(The Dallas Examiner) – “We have over 760 million cases worldwide. Sadly, 639 million deaths, and we are just about to approach the 4-year anniversary of the outbreak,” said Dr. Purvi Parikh, allergist, immunologist and a clinical instructor of medicine and pediatrics at the New York University School of Medicine, as he discussed COVID statics during a recent webinar, “COVID, Flu, RSV: How to Stay Healthy this Winter.”
Respiratory viruses are common during the winter months, but there are things you can do to protect yourself and others around you. During the webinar, Parikh discussed symptoms, presentation and treatment for COVID, flu and RSV.
COVID-19
The SARS-CoV-2 virus causes COVID-19 and spreads between people by close contact. COVID-19 vaccines protect against severe illness and death. Although people can still contract COVID after vaccination, they are more likely to have mild or no symptoms. People over 60 and those with existing medical conditions have a higher risk of getting seriously ill.
COVID symptoms include fever and chills, muscle aches, severe fatigue, appetite loss, sore throat or hoarse voice, persistent cough, loss or change in sense or taste or smell, headache, irritated eyes, and dizziness.
“Treatment must be started fairly quickly, within a few days of when symptoms develop, but anytime is better than none.”
To prevent the spread of COVID-19, avoid crowds and keep a safe distance from others, even if they don’t appear to be sick. Wear a properly fitted mask if you feel sick, have been close to people who are sick, are at high risk or in crowded or poorly ventilated areas. Cover your mouth and nose with a bent elbow or tissue when you cough or sneeze. Dispose of used tissues right away and clean your hands; and if you develop symptoms or test positive for COVID-19, self-isolate until you recover.
Parikh discussed the current vaccine recommendations from the Centers for Disease Control. For people aged 5 and older, getting one updated COVID-19 vaccine at least two months after the last dose of any COVID vaccine is recommended. People who are immunocompromised may get additional doses of the updated COVID-19 vaccine, but this should be discussed on an individual basis. Children aged 6 months to 5 years old should get two or three doses depending on which vaccine they received.
“There’s been a lot of controversy and sometimes hesitation with Novavax vaccines, even though I think they’re a very safe and effective option, the nice thing is that there is another option now if you are hesitant. For those who are 12 and up who want another vaccine option, there is Novavax. Or if you’ve had an intolerance of some kind to Pfizer or Moderna, such as an allergic reaction or very severe side effects, there’s now, luckily, other options,” Parikh stated.
Being vaccinated makes patients much less likely to get very sick. Still, some vaccinated people, especially those ages 65 years or older or who have other risk factors for severe disease, may benefit from treatment if they get COVID-19. Common treatments include Nirmatrelvir with Ritonavir (Paxlovid), Remdesivir (Veklury), and Molnupiravir (Lagevrio).
“There are options, so please get in contact with your physician if you do get sick because you don’t have to suffer, especially if you’re high-risk.”
Influenza – Commonly referred to as the flu
The flu is caused by various viruses and is spread by breathing airborne droplets from coughs and sneezes of close contact or touching infected items. Flu vaccines lower the risk of severe complications. Annual flu shots have been encouraged by health experts for years.
People at risk for complications include children aged 12 months or younger, pregnant women, adults over 65, and people who work in facilities with many residents. Flu symptoms include fever and muscle aches, headache, eye pain, dry-persistent cough, shortness of breath, chills and sweats, tiredness and weakness, runny or stuffy nose and sore throat.
“A lot of these symptoms can be very similar, so I’ve been advising people these days, since everybody’s getting sick, to test yourself. If you have an at home COVID test, test yourself. If it’s negative, we can diagnose flu.”
To prevent the flu, avoid crowds and people you know who have the flu, get an annual flu vaccination, and maintain a healthy lifestyle all year.
The CDC recommends that everyone 6 months or older get the updated flu vaccine. For those who are immunocompromised, get the age appropriate IIV4 or RIV4 – LAIV4 should not be used. If you are 65 years or older, you should receive a higher dose or adjuvanted vaccine. If you have an egg allergy, you should get the influenza vaccine.
“There is a big misconception that people with egg allergies can’t get flu shots, that is absolutely false. Even if you have an egg allergy, you can still get the flu vaccine.”
Treatment for influenza includes drinking plenty of fluids to prevent dehydration – water, juice, and warm soups; getting more sleep and changing your activity level to aid your immune system in fighting the infection; and pain relievers to combat fever, headaches, and achiness.
Respiratory Syncytial Virus – RSV
“This is a virus that’s been around for many years, but people are just kind of understanding it this year because now we actually have a vaccine for RSV. But, this virus has just as many cases as flu and COVID, or even more cases right now.”
RSV is caused by the RSV virus and is spread between people by close contact with secretions from those coughing or sneezing. RSV vaccines are available and will protect older people from severe RSV. Those at high risk of RSV include people over 60, infants and young children, and pregnant women.
“It’s very important to know if you’re somebody who’s in a high-risk group because often people thought of this virus as a pediatric thing, but actually, it can be just as dangerous for adults. Many of my colleagues who work in the hospital setting, they are all telling me that their hospitals are getting full with very sick adults with RSV.”
Symptoms of RSV include runny nose, decreased appetite, coughing, sneezing, fever and wheezing.
To prevent RSV, stay home when sick. Cover your coughs and sneezes with a tissue or your shirt sleeve – not your hand. Wash your hands often with soap and water for at least 20 seconds. Avoid touching your face with unwashed hands. Avoid close contact with others such as kissing, shaking hands and sharing cups or eating utensils; and clean frequently touched surfaces such as doorknobs and mobile devices.
There are two approved vaccines for RSV – Arexvy by GSK and Abrysvo by Pfizer. Both have been licensed by the Food and Drug Administration and recommended by CDC for adults ages 60 and older after discussing with your physician.
To manage RSV symptoms, take over-the-counter fever reducers and pain relievers to manage fever and pain; drink enough fluids to prevent dehydration; and talk to your health care provider, especially before giving medications to your child.
Long COVID
Long COVID is broadly defined as signs, symptoms, and conditions that continue or develop after an acute COVID-19 infection. Symptoms that persist one month after a COVID infection are considered long COVID.
“Long COVID still remains an issue, and many people are suffering, even years after infection.”
Long COVID symptoms include post-exertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, changes in sexual desire or capacity, loss of or change in smell or taste, thirst, chronic cough, chest pain and abnormal movements.
The majority of people with post-COVID syndrome are PCR-negative, indicating microbiological recovery. Post-COVID syndrome is the time lag between microbiological recovery and clinical recovery. Most people with long COVID show biochemical and radiological recovery.
Long COVID can affect anyone. Most patients are generally not obese or diabetic, which are risk factors during the acute phase of the disease. However, long COVID has been found to be more common in women than in men.
Doctors have learned that selective serotonin reuptake inhibitors, known as SSRIs, can be effective in treating long COVID. Exercise can also help patients who don’t have exercise-induced fatigue.
There’s currently no test that can determine if someone has long COVID. Also, no blood test is available to determine if SARS-CoV-2 is still active in someone with long COVID.
“There’s no clear one-size-fits-all treatment. So, we’re using all different treatment modalities. Most do get better, but it does take a while.”
What does the future hold?
“We are moving from a pandemic crisis to an endemic health situation.”
Parikh explained that COVID-19, flu and RSV are likely respiratory issues that we will live with every year, and learning to assimilate new preventative measures into our everyday practice and lives is important.
She encouraged vaccination, the practice of social hygiene, staying current on the spread and treatment of seasonal respiratory health conditions and supporting each other.