There are many things to love about fall and winter: colorful leaves, Halloween season, crisp air and cozy sweaters.
But there are scary things about this time of year, too. No, we’re not talking about haunted houses or the inevitable Seattle snowpocalypse: We’re talking about viral illnesses.
How bad will the 2023 virus season be?
The world is full of viruses, but there are some repeat offenders that are more likely to get you sick: the common cold, which can come from any of 200-plus viruses; influenza (flu), which can turn into pneumonia in serious cases; respiratory syncytial virus (RSV), which primarily infects infants and young children but is an equal opportunist; and, of course, COVID-19, which is still hanging around like a bad habit.
While COVID-19 raged over the past few years, particularly during the dominance of delta and omicron variants, other viral illnesses like the flu and common cold fluctuated; at first, they declined, but then they started picking up again. (Others, like RSV, never stopped.)
So, what will this virus season be like?
“We expect that we'll see all three viruses circulating,” said Dr. Helen Chu, a professor of medicine in the Division of Allergy and Infectious Diseases, at the University of Washington School of Medicine in Seattle. “It's unclear which one is going to peak first, but we expect all three of them to peak.”
The Centers for Disease Control and Prevention (CDC) predicts that this year will be another not-fun one, aka that more people will get sick now that we have a third virus in the mix. Before the pandemic, flu and RSV peaked during the fall and winter, but now COVID-19 does, too. (What’s that saying about bad news coming in threes?)
The COVID-19 variant to watch currently is BA.2.86, which has already been found in Washington and several other states, though doesn’t seem to be significantly more infectious than other variants.
How can I differentiate between cold, flu, RSV and COVID-19 symptoms?
The short and unfortunate answer is: You probably can’t.
The flu, RSV, COVID-19 and common colds, despite being caused by different viruses, can all cause these symptoms:
- Sore throat
- Runny, stuffy nose
Additionally, COVID-19 and the flu can cause chills, fatigue, muscle and body aches, headache and, rarely, nausea, vomiting and diarrhea. COVID-19 can also cause the infamous loss of taste and smell plus shortness of breath, though this isn’t as common with newer variants. RSV is linked to ear infections and colds can also cause post-nasal drip, sneezing and watery eyes, masquerading as allergies (and yes, fall allergies are a thing).
Colds tend to develop gradually, while the flu is more likely to come on suddenly. COVID-19 can show up days after you’ve been exposed, giving you the chance to spread it to others before you even know you’re sick.
Should I get a new COVID-19 vaccine?
Updated COVID-19 vaccines are available to and recommended for everyone older than 6 months. It is especially important that young children, pregnant people, people who are immunocompromised, and people who are over age 65 get vaccinated.
Early research is also showing that vaccination may be helpful at lessening symptoms and reducing inflammation for people who were previously infected by the SARS-CoV-2 virus and developed post-COVID-19.
Data from the Washington State Department of Health shows that only a quarter of our population is up to date with their COVID-19 vaccines.
That’s a problem because immunity from the original COVID-19 vaccines decreases over time — plus it doesn’t protect as well against the newer strains of the virus.
COVID-19 took a bit of a break this past summer, but the state has seen infection rates starting to rise again. To best protect against the virus, try to get your shot before November. If you’ve recently had COVID-19, though, you should wait 90 days before getting your shot.
The vaccines are not free anymore for everyone; make sure to check with your insurance company to see if the shots are covered or if you have to pay for them.
Should I get a flu shot or RSV vaccine?
As for flu, this year’s flu vaccines have been updated to reflect experts’ best predictions for which influenza virus strains will circulate widely this fall and winter.
“People can get flu and COVID-19 shots at the same time now,” says Chantal Cayo, chief nursing officer for UW Medicine Primary Care and Population Health. This is different from when the COVID-19 vaccines first came out and doctors recommended not getting another vaccine within the two weeks following.
It’s best to get the flu shot before the end of October, according to the CDC.
Monoclonal antibody vaccines against RSV are now available for infants and toddlers, who are especially at risk for getting seriously ill from the virus.
“The monoclonal antibody vaccine is recommended for every single baby at birth, and for high-risk babies in their second year of life,” says Chu.
RSV vaccines are also available and recommended for people over age 60, and a vaccine is now approved and available for pregnant people. It’s best to talk with your doctor to see if you’re a candidate for the RSV vaccine, as they are primarily recommended for people who are immunocompromised.
Getting all of the recommended vaccines is not only a great way to protect yourself, but also to help prevent another tripledemic — and help prevent COVID-19, RSV and flu cases from overwhelming hospitals and the people who work there.
Show off your bandage of honor.
When should I get tested for COVID-19, flu or RSV?
There are laboratory tests that can be done at hospitals and clinics to see if you have COVID-19, the flu or RSV (of course, there are also at-home COVID-19 tests, and the federal government just made them free to order again).
Infants and people who are immunocompromised or over age 65 should get tested for flu, RSV and if they develop symptoms of respiratory illness because they could get more seriously ill and the treatments that help are best administered early in the infection.
“If you have any symptoms, you should go get tested because we know COVID-19 can manifest in different ways. Don’t assume it’s nothing just because it’s mild,” says Dr. Abir “Abby” Hussein, assistant professor in the UW Division of Allergy & Infectious Diseases and associate medical director of Infection Prevention and Control at UW Medical Center.
Are flu and COVID-19 symptoms different in vaccinated people?
“People who are vaccinated are definitely more likely to experience mild symptoms, something they’d typically write off as nothing,” says Hussein.
This is true for people vaccinated against COVID-19 and the flu. If a vaccinated person gets infected, they may not have symptoms at all.
COVID-19 vaccines are very effective at protecting people from the virus. Research has shown the COVID-19 vaccines greatly reduce the risk of infection and are highly effective in preventing severe illness, hospitalization and death.
The same is true with the flu vaccine: You can still get infected but your symptoms will likely be milder and you’ll be less likely to experience serious complications such as pneumonia.
How can I treat mild cold, flu, RSV or COVID-19 symptoms?
First off, if you feel sick, you should stay home and rest. This will help you heal faster and prevent you from spreading illness to others.
If you have a confirmed but mild case of COVID-19 — or a highly suspected one, such as after being exposed to someone who has it — you need to stay home and stay away from other people for at least five days, per the CDC’s updated recommendations. It’s OK to go to the doctor if you need to, but call ahead, wear a mask and stay physically distant from others.
There are many things you can do at home to treat mild symptoms of a cold, flu, RSV or COVID-19. If you have a headache or fever, take over-the-counter medication like Tylenol. Cough syrups can help with a cough, while nasal sprays can help with nasal congestion.
If your throat is sore, try gargling salt water, drinking warm liquids or sucking on hard candies or throat lozenges. Having a humidifier in the room or taking a hot shower can also help with congestion.
It’s also important to rest as much as possible and drink plenty of fluids. You can also try some home remedies like chicken broth, honey or vitamin C if it makes you feel better (though it’s worth noting that there isn’t much evidence these things speed up recovery, especially with COVID-19).
When should I see a doctor or go to the ER?
One telltale sign that it’s time to see a doctor is if you’re having difficulty breathing.
“If you are not able to walk around or catch your breath, we would want to make sure your oxygen levels are OK,” says Hussein.
If you have a pulse oximeter at home, you can use that to check your oxygen levels if you’re feeling shortness of breath, Hussein adds, and if your reading is below 92% you should contact your doctor.
Extreme fatigue (where you can’t do basic tasks), continued vomiting or diarrhea, or a high fever are also reasons to go in.
“A high fever is a fever over 100.9 and above. Go to urgent care or the emergency department if you have a fever of 101, as that is not a normal temperature,” Cayo explains.
Even if you don’t have any of these symptoms but are still concerned or feel like you aren’t getting better, you should feel free to make an appointment with your primary care provider, Hussein recommends.
The bottom line
No one knows exactly what this virus season will be like, so it’s important to keep yourself protected. Get your COVID-19 vaccine if you haven’t already and get a flu vaccine as well. Doing these things won’t just protect you but will also protect everyone around you.
This article was originally published on October 6, 2021. It has been reviewed and updated with new info.