How to handle COVID, flu and RSV this holiday season

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There are what you might call three Grinches this holiday season. You've heard of them: the flu, COVID and RSV.

What's the difference between them? And are there different ways to defend against them? You may want to know answers to questions like that if you're braving holiday parties or heading out to visit family. So we're turning to Dr. Gabriela Andujar Vazquez, an infectious disease physician and hospital epidemiologist at Tufts Medical Center.

Interview Highlights

There's COVID, the flu and RSV. Which of those concerns you the most, and why?

"All three are concerning — and the three of them are viruses that cause respiratory illness. But there's a little bit of differences in each of them, on what age groups they affect the most. For example, RSV is a virus that [most] affects very young children and it can be quite severe at times, especially in children that have multiple medical problems. And then the other two, COVID and the flu, are similar in some of the presentations. The difference is that COVID can be asymptomatic, as we all know now, and flu is rarely asymptomatic. The good news is that we do have vaccines for those two viruses that are very good at protecting for severe illness. The flu vaccine this year is a great, great match in protecting for the circulating strains of flu right now."

And does that mean that we should protect ourselves differently depending on age group and where we are?

"All three are transmitted by respiratory droplets, right? So cough, sneeze. The way to protect other people is the same way that we've been doing. So for COVID, for example, if we're coughing or sneezing, we cover that, we use masks. And then, not being around people while we're sick and then vaccinated when we have a vaccine available to us. Being up to date on that on both flu and COVID. We don't have a vaccine for RSV, unfortunately, but we do for the other two viruses we've been talking about."

Some people are calling this a triple-demic. Is that what it looks like in hospitals? One big phenomenon that's hitting hard all at once.

"I have to say, we are diagnosing a lot of flu this past week particularly. We had been having a rough time with RSV. It seems to be trending down and then we're sort of seeing some a trend of increasing COVID cases. But fortunately, I have to say that in the hospital, it seems like it's not yet overwhelming. It can be if both flu and COVID continue to increase at the pace that it's been the past two weeks, it could overwhelm some of the hospitals in the state and nationally. But right now we have been diagnosing there's cases, but not necessarily that many hospitalizations, although I think that that's probably a testament to, you know, vaccination, the medications we have now available for both COVID and the medication that we have had available for flu treatment for many years."

If we're feeling sick, how can we tell the difference which of these three we have? And is it important to identify which we have?

"Yeah, they can present very similar. You can have fever, chills, sweats, cough, runny nose, sore throat. All of those are things that you can have with either it's important to know which one because you may need treatment. Right. And if you have COVID, there's treatments. If you have flu, there's also treatment depending on medical problems and age and RSV, it's one that you don't necessarily need to know unless you have children that are very young and have respiratory issues, let's say asthma or other lung diseases. You might want to know to keep an eye closely whether they need to be seen in the hospital or taken to the hospital or not."

And then I wanted to get your forecast. Unfortunately, for the upcoming season last year, there was a huge spike in COVID cases after the holidays. Do you think that's going to happen again this year?

"So I think that it won't be as overwhelming and as increased as before. But I do think the flu will become more of an issue, an increase in cases as compared to last year."


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