Perspectives 5 minute read

Is it COVID, the flu, or RSV? 5 Questions Answered

Dr. Gary Greensweig, Chief Physician Executive for the Physician Enterprise at CommonSpirit Health, addresses some common questions about COVID, flu and RSV.
Dr. Gary Greensweig, Chief Physician Executive for the Physician Enterprise at CommonSpirit Health, addresses some common questions about COVID, flu and RSV.

It is a fact that viruses spread more easily in winter. That’s in part because we spend more time indoors. It’s also around the time we see an increase in cases of the common cold, flu, and RSV. Add to that COVID-19, which is still present in our communities. With so many viruses lingering in the air, knowing the difference between these conditions is essential.

Here, Dr. Gary Greensweig, Chief Physician Executive for the Physician Enterprise at CommonSpirit Health, addresses some common questions and answers to help you understand when to test or seek medical help:

With the symptoms being so similar, how can I tell these viruses apart?
It can be difficult to distinguish symptoms between each of these viruses. In some cases, younger kids and adults may have one or more conditions at the same time. For instance, they could have flu and RSV or flu and COVID-19. Testing babies and adults 75 or older early is essential since treatments are available. For example, when given within the first 48 hours, Tamiflu can assist with the treatment of flu infections in children and adults. There are also therapies available for RSV, but the supply is limited at this time. Patients 12 and older with COVID-19 and at risk for severe disease can take Paxlovid within the first five days of the onset of symptoms. Getting treatment early is important in older adults and babies because their immune systems aren’t as strong or fully developed yet.  

Which should I be most concerned about: flu, RSV, or COVID-19?
All three viruses can lead to complications. This is particularly true for babies under age 1 and older adults with asthma, heart failure, or COPD. Contact your primary care provider or seek medical help immediately if you or a loved one fall into any of these groups and have symptoms of flu, RSV, or COVID-19. 

When should I go to the doctor or the emergency room?
Feeling tired for no reason or being unable to breathe is something to worry about, regardless of the infection. If you or a loved one have difficulty breathing, a common symptom of severe flu, RSV, and COVID-19 infections, you should immediately head to an urgent care center or the ER. If a child with RSV has a high fever, experiences vomiting, or has difficulty eating or drinking, you should seek urgent help. In flu cases, chest pain, persistent vomiting, or sudden dizziness are serious signs and need immediate medical attention. If you or someone with COVID-19 are confused, disoriented, or have discolored lips or hands, it’s time to head to the ER. You can schedule a virtual or in-office visit if the symptoms are milder, like those of the common cold.

Do older adults need a different type of flu vaccine for better protection?
If you’re 65 or older, you should get a high-dose flu vaccine if available. The CDC made this recommendation for the 2022-2023 flu season after reviewing studies that suggest they're more effective for people in this age group. That extra protection is crucial for older adults whose immune systems don’t respond as strongly to vaccines as younger populations. People 65 and older also have an increased risk of complications and hospitalization. Any of the following high-dose vaccines are recommended for adults 65 or older: 

If you haven’t received your annual flu vaccine, now is the time. Talk to your health care provider if you are allergic to eggs or any vaccine ingredients other than eggs. You can find information about vaccine ingredients in the package inserts.

What else can I do to protect myself and my family?
In cases of RSV, keep infants younger than 12 months away from people coughing or sneezing or ask them to wear a mask. Wash your hands often, stay home if you are sick, and cover your coughs and sneezes. Most children and adults are eligible to receive the annual flu shot and the COVID-19 vaccine series. The medical literature discusses how important the newly updated COVID-19 vaccine is to protect both children and adults against severe complications, hospitalization, and death from COVID-19. That’s because the new vaccine works well with the newer COVID-19 variants. Talk to your health care provider if you have questions about the COVID-19 vaccines or the flu shot. It’s never too late to get vaccinated to help prevent complications.

The takeaway: While there are treatment options for RSV, the flu, and COVID-19, not every age group qualifies for them. And in some cases, the medications may be in short supply. Getting the flu and the most recently updated COVID-19 vaccine is the best way to protect yourself and your loved ones. Keep the little ones home when sick, and wear masks indoors as the CDC recommends. 



GRADE: Higher Dose and Adjuvanted Influenza Vaccines for Adults Aged ≥65 Years | CDC

Quadrivalent Influenza Vaccine | CDC

Who Should and Who Should NOT Get a Flu Vaccine | CDC