As a “Tripledemic” Takes Hold, Authorities Recommend Indoor Masking

As a “Tripledemic” Takes Hold, Authorities Recommend Indoor Masking

woman wearing mask outside amid tripledemic of covid, rsv, and flu

Some local officials are urging indoor masking as the country faces a brutal holiday season of COVID, the flu, and respiratory syncytial virus (RSV). Dubbed a “tripledemic” or “tridemic,” these three infections are causing a surge in illness, overwhelming some hospitals, and affecting millions of Americans.

“Hospitalizations for flu continue to be the highest we have seen at this time of year in a decade,” CDC director Rochelle Walensky, MD, MPH, said in a recent briefing, per Reuters. Over 25,000 people were hospitalized last week with the flu alone, according to the CDC.

Meanwhile, the Children’s Hospital Association and the American Academy of Pediatrics called on the federal government in a Nov. 14 letter to declare a state of emergency to address the “alarmingly high rates of RSV and other respiratory illnesses” amid workforce shortages. And as of Dec. 7, The New York Times reports that COVID cases and hospitalizations are up more than 25 percent in the last two weeks, with positive tests on the rise.

“COVID cases, flu cases, and RSV cases are all starting to tick up,” confirms Dean Winslow, MD, an infectious-disease doctor at Stanford. In response, public health officials in Washington, Oregon, New York, and Los Angeles are urging residents to wear masks indoors.

“The combination of surging flu, RSV and COVID-19 cases is pushing hospitals past their current ICU bed capacity, which never happened during the darkest days of the COVID-19 pandemic in Oregon,” health officer and state epidemiologist at Oregon Health Authority Dean Sidelinger, MD, said in a press briefing on Dec. 8.

Then, on Dec. 9, a group of over two dozen health officers and health care leaders in Washington released a joint letter, “recommend[ing] that everyone wear a high-quality, well-fitting mask when around others in indoor spaces to protect against both acquiring and spreading these infections to others,” in addition to staying up-to-date on vaccinations. What does this mean for you? Here’s what you should know about the tridemic and how to stay safe.

What to Know About the Tridemic

Dr. Winslow says a tridemic of COVID-19, the flu, and RSV is not a major surprise to the medical community. “Wintertime in the Northern Hemisphere is when we see a larger rate of respiratory infections,” he tells POPSUGAR. “You’re indoors more, and with viruses that are spread by small-particle aerosols and droplets, you’re more likely to be exposed in an indoor environment.” Relaxed travel restrictions, decreased mask-wearing, and low rates of vaccination for the flu and COVID-19 (particularly the bivalent booster) are also playing a role in the increased spread of these illnesses, he adds. RSV, in particular, is very common — nearly all children get an RSV infection by their second birthday, according to the CDC — but may be surging right now as young, pandemic-born children go into restriction-free areas and are exposed for the first time, experts told CNN.

It’s worth noting that you’re unlikely to contract more than one of these viruses at the same time, Dr. Winslow says, because your body’s immune response from fighting off one of them should provide some “very short-term” protection from the others. That’s at least some good news, because coming down with just one of these viruses is taxing enough. RSV can lead to more severe conditions like bronchiolitis, an infection of the small airways in the lung, which is especially dangerous for small and premature infants. Immunocompromised adults are also at greater risk of experiencing RSV complications and more serious cases of COVID-19 and the flu. And from a broader perspective, the overlapping surges of COVID, the flu, and RSV have the potential to overwhelm healthcare services that are already under strain.

How to Protect Yourself During a Tridemic

Getting vaccinated against COVID-19 (including boosters) and the flu is the number one way to stay safe during a potential tridemic, Dr. Winslow says. With the holiday season comes lots of travel, parties, and indoor time, so it’s important to make your vaccine appointments ASAP. “Now’s the time to get the two vaccines that are available that will help protect against serious illness and hospitalization and death,” Dr. Winslow says. (There is no RSV vaccine currently available, although one is in development.)

For large gatherings, keep in mind “the more people one is exposed to, the more chance there is for respiratory virus transmission to occur,” infectious-disease expert Amesh Adalja, MD, senior scholar at the Johns Hopkins University, says. Each event also has its own dynamics (e.g., the ventilation, the vaccination status, etc.) that affect the risk for attendees, Dr. Adalja adds.

It’s important to “encourage people to stay home when sick, wash hands frequently, and if [you’re at] high risk for severe disease, wear a mask in congregated indoor settings,” Dr. Adalja says. “For extremely high-risk individuals, they can ask people to test for COVID pre-event.”

It’s also a good idea to dine and socialize outdoors when possible. “A lot of us in infectious diseases are still personally being very careful,” Dr. Winslow says. “Those are just small, prudent steps that you can take to additionally protect yourselves and protect others.”

For any social gatherings — or any situation where you’ll be around other people — masking is one of the most important preventative measures to keep you and others safe from infection. Dr. Walensky is encouraging masking, especially for those who live in areas with high rates of COVID. You can check your community levels and the CDC’s specific guidelines for your area using their tracking page.

If you’re not feeling well, make sure to take a COVID-19 test or a flu test (available at most pharmacies) and to stay away from others to avoid further transmission. While some cases of COVID-19, RSV (especially in adults), and the flu can be managed at home, Dr. Winslow recommends going to a doctor if you’re experiencing a persistent high fever or shortness of breath, which are concerning symptoms experienced across all three illnesses.

For COVID-19, other signs to see a doctor include persistent pain or pressure in your chest, confusion, inability to wake up or stay awake, and discolored (bluish) skin, lips, or nail beds, according to the CDC. For the flu, see a doctor if you’re experiencing faintness, a severe sore throat, or a cough with lots of green or yellow mucus, according to UCSF Health. For RSV, the Mayo Clinic notes that warning signs to go to the doctor include bluish and discolored skin, lips, or nail beds in addition to high fever and difficulty breathing.

— Additional reporting by Alexis Jones and Sara Youngblood Gregory