What’s the best way to avoid COVID-19 and other respiratory infections in the days and weeks ahead? An expert shares top tips, including his own personal tactics.
As the respiratory virus season hits its stride this fall, you may see more and more people around you falling victim to a cold or COVID-19 or maybe even RSV or the flu. But that doesn’t mean you’re destined to get sick, too.
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For answers about how to stave off respiratory illnesses during the coming days and weeks, we spoke with Dean Winslow, MD, an infectious-disease specialist and a professor of medicine at Stanford University in California. Here Dr. Winslow answers questions about the season ahead and reveals a few of his own personal tactics for staying healthy.
What is your prediction regarding COVID, flu, and RSV as we move deeper into fall?
Dean Winslow, MD: Overall, I think we’re going to see a lot of cases in the weeks ahead.
Although some COVID numbers have dipped slightly recently [according to the Centers for Disease Control and Prevention (CDC)], anecdotally we’re hearing of people testing positive, and we’re not getting the full picture because most people are self-diagnosing using rapid antigen tests and are not reporting results to any public health department.
So I tend to think there’s a little more COVID out there than the numbers may reflect.
That said, a high proportion of the population has at least some degree of immunity [either through previous infection or vaccination], so we’re not seeing the high numbers of hospitalizations that we did in 2020 and through 2021.
Influenza and RSV are typically more late fall, winter, and early spring diseases. That’s when they tend to generally increase, so my sense is that we’re gonna see a lot higher numbers later in the year.
[The CDC sent out an RSV alert in early September warning of an increase in cases in the Southeastern United States, which could signal the beginning of the 2023–2024 RSV season nationally. CDC tracking of the flu suggests that cases are relatively low currently compared with the numbers typically seen later in fall and winter.]
CDC figures showed that deaths related to COVID-19 rose 8 percent for the week ending September 23. What does that suggest to you?
DW: I suspect these deaths are among the more vulnerable. Older people, people with underlying health conditions, and pregnant women are at higher risk of developing severe disease due to COVID-19, influenza, and other respiratory diseases.
I’m 70 now myself, and we certainly know that our cellular immunity is not nearly as strong when we’re older. So older people and other vulnerable groups may especially need to do more to protect themselves.
[A CDC report released October 6 found that adults 65 and up accounted for almost two thirds of all COVID-19-associated hospitalizations in 2023; of these hospitalized seniors, fewer than a quarter had received the COVID-19 bivalent vaccine.]
What are the best actions people can take to avoid getting sick?
DW: It’s very important that folks receive not only the flu vaccine and the new omicron booster [both recommended by the CDC for everyone ages 6 months and up], but also the new RSV vaccine if they qualify.
[The CDC recommends the RSV vaccine for adults ages 60 and over, and for people who are 32 to 36 weeks pregnant to protect their babies from severe RSV. The health agency also recommends a new RSV treatment called nirsevimab to protect babies and some toddlers from severe RSV].
I know the omicron booster may still be a little hard to get now since the U.S. Food and Drug Administration (FDA) approved these vaccines by Pfizer-BioNTech and Moderna in mid-September.
We don’t even have it yet at our employee health center, so I probably have to go to CVS or one of the other local pharmacies for my shot.
Should people be concerned about getting all these vaccines?
DW: The vaccines have been thoroughly tested for safety and effectiveness. I plan on personally getting the flu shot and the omicron COVID-19 booster at the same time and then will maybe wait a couple of weeks and get the RSV vaccine.
It’s probably safe to get all three at the same time, but because RSV may not peak until later in the fall I plan to spread it out.
Are there additional things you advise people to do to protect themselves?
DW: During this virus season, people may also want to take those extra measures, such as masking or avoiding crowded spaces. I’m still a bit careful about going into real crowded bars or restaurants — most of the time when I’m out to dinner I’m sitting outside and putting on a sweater.
If I’m going for more than just a few minutes in a crowded indoor environment, I will mask — not just for my own protection but because I don’t want to infect others if I get flu, RSV, or COVID-19 and am asymptomatic and shed the virus. It’s basically good citizenship to do that. People working closely with other people may want to mask, too. I wear a mask in patients’ rooms.
What should you do if you start to get symptoms of sickness, such as sniffles and a cough or scratchy throat?
DW: If you’ve got any respiratory symptoms, I recommend testing yourself for COVID.
[As of September 25, every U.S. household can again place an order to receive four more free COVID-19 rapid tests mailed directly to their home.]
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Also, you want to isolate yourself: You are usually most contagious within the first four or five days after onset of symptoms. These viruses spread easily through a cough or sneeze. With any virus, stay home and away from other people to avoid spreading illness. Also, washing hands frequently will help limit the spread.
If your symptoms are severe or you are high-risk, you may want to visit a healthcare professional for a more definite diagnosis and treatment advice. For many, a virus will clear with rest and drinking fluids.
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