If you are a parent with a school-aged child, then you are keenly aware of the sudden increase in respiratory infections.
In a recent interview with Noozhawk’s Giana Magnoli, I shared some thoughts on the early start to cold and flu season, some differences between RSV, COVID and influenza infections, and steps we can all take to stay healthier during this time.
Since so many parents have been reaching out with similar questions, I thought that it would be helpful to publish the interview in a Q&A format.
Noozhawk: What do health providers expect from this fall and winter virus season after two years of below-normal influenza rates? How does this October compare to October 2020 and October 2021 in terms of types of cases you’re seeing?
Dr. Brennan: We seem to be experiencing a very early start to the cold and flu season. I have seen more RSV and Influenza already this October than I recall seeing in October of 2020 and 2021.
Noozhawk: Some areas of the country and state are reporting unusually high numbers of RSV cases in children, resulting in busy pediatric hospitals and widespread school absences. What do health officials think is causing it? Is the Santa Barbara community also experiencing an increase in cases right now?
Dr Brennan: RSV is a virus that pediatricians are very familiar with. For most adults and older children, RSV causes typical common cold symptoms. But for infants, preemies and those with high risk conditions, RSV can create enough mucus and inflammation in the lungs to result in a need for hospitalization to provide things like breathing treatments, deep suctioning, supplemental oxygen, intravenous fluids, and sometimes respiratory support in severe cases.
Some high risk infants may be eligible for a monthly monoclonal antibody treatment called Synagis that can help prevent RSV infection when there is an outbreak.
We are definitely seeing an uptake in RSV infections locally.
Noozhawk: Many people have mild cases when infected with respiratory viruses, but some groups have higher risk of severe illness. Who is at high risk, and what prevention measures are available (vaccines, treatments, public health precautions) for people to protect themselves and others?
Dr. Brennan: This is an excellent point. The same virus may impact people in different ways. For example, a typical elementary school student may have a very mild viral infection that causes minimal runny nose and a mild cough, but if the friend sitting next to him catches the same virus and has a high risk condition such as asthma, the same virus could have a much more significant impact on the high risk friend.
Similarly, a preschooler may go back to preschool prematurely with mild symptoms of RSV, but still be contagious. He may then share RSV with a classmate who then brings it home to a vulnerable newborn sibling. The newborn catching the same RSV infection may have a much tougher time fighting off the infection than an older child.
We do have tools to help minimize the severity and spread of many viruses. We have vaccines for Influenza and COVID down to the age of 6 months. We have antivirals for influenza that can shorten the course of illness for someone who is infected and can also be taken by someone who was exposed to reduce the chances of catching influenza. We have antivirals for COVID.
For RSV, we have a monthly preventive treatment with a monoclonal antibody called Synagis available for certain high risk infants. We also have a lot of experience with public health measures that work, such as staying home when we are sick, enhanced hygiene, improved ventilation, and high quality masks that can be used to reduce the spread of respiratory viruses.
Noozhawk: COVID, flu, RSV and other respiratory viruses have similar symptoms, so how can people determine what they have, what to do, and when to seek medical care for themselves or their children? Is it important to seek out tests to find out which virus someone has?
Dr. Brennan: It is true that COVID, influenza, RSV, rhinovirus and other respiratory viruses can present with very similar symptoms. The good news is that for most people, viral infections will resolve with supportive care, time and rest.
These days we can sometimes test and identify what type of infection a person has. Depending on the situation, this may be important for treatment options and containment of a particular virus. Identification is not necessary in all cases, however.
For COVID, we do have antivirals and treatments that can be used for patients who test positive, and we recommend timelines to isolate to prevent the spread of this virus.
For influenza, we also have antivirals like Tamiflu that can be prescribed to speed up recovery for those who are sick and also for people who were exposed in order to prevent infection.
So for people who have COVID and influenza, there could be a significant benefit in knowing what virus they have. It is not always practical, possible or necessary to identify what virus a person has.
My advice is to reach out to your doctor if you are feeling symptoms and let the physician help sort out testing and treatment options. Telehealth has become a great tool for patients to access their health care provider from home and talk through what symptoms you are feeling, what you were exposed to, and how to proceed with testing and treatment.
Noozhawk: If children are sick and test negative for COVID, should they still be kept home from school/childcare/activities?
Dr. Brennan: This question comes up multiple times every day. We have been so focused on COVID for the last two years that we often forget about other respiratory viruses and how they behave and spread.
It has always been a good idea to stay home until you are feeling better. This is just a kind thing to do to keep your school community, teammates and friends healthy.
Some viruses take longer to resolve than others, and some children may continue to shed certain viruses longer than most of us realize. These are factors that can be taken into consideration when parents are deciding when to send their kids back to school, or when daycares/preschools are setting their return-to-school health policies.
Part of our training as pediatricians includes learning about how certain viruses behave, how they spread, and how long our patients may be contagious to others. Reaching out to your pediatrician for advice could be helpful when deciding when to send your child back to school (or other activities) if your goal is to minimize the spread of illness.
Noozhawk: Anything else people should know?
Dr. Brennan: The last two years of the pandemic have been so difficult, but there are many good lessons we can take away to improve our community health.
Being mindful of when we are sick and taking steps to protect those around us is a kind thing to do. We now know how well measures like good hygiene, handwashing, ventilation, and staying home until we are feeling better can help keep those around us from getting sick.
We also know that high quality masks are can help reduce the spread of germs if you are experiencing symptoms or just want to lower the chances of being exposed if you are in an indoor or classroom setting.
Many viruses can survive on surfaces for hours. When coming home from preschool, a good practice is to wash hands, face, and maybe even change into a clean shirt before interacting with other siblings.
We have many tools for influenza and covid, such as vaccines and antiviral therapies that can reduce the length of infection and spread to others.
Pediatricians are able to help parents identify and manage their child’s infections. We are also available to provide specific advice and guidance if you have a high risk child or are curious about how long your child may be contagious to others.
Telehealth is a great option to have these conversations — most viral infections only require supportive care and we can help you manage your sick child in most situations from the comfort of your own home, so please don’t hesitate to reach out.
Health care workers are exhausted and health systems are strained. Many offices are struggling to have enough staff to keep their practices afloat. Hospitals may not have enough staff to open to full capacity.
We all want to be there for our patients, and the more steps we can all take as individuals to stay healthy (eat well, exercise, get good sleep, stay up to date on vaccines, stay home when we are sick) will help to reduce the burden of illness that we may face during the upcoming cold and flu season.
— Dr. Dan Brennan is a board-certified pediatrician at Sansum Clinic. He can be contacted at 805.563.6211, or click here for more information about Santa Barbara Pediatrics. The opinions expressed are his own.
