California and many parts of the US are experiencing a “tripledemic” with flu, SARS-CoV-2, and respiratory syncytial virus (RSV) filling hospital beds. The Centers for Disease Control and Prevention (CDC) issued a recent health alert about early, elevated respiratory disease incidence caused by these viruses. The California Department of Public Health offers the following advice to protect your patients and prevent stress on health care systems this winter.

Influenza

It’s already a busy influenza season with high activity reported in California. Hospitalization rates for influenza haven’t been this high this early in the season since the 2009 H1N1 flu pandemic, according to the CDC. So far, there have been an estimated 1,300 flu deaths in the U.S., including at least 30 children. Circulating strains appear to match those in the influenza vaccine this year. With the holiday season underway, now is a great time to make sure all of your patients 6 months of age and older have received their annual flu shot. Ensure that children 8 years and younger receive 2 doses if they haven’t received flu vaccine before. 

SARS-CoV-2

Vaccination against COVID-19 lowers the risk of severe COVID-19. A modeling study suggests that tens of thousands of deaths and hundreds of thousands of infections have been prevented by the 85 million doses of COVID-19 vaccine administered in California. Help make sure your patients maintain optimal protection by staying up to date on their COVID-19 boosters. Vaccination, including updated bivalent booster doses, is recommended for individuals 6 months and older. Learn more by viewing the COVID-19 Vaccine Eligibility Chart.

Once an individual is diagnosed with COVID-19, early proven treatments can prevent serious illness, hospitalization and death from COVID-19 by up to 88%. There is an ample supply of COVID-19 therapeutic agents, but they have been underused – especially among populations disproportionately impacted by COVID-19, including communities of color, low-income communities, and residents of long-term care facilities.

Higher risk patients that can benefit from prompt treatment for COVID-19 include anyone older than age 50 years or who has common health conditions and behaviors such as physical inactivity, obesity, depression, smoking (former or present), and disabilities (a more comprehensive list can be found here: Underlying Medical Conditions Associated with Higher Risk for Severe COVID-19: Information for Healthcare Professionals | CDC)

Several decision-making guides for navigating COVID-19 treatment are available. Providers should evaluate all patients aged 12 years and older who weigh more than 40 kg and who are seeking care within 5-7 days of symptom onset. The decision to withhold COVID-19 treatment should be restricted to limited situations in which the risk of an adverse event clearly outweighs the benefits of preventing hospitalization, death, and potentially, long COVID.

Respiratory Syncytial Virus (RSV)

Pediatric hospitalization rates from RSV have been at a five-year high. To learn more, see the recent webinar – RSV Surge and Prevention Strategies hosted by the California Immunization Coalition and the American Academy of Pediatrics – California Chapters. The recorded webinar discusses the current RSV surge, how to counsel families, and maternal immunization and monoclonal antibody prevention strategies.