Flu, RSV and COVID-19: Advice From Family Doctors on How to Get Through This Winter’s “Tripledemic”


Over the past month, clinics have seen a surge of sick children presenting with RSV, the flu and other viruses. Photo: FamVeld/Getty Images

As community-based family doctors, we have been attending to patients who showed the early warning signs of the oncoming wave of our viral season. We are now in the middle of that wave: a “tripledemic” of RSV, influenza and COVID-19.

While much of the news coverage of this viral surge has focused on overcrowded emergency rooms and intensive care units, family physicians are an important front line of protection against serious illness.

We should remember that this wave of viruses hits us every year around this time, even though this appears to be a particularly bad wave of RSV and the flu. We don’t yet know for sure why this wave is so much worse than recent years.


Observations by Family Doctors


Family doctors have learned important lessons through the COVID-19 pandemic that we need to apply during the current viral season.

First, the vast majority of viral infections will be mild to moderate in severity and can be managed by a family physician in an outpatient setting. Most children do not need to visit emergency rooms to seek care for viral infections.

Over the past month, our clinics have seen a surge of sick children presenting with RSV, the flu and other viruses. It has become more common to see fevers lasting longer than five days, ongoing coughs and superimposed lung and ear infections that require treatment.

In most cases, these conditions can be managed by a family physician. In a small number of cases, we reach out to our pediatric emergency colleagues to let them know a child is on their way for assessment and further management.

Second, patients should continue to seek medical care from a family doctor if they have a health concern, despite the presence of new or returning viruses. Throughout the pandemic, we have seen countless numbers of patients who delayed seeking care for serious health problems. These patients missed crucial time needed to diagnose and treat their conditions in a timely manner.

Patients should continue to see their family doctors to seek advice or treatment for a health condition, including guidance on concerning viral symptoms.

Third, we are also observing the ongoing and significant harm caused to children and young people by prolonged periods of social isolation. We are also seeing the impact of excessive screen time and social media on many of our young patients.

Accepting or imposing repeated limitations on social contact has consequences in the form of depression and anxiety. While some vulnerable people may try to avoid crowd settings during the viral season, many of our patients — especially younger ones — need to continue to find safe ways to expand and deepen their social contact with others, rather than limit it further.

Finally, vaccination is an excellent protective measure against severe illness. And masks can help to limit transmission. COVID-19 booster shots are widely available and recommended for those over five years old. Those over 12 years old can receive the bivalent booster, which offers more protection against the omicron variant.

The flu vaccine can be given at the same time. It is strongly recommended for children ages six months and older. Masking indoors has now been recommended by the Chief Medical Officer of Health for Ontario, to help reduce transmission for those that are symptomatic and to protect those who are vulnerable to serious illness as a result of contracting RSV, the flu or COVID-19.


Supporting Through the Next Wave


As we all push through another wave of illness, along with the pressures imposed on families, education systems and the healthcare sector, we can draw on the insights that family doctors have gained from the COVID-19 pandemic.

We can be mindful of our responsibility to protect our most vulnerable by getting vaccinated, staying at home when we aren’t feeling well, and making responsible use of our medical system.

Family doctors are there to support our patients’ health, attend to chronic disease management and provide advice and direction — especially in the case of viral infections. We are there to help our patients get through this viral wave and onto the other side.The Conversation

Lita Cameron, Family Physician, Assistant Clinical Professor (Adjunct), Department of Family Medicine, McMaster University and Skylar Neblett, Family Physician, Assistant Clinical Professor (Adjunct), Department of Family Medicine, McMaster University