Physicians and public health officials are raising alarms about a “tripledemic” happening as the holiday travel season approaches. Communities around California are susceptible to infection by new COVID-19 variants, the seasonal flu, and the Respiratory Syncytial Virus (RSV).
People who are vulnerable to serious infection, especially those over age 50, are encouraged to get the updated bivalent COVID vaccine and this year’s flu vaccine.
“Young babies, our older patients, and of course people who have complications from things like diabetes or heart disease, or people who have obesity, people who have immuno-compromised symptoms, these people are very vulnerable,” said Dr. Sharon Okonkwo-Holmes a Kaiser Permanente family practice physician during an informational event at the Yvonne B. Burke Senior & Community Center in Los Angeles. “The CDC is really recommending that you get your flu vaccine at the same time as your COVID vaccine.”
The flu vaccine, which changes every year to protect against the flu strains most likely to circulate in the coming season, appears to be “a very good match” according to US Centers for Disease Control and Prevention (CDC) Director Dr. Rochelle Walensky.
However, data shows fewer people are getting vaccinated, including fewer pregnant women, seniors, and children.
RSV is a common respiratory virus that usually causes mild cold-like symptoms. Although it is not dangerous for most people, it can cause serious problems, especially in infants and seniors. No vaccine is currently available for RSV.
COVID-19, flu and RSV share many of the same symptoms, leading to confusion about which course of treatment to take.
The first action people should take if they are not feeling well is to isolate, and do a home test for COVID. An infected person may test negative on the first day of symptoms.
“In early infections, the home test may not pick it up right away, but it will pick it up on day two or day three,” said Okonkwo-Holmes. “Keep your mask on, try and stay in your room… On days one to five, you really do want to avoid exposure with everyone else because you are shedding virus… By day five, you’re considered to be okay. If you're not having fever for two days, go ahead and put your mask on and you can go out into the community, but we're still asking you to keep your mask on until day ten.
People over 50 should strongly consider getting vaccinated for Shingles, a viral skin condition causing blisters and a burning or tingling sensation that can last for weeks.
Shingles and associated inflammation can cause complications, including long term nerve pain, vision loss, and has also been linked to increased risk for stroke and dementia. The two-dose shingles vaccine, Shingrix, is recommended for all people over the age of 50 and people who are 19 and older with a weakened immune system due to disease or medication.
“If you've ever had chickenpox as a kid, when you're 50 you should ask your doctor for your shingles shot,” said Okonkwo-Holmes.
Doctors know that three shots at the same time can be too much for some patients. But due to the urgency of the situation, doctors are recommending getting the flu and COVID vaccine together.
“Right now, we're seeing more COVID, number one, flu, number two, then shingles. So, if you want to put off that third one, then go ahead and put off the shingles one… Get your COVID and flu shots at the same time,” Okonkwo-Holmes said.
Communities of color have been hit especially hard by the pandemic because of “social determinants of health,” like where we live, the types of jobs we have, and our level of the stress hormone cortisol.
“The stress that we endure in America, it has an impact on our cells,” said Okonkwo-Holmes. When society treats you differently, when you are profiled, when the police are following you, when you hear bad news in the media about another person who has been killed who looks like us… It raises our blood pressure; it also raises a [stress] hormone in our bodies called cortisol… It makes us more susceptible to things like diabetes, hypertension, heart disease, [and] stroke… So, I would argue that a lot of the systemic racism and microaggressions in our society are directly impacting our DNA and impacting our health… The racism is making us sick.”
For our communities to stay healthy, we must take action. “For me, action means trying to sleep well, avoiding alcohol, avoiding smoke [including] marijuana, trying my hardest to eat well.”
As for stress, Dr. Okonkwo-Holmes recommends laughter. “Go ahead and laugh out loud and have some enjoyment, go on long walks 30 minutes a day and spend time with people who make you feel good.”
As Black communities continue to navigate the pandemic, it is important to use the tools available to keep us as healthy as we can.
Okonkwo-Holmes believes people should wear masks indoors, even though it is not currently a requirement in many places, we should stay up to date with vaccinations to prevent serious illness and hospitalization, and if a COVID infection is acquired, get one of the available treatments, which most seniors will qualify for and usually tolerate well.
“None of my patients have had severe complications at all from treatments,” said Okonkwo-Holmes. “You don't want to stay really sick. If you don't feel well and you're having difficulty breathing. You want to get to the hospital right away or call 911.”