Triple health threat: RSV, Flu, COVID

The RI Department of Health has released information about measures to take to prevent RSV, in particular, and also Flu and COVID which is upticking at the same time and devastating hospitals, particularly Hasbro Children’s Hospital with hours long wait times most times of the day and night.

These guidelines come as we note the city of Worcester is advising mask wearing over the triple threat, though they have no plans to make any mask wearing mandatory in schools or elsewhere. Massachusetts officials describe “availability of pediatric ICU beds in Massachusetts is at DefCon 5.” Massachusetts officials leave open what may happen in the future in terms of prevention as RSV continues to surge.

COVID in Rhode Island

COVID ebbs and wanes in Rhode Island, mostly waning. However, little hotspots of infection continue to be reported. We just came off a “Medium Risk” alert for Newport county, which has now returned to “Low Risk” – but up pops the East Bay county as a new “Medium Risk”. Of course those at serious concern for infection, immune compromised, etc. should maintain all risk protection protocols widely noted.

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Respiratory Virus Prevention Measures from RIDOH:

Simple steps can help prevent RSV, flu, and COVID-19

With Rhode Island and states throughout the region currently seeing the circulation of several respiratory viruses, including RSV, flu, and COVID-19, all Rhode Islanders are reminded to take basic prevention measures to help themselves and their family members stay healthy and safe.

“While RSV is a common virus that we see every year in Rhode Island, we are seeing cases earlier than usual, and we are seeing more virus circulating in the community,” said Interim Director of Health Utpala Bandy, MD, MPH. “The good news is that many of the prevention measures that help prevent the spread of the flu and COVID-19 also help prevent the spread of RSV. Regular hand washing and staying home from school or work when sick are two steps that everyone should be taking, especially kids and people who are in regular contact with school-age children, older adults, and people with underlying health conditions.”

All Rhode Islanders should:

• Get your flu shot. Everyone older than six months of age should be vaccinated every year. For information on where to get a flu shot, see health.ri.gov/flu.
• Be up to date on your COVID-19 vaccinations. For many people, that means getting a booster. For information on how to get vaccinated against COVID-19, see C19vaccineRI.org.  
• Cough or sneeze into your elbow. 
• Wash your hands often with soap and water. 
• Clean and disinfect frequently touched surfaces at home, work, and school. 
• Stay home if you are sick.
• Keep children home from daycare or school who have fever, especially with a cough, difficulty breathing or shortness of breath, congestion, runny nose, or sore throat, until they are fever-free for 24 hours without medications that reduce fever.
• Contact your pediatrician or healthcare provider if you believe your child needs medical care. Your provider can offer advice on whether your child needs to be evaluated in person, tested for COVID or flu, and the best location (doctor’s office, urgent care, emergency room) for care.

RSV usually causes mild, cold-like symptoms. Most people recover in one to two weeks. However, some infants and young children are at higher risk, such as premature infants, children younger than two years old with chronic lung disease or congenital (present from birth) heart disease, children with weakened immune systems, and children who have neuromuscular disorders. Additionally, some adults are at higher risk, including people older than 65, adults with chronic heart or lung disease, and adults with weakened immune systems.

The current increase in RSV cases may be due to lower levels of immunity in the community, resulting from the prevention measures that were taken during the COVID-19 pandemic, such as social distancing. Lower levels of immunity in the community may also result in a more severe flu season.

Cases of RSV usually peak in Rhode Island in early January. RSV cases are currently at roughly double what is seen during a typical January peak. The flu is starting to circulate in Rhode Island as well. The flu typically circulates in Rhode Island through the spring. Although rates of COVID-19 are lower than they have been previously, more than 100 people are currently hospitalized with COVID-19 and with people increasingly spending time indoors, health officials across the country are expecting case increases in the coming weeks and months. 

In addition to the prevention messages listed above, Rhode Islanders should know about the right places to seek care. Hospital emergency departments in Rhode Island are currently very crowded. Children and adults in emergency departments with less serious health issues are experiencing long wait times. People who do not need emergency medical care should not go to the emergency department. Long waits in the emergency department are frustrating, and they expose people to new sicknesses. 

Many health issues can be treated more quickly and effectively by a primary care provider, in an urgent care facility, or in a health center. The Rhode Island Department of Health (RIDOH) has lists of primary care providers, urgent care centers, and health centers posted at health.ri.gov/rightplace. The health issues best treated in these settings include back pain, sprains, minor cuts, colds, sore throat, low-grade fevers, and most cases of norovirus (sometimes called “the stomach flu”). 

Some health issues need emergency medical care (either by calling 911 or going to the emergency department). Examples include trouble breathing; persistent chest pain; new difficulty speaking or confusion; inability to wake or stay awake; heavy bleeding; deep wounds; serious burns; possible broken bones (especially if the bone is pushing through the skin); and severe allergic reactions. 

This is not a complete list of health issues that require emergency medical care. For more information, see health.ri.gov/rightplace.