Experts Advise Handwashing to Curb RSV, Flu, and COVID ‘Tripledemic’

A Texas mom exemplifies the helplessness felt by many parents as the nation’s pediatric wards fill with young children afflicted by respiratory illnesses.

After her 5-week-old daughter Lily experienced three days of supplemental oxygen at Texas Children’s Hospital in Houston, Rebecca Lara told ABC News’ Whit Johnson that she felt “helpless. You don’t really know how to help them.” (Kindelan & Pezenik, 2020)

An unprecedented “tripledemic” of respiratory syncytial virus (RSV), flu and COVID is pushing pediatric bed occupancy to the limit in many hospitals. Experts advise children, their parents and health care workers in these settings to practice good handwashing, stay home when sick, get the flu and COVID vaccines, and consider wearing masks in crowded, indoor situations.

There is no vaccine to protect against RSV infection, but a medication called palivizumab, given as a shot to children considered at high risk of developing serious complications, can prevent severe RSV illness, according to Yale Medicine (2022).

Children – especially those who are unvaccinated – are more vulnerable

A particularly contagious virus, RSV can spread through coughing or sneezing or from direct contact with the virus. This direct contact includes kissing a child or adult infected with RSV or touching surfaces having the virus on them, and then touching one’s eyes, nose or mouth before handwashing, according to the CDC (Nov. 1, 2022). RSV is especially dangerous, even life-threatening, to children age 5 and younger (CDC, Oct. 28, 2022) and adults 65 and older and adults with chronic medical conditions (CDC, Oct. 28, 2022)

After two years of COVID precautions, children are more vulnerable now to the flu, RSV, and other respiratory viruses, such as parainfluenza virus, adenovirus, rhinovirus and enterovirus. “What we lacked is a couple of years of little kids developing the immunity that’s needed to keep these colds at bay,” said Dr. Buddy Creech, a pediatric infectious disease expert at the Vanderbilt University Medical Center, in a NBC News report (Edwards, 2022).

Lynnette Brammer, team lead of the Domestic Influenza Surveillance Team at the Centers for Disease Control and Prevention (CDC), wrote in an email to NBC News that “reduced population immunity to circulating respiratory illnesses, particularly among young children who may never have had exposure or been vaccinated, could bring about a robust return of flu and other respiratory viruses, like RSV.”

How to stop the spread

With the triple threat of COVID, flu and RSV expected to rage through the fall and winter, practicing good hand hygiene is especially important for children and those around them, including health care workers in pediatric settings. According to Yale Medicine, you should wash and scrub your hands with water and soap regularly, especially before and after holding infants, which are especially vulnerable to RSV due to the amount of mucus that forms in their tiny nasal passages and airways.

“This (mucus) can create difficulty in their breathing, and sometimes their noses are so congested they have trouble breathing through their noses,” said Magna Dias, a Yale Medicine pediatric hospitalist. “Of course, they are going to choose to breathe (through the mouth) over eating, and that can lead to dehydration and needing IV fluids.”

Learning to live with and manage infection risk

People and organizations routinely take precautions they couldn’t have conceived of prior to the COVID pandemic. That’s true for individuals who get vaccinated, wear masks and practice physical distancing, as well as for organizations committed to improving hand hygiene and reducing infections.

As the tripledemic progresses through the fall and winter, we can apply our knowledge of infection prevention and control and get through it together.

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