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I'm an Infectious Disease Specialist and Here's What to Know About the Winter Surge

Learn what infectious disease specialists think will happen this winter and how you can stay healthy. 
FACT CHECKED BY Emilia Paluszek

Cases of COVID-19 and influenza are starting to rise as predicted by many experts and some city health officials are issuing warnings. Los Angeles is currently experiencing an uptick with COVID and Los Angeles County Public Health Director Barbara Ferrer urged residents to stay safe in a statement. "With recent unusually high levels of flu and other respiratory diseases, there are signs the county could be headed toward a COVID surge this fall and winter…As families are about to start their holiday travel and get-togethers, it continues to be important to follow simple steps to prevent respiratory illness and COVID-19."

Other cities are also expressing a growing concern of a surge and doctors are urging people to take precautions against three different viruses. Dr. Nesochi Okeke-Igbokwe, public health expert and CEO Dr. Nesochi LLC internal medicine practice tells us, "There is concern of a potential "tripledemic" with a triple threat of contagious respiratory viruses (i.e. influenza, COVID-19, RSV) impacting communities this winter season. The flu is highly contagious, and with the arrival of flu season earlier than usual this year, it is critical to protect ourselves as best as possible from the threat of contagious respiratory viruses. Potential co-infection with these viruses may cause quite severe illness."

With three viruses potentially striking at once–COVID, Influenza and RSV, hospitals are preparing for the worst. "If you go around the nation and ask hospitals how busy they are, every single one of them will tell you: They're busy," said Dr. Carlos del Rio, an executive associate dean at the Emory University School of Medicine and Grady Health System in Atlanta, told NBC. Eat This, Not That! Health spoke with infectious disease specialists who explained what to know about this winter and how to stay safe. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.


Count on a Surge for COVID and Influenza

Young sick woman lies tired in bed with a face mask and holds her head because of a headache.

Erica Susky, A certified Infection Control Practitioner, possessing a Masters' Degree in Medical Microbiology and over fifteen years of training and experience in laboratory and clinical settings,

tells us, "Influenza normally surges every winter. The past two years saw a lot of restrictions to prevent the spread of SARS-CoV-2, which spreads the same way as influenza. Naturally, with the pandemic restrictions, cases of influenza decreased. This winter, many places have removed all COVID-19 restrictions that prevented influenza from spreading. Working in the hospital during the pandemic, there were virtually no cases of influenza. This month is different as we are already seeing a few cases of influenza in the hospital and it is yet early in the flu season.

COVID-19 has been coming in periodic waves in responses to the eases on public health restrictions, and has attained a baseline level in the community with the final removal of all pandemic restrictions. However, during the pandemic, waves have been more intense in the winter months as the SARS-CoV-2 virus has even more opportunities for transmission. Opportunities for transmission are facilitated indoors as people may be more crowded and air exchanges are far less than outside."


Influenza Will Be Bad This Season

Sick young woman lying in the bed covered with blanket

Dr. Javeed Siddiqui MD/MPH, Co-Founder and Chief Medical Officer at TeleMed2U says, "The last two years we have barely seen influenza because we were public masking, we were social distancing, we were limiting mass gatherings and we were using good hand sanitizing techniques such as alcohol based gels and hand washing. No majority of the public is doing none of the above we are not masking on a regular basis we have mass gatherings occurring throughout the United States we have schools that are not masking therefore it is a perfect environment for us to see a significant increase in the number of viral influenza cases now and continuing throughout the winter."

Susky adds, "As mentioned prior, pandemic restrictions have not only prevented the spread of SARS-CoV-2, but also the spread of other respiratory viruses like influenza. With no pandemic restrictions or infection prevention methods, influenza and other respiratory viruses can spread more readily. This was seen more recently in Australia, which experienced the largest number of influenza cases in the past 5 years. The Southern hemisphere is often a predictor of what the flu season will be like in the Northern hemisphere."


The Flu Can Be Deadly

Doctor and infected patient in quarantine in hospital, coronavirus concept.

Health officials recommend a flu shot and avoiding the virus if possible because it can be deadly. The Centers for Disease Control and Prevention states, "The CDC estimates that flu has resulted in 9 million – 41 million illnesses, 140,000 – 710,000 hospitalizations and 12,000 – 52,000 deaths annually  between 2010 and 2020.

Susky explains, "Certain risk groups are more at risk for having severe influenza. This is either because of a suppressed immune system, or reduced function of the respiratory tract of which influenza infects. For example, people with cardiac or pulmonary conditions may experience more severe illness as the cardio-pulmonary function is less than maximal, and those with neurologic or neuromuscular conditions are less able to clear out their lungs with a strong cough. In these cases, the virus may move deeper into the respiratory tract to cause pneumonia. The very young and the elderly are more likely to get severe illness because of impaired immune function."

Dr. Siddiqui says, "Influenza has a significant mortality rate, specifically in the elderly, the immunocompromised, pregnant women, and infants and young children. Influenza can result in viral pneumonia, therefore, leading to respiratory failure in addition, any respiratory viral infection can lead to a secondary bacterial infection which again can result not only in traditional pneumonia but, at times, in necrotizing pneumonia. And finally, there can be additional effects of the influenza virus, such as myocarditis which can also have significant morbidity and mortality."


What to Know About RSV and Why It's Concerning

5 months old baby with respiratory syncytial virus, inhaling medication through inhalation mask while looking at with his tired eyes

Dr. Siddiqui tells us, "We are seeing an unprecedented number of cases of RSV among children. The hospitalization rates have been significant in many children's hospitals across the country are at near or full capacity. RSV has the ability to cause viral pneumonia and lead to respiratory failure. In addition, RSV can cause significant morbidity and mortality in the elderly and immuno-compromised adults."

Susky says, "Respiratory syncytial virus (RSV), like SARS-CoV-2 and influenza, are RNA respiratory viruses that spread by coughing, sneezing, talking, and breathing. RSV is a virus that can cause severe illness in at-risk groups; one large group being children under 5 years of age. Not all children are equally at risk, children under 6 months old, premature babies, immunosuppressed children and those with heart, lung and neuromuscular conditions are at an especially large risk of developing a severe infection." 


How to Stay Safe


Susky advises, "The ways to minimize potential transmission and severe illness remain the same measures that have been used throughout the pandemic; get vaccinated (for flu and COVID-19), mask, social distance or be outside whenever possible, and remain away from others if ill. Some measures, such as staying outside, can be a challenge in winter months, but groups can be made smaller to minimize potentially large transmission events. People can opt to wear medical masks to protect themselves and others during gatherings. 

Also, medical masks can be worn when seeing those listed above that may be at risk of acquiring a severe infection from RSV, influenza or COVID-19. Lastly, two measures that have a large benefit and should be prioritized as measures to use this holiday season are to be current with one's vaccines and to not go to gatherings when sick. Frequent hand hygiene is also key."

And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

Heather Newgen
Heather Newgen has two decades of experience reporting and writing about health, fitness, entertainment and travel. Heather currently freelances for several publications. Read more about Heather