like Denver there's a very large tent set up in front of their children's hospital [to care for RSV patients]. So [it's] important to use the resources that we have before overwhelming the health care system.”

Doctors say people need to stay vigilant about continuing the public health behaviors like handwashing and staying home when sick that were drilled into the public during the pandemic. Still, Alexandra admits it’s hard to get that message across when many people are ready to move on.

“I do 100% understand how folks feel tired,” Alexander said. “They want normalcy. Many view masks as not part of their normal life. I would just urge them to rethink that.”

In addition to masking, Alexandra said the COVID-19 bivalent booster and flu shot are the best lines of defense against disease and death. There is no vaccine for RSV, but there are some currently in development.

Another reason to get the COVID-19 shots is to prevent long COVID, said Hoyen.

“I've been doing this for 25 years and... have never had a long flu clinic or a long RSV clinic,” Hoyen said. “But I can tell you, we actually at Rainbow see children from around the country who have long COVID. So there are things that are COVID that are a little different, and the vaccines can protect us.”

Taylor Wizner is a health reporter with Ideastream Public Media.