Covid, influenza and respiratory syncytial virus (RSV) are causing a nationwide wave of respiratory disease.
About 76% of hospital beds in the United States are full, according to data from the Department of Health and Human Services. Pediatric beds are at a similar level, although six states have 90% or more of their pediatric beds full, according to an NBC News analysis of HHS data.
Covid, influenza and RSV can be difficult to tell apart, as they share many common symptoms. But it helps to know which virus you have, as it determines what treatments you need to receive and how long you need to self-isolate.
Certain characteristics – either symptoms or disease progression – can help differentiate each virus. Here are five factors to consider.
Some symptoms are unique to particular viruses
A runny nose, cough, congestion, or sore throat can occur from any of the three viruses or from a cold. But a loss of taste and smell is more often associated with Covid than with the flu or RSV. And wheezing is often a telltale sign of a serious RSV infection, which is usually found in children or older adults.
The only way to know for sure, however, is to get tested.
“I don’t think anyone would ever say, ‘Hey listen, I think you have a virus based on your symptoms,’ and be confident in saying what virus it is,” Dr Frank said. Esper, specialist in pediatric infectious diseases. at the Cleveland Clinic.
Do the symptoms appear gradually or suddenly?
Flu symptoms tend to develop more suddenly than those of Covid or RSV.
“Influenza classically manifests as a sudden fever that comes on quite quickly. This contrasts somewhat with RSV and Covid, where we think of a slow escalation of symptoms,” said Yale infectious disease specialist Dr. Scott Roberts. Medical.
How long has it been since the exposure?
Diseases have different incubation periods – the time between exposure and symptoms. On average, flu symptoms tend to develop two days after exposure to the virus, while RSV symptoms tend to take around four to six days to appear, and the typical incubation period for Covid is three four days for the omicron variant.
“If I go to a party and have symptoms the next day, it’s probably the flu because it can be as short as 24 hours of incubation,” Roberts said.
Age makes a big difference in the symptoms and severity of a disease
RSV is unlikely to make a healthy adult very sick, while Covid and flu certainly can.
“Generally, if you’re a healthy young adult or you’re not in an extreme age bracket and you get a fairly severe disease, it’s probably not RSV,” Roberts said.
The groups most vulnerable to serious RSV infections are babies, children with lung disease, adults 65 and older, and people with weakened immune systems.
Symptoms may also be different depending on your age and immune status. Many children encounter respiratory viruses for the first time this year as they return to regular school and socializing, so their bodies may find it harder to clear the infection, which can lead to symptoms. more extensive.
According to Esper, almost a quarter of children have gastrointestinal symptoms (such as diarrhea, stomach pain or vomiting) due to viral infections. It’s less common in adults with seasonal flu or RSV.
People with weakened immune systems, meanwhile, are more likely to develop severe symptoms or pneumonia from one of the three viruses.
Consider which virus is circulating the most in your community
Disease experts predict Covid cases will spike over the holidays as more people travel and congregate indoors. Average daily cases reported to the Centers for Disease Control and Prevention have already increased nearly 11% in the past two weeks, according to the NBC News tally.
But determining local levels of Covid transmission is difficult because many people use home tests. RSV and influenza tests, on the other hand, are done in a doctor’s office or ordered by prescription.
RSV infections appear to have passed their national peak. Although the CDC does not keep a national tally of RSV cases, the number of positive weekly tests fell from more than 17,000 in the week ending Nov. 5 to around 9,000 in the week ending Saturday. .
In contrast, flu cases are skyrocketing. The national share of flu tests that came back positive rose from around 8% in the week ending October 30 to almost 15% in the week ending November 13. Flu hospitalizations are the highest they have been at this time of year in more than a decade.
Esper said he expects the Cleveland clinic to be “swimming in the flu” in two weeks.
However, the picture varies by region. In the Northeast, Roberts said, “we’ve seen RSV go up over the last one to two months and it’s actually plateaued – which is great news – and then the flu, it’s just these last few weeks that we are seeing an exponential increase.”
“The southeastern United States – Georgia, Alabama, Mississippi – they saw a bit of the opposite. First they saw an upsurge in the flu, then now you see RSV starting to catch up,” he added.
Treatments and vaccines available
Unlike Covid and the flu, there are no universally prescribed vaccines or treatments for RSV.
“RSV scares me the most, probably, because there’s nothing you can do about it and so many young kids haven’t seen it. We’re really seeing record increases in our pediatric hospitals,” Roberts said.
However, to reduce the duration of flu symptoms, doctors usually prescribe Tamiflu or one of three other approved treatments. For some people with Covid, doctors may prescribe Paxlovid.
Dr. Ashish Jha, the White House’s Covid-19 response coordinator, highlighted the benefits of getting a flu shot and Covid boosters.
“At this time when we have a lot of flu, still have a decent amount of RSV, still have a good amount of Covid, the most important thing people need to do is go and get their shots,” Jha said during of a briefing on Tuesday. “It prevents you from going to the hospital.”