Tripledemic: Navigating the Cold, RSV, Flu, and COVID Maze

Do You Have the Flu, RSV, COVID-19, or a Cold?

Flu, RSV, COVID, or Just a Cold?

Winter is upon us, bringing its usual suspects – runny noses, coughing, and congestion. But what if these symptoms are more than just a common cold? Could it be the notorious “tripledemic” – a combination of RSV (respiratory syncytial virus), COVID-19, and influenza? Distinguishing between these respiratory viruses based on symptoms alone can be a real head-scratcher. Luckily, we’ve consulted some experts to help us make sense of it all.

How Viruses Set Themselves Apart – or Don’t 

In this day and age, COVID-19, especially for the vaccinated bunch, can often present itself as nothing more than a run-of-the-mill cold. So, it’s crucial to keep those at-home tests nearby. According to Dr. Panagis Galiatsatos from Johns Hopkins, “Being vaccinated does keep these viruses from striking the chest. Vaccinated patients may get a mild cough, but a lot of their symptoms stay more as an upper respiratory issue, like nasal congestion – like a bad cold.” In other words, your upper respiratory system might feel like the traffic jam on a Monday morning.

When it comes to COVID-19, the loss of taste and smell used to be the telltale sign, but it’s not as common these days, especially among the vaccinated crowd. Dr. Galiatsatos explains that loss of smell or taste among the vaccinated is often due to the dreaded upper respiratory congestion, whereas before, “it was more of a neurological invasion of the virus.” So, consider it a victory that the antibodies from vaccinations are now protecting us from the more severe consequences. It’s like having an army of tiny superheroes guarding your nasal passages.

But unlike RSV, the common cold, and even the flu, COVID-19 might bring along some gastrointestinal symptoms like nausea, vomiting, and diarrhea. Admittedly, these GI issues are rare, but if you’re experiencing them, it’s a good idea to get tested for COVID-19. Think of it as your stomach doing a stand-up comedy routine, except it’s not really funny.

For healthy individuals who are neither children nor over the age of 65, RSV might be mistaken for a mild case of COVID-19 or just a regular cold. However, for children and seniors, wheezing or asthma flares could be red flags indicating a potential RSV infection. It’s like RSV is trying to mimic its older, more infamous siblings, but it’s not fooling anyone.

What the Timing of Symptoms Can Tell Us 

The common cold strikes like lightning, with symptoms quickly appearing out of the blue. On the other hand, if you fell victim to RSV, it might take anywhere from 4 to 6 days to show its true colors. But the most dramatic of them all is the flu. As Dr. Peter Chin-Hong of the University of California, San Francisco explains, “[When you get the flu], you might be minding your own business, feeling OK, and then all of a sudden you get in your car and you feel like you’ve been hit by a dump truck.” It’s like getting a surprise visit from a circus troupe of dramatic symptoms.

COVID-19, on the other hand, likes to play a mysterious game. You might not have any symptoms at all, or you could have mild cold-like symptoms for about a week before things take a turn for the worse. As Dr. Chin-Hong puts it, COVID-19 has a “biphasic” pattern. You’re going along just fine, and suddenly, you plunge into the abyss. That’s why it’s crucial to receive early treatment with medications like Paxlovid or remdesivir. It’s like avoiding a roller coaster that goes from a gentle ride to a wild freefall.

Testing Is Your Best Bet

Dr. Galiatsatos strongly recommends getting tested for COVID-19 as your first move. If you receive two negative tests within a 24-hour period, it might be a good idea to seek a flu test at a local healthcare facility, if possible. Staying vigilant with testing can grant you access to the right antivirals, like Tamiflu, that can kick symptoms to the curb, giving you a head start on recovery. And trust us, when you’re down with the flu, those couple of days can feel like an eternity. It’s like winning a race against time.

Assuming you have COVID-19 without getting tested can be a risky gamble, especially if you end up with long-lasting respiratory symptoms. Dr. Galiatsatos shares his heartbreak over patients who never got tested and now suffer from long COVID symptoms. Without a positive COVID-19 test, it becomes challenging to prove that these symptoms are related. So, don’t let uncertainty hang in the air like a bad smell. Get tested and give yourself some peace of mind.

Remember, the key to surviving the tripledemic is vigilance, early detection, and of course, a dash of humor. So, if your nose is running, remember to chase it with a sense of curiosity. Stay safe, stay healthy, and keep on laughing!

*[RSV]: Respiratory Syncytial Virus