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They're calling it the "tripledemic."
The St. Louis Metropolitan Pandemic Task Force recently issued a set of recommendations for St. Louisans ahead of what is expected to be a difficult winter season chock-full of cases of three respiratory illnesses: COVID-19, influenza, and respiratory syncytial virus, or RSV, which can cause trouble with breathing.
With RSV, most children will have cold-like symptoms. Some children, such as preemies, babies under 6 months of age, and kids with heart, lung, or immune conditions—particularly the first time they have RSV—can have more serious illness. And already, cases of RSV in children are surging across the country, including in St. Louis, the task force representatives say.
The good news? Dr. Clay Dunagan, BJC Chief Clinical Officer and Pandemic Task Force co-lead, says that St. Louis is in a “manageable phase” in regards to the first prong of the tripledemic, COVID-19. He reported that COVID-19 cases and hospitalizations are holding steady. However, because of the uptick in cases in Europe and new COVID-19 variants in the U.S. and St. Louis region, he expects an increase in COVID cases and hospitalizations in the coming weeks. The COVID-19 vaccines still offer protection against severe disease, Dunagan said.
The not-so-good news? “At the same time, over the next few months, we’ll be dealing with an unusually high level of respiratory illnesses, at least two of which will be RSV… and influenza,” Dunagan said.
Dr. Marya Strand, the Chief Medical Officer at SSM Health Cardinal Glennon Children’s Hospital, says that the hospital has already seen a large number of patients with RSV, and as the weather turns colder, doctors expect that number to grow. Children who would normally have had their first case of RSV as infants are now getting the virus for the first time at 2, 3, 4, and 5 years old, Strand says, and because they’ve never had it before, they don’t have immunity and are experiencing more severe symptoms.
Hospitals are filling up, Strand says, and because the region is expected to have a bad flu season, emergency rooms might not be the best option for care for kids sick with a respiratory illness. If your child has respiratory illness symptoms that are not severe, talk to your child’s pediatrician. Urgent care centers can also help with managing symptoms if your kid is sick outside of regular pediatrician office hours.
To prevent the spread of COVID-19, the flu, and RSV, the St. Louis Metropolitan Pandemic Task Force recommends:
- Staying at home if you or your kids are sick.
- Getting your flu shot.
- Making sure you're up to date on COVID boosters.
- Washing your hands and making sure your kids are practicing good hand hygiene.
- Sanitizing surfaces in your home, especially those that come into contact with respiratory secretions such as kids' toys and books.
- Wearing an N-95 mask if you are at high-risk or are in contact with infants or immunocompromised people.
Beginning November 10, the Missouri Department of Health and Senior Services will offer free drive-through testing for all three respiratory viruses. Grab a test 8 a.m.–4 p.m. Thursdays at the South County Health Center or 8 a.m.–4 p.m. Tuesdays at the John C. Murphy Health Center. You don't need an appointment to take advantage of the testing.
Long-term, there is some hope that future cold and flu seasons might not be so severe. On Tuesday, Pfizer announced results of a trial for an RSV vaccine, which would be given to pregnant people to offer protection from the virus for infants. The vaccine showed 82 percent efficacy against severe RSV for infants' first 90 days of life; through their first six months, that number was 69 percent. Pfizer said that it plans to submit to the Food and Drug Administration for the vaccine's approval by the end of 2022.
Here is some more information from BJC's Children’s Hospital St. Louis on RSV:
What is RSV?
RSV is a viral illness that causes breathing problems. Most children will get RSV by the time they’re 2 years old. Babies born prematurely or babies with heart, lung, or immune conditions are at more risk for severe illness such as pneumonia.
What are symptoms of RSV?
Babies and children who have RSV may have runny noses, fever, cough, loss of appetite, and trouble breathing. RSV in older kids might present with asthma-like symptoms. Your child’s doctor can test the fluid in your kid's nose for the virus.
How does RSV spread?
RSV spreads through droplets from sneezing or coughing. Children can also get RSV by touching surfaces that have been contaminated with the virus and then touching their eyes, nose, or mouth. RSV spreads in daycares and schools, and outbreaks of the virus are more common in the winter and early spring.
What is the treatment for RSV?
There is no antibiotic for RSV. Your child might need extra fluids, supplemental oxygen, bronchodilator medicine, or a tube to help suction mucus from their lungs depending on how severe their illness is. High-risk babies with RSV might need a medication called palivizumab.
