Between influenza, SARS-CoV-2 (COVID-19), and Respiratory Syncytial Virus (RSV), doctors face the daunting challenge of keeping themselves – and their patients – healthy. As you know, these viruses spread mainly by droplets made when people cough, sneeze, or talk, which can then land in the mouths or noses of people who are nearby (within 6’) or perhaps be inhaled into the lungs.

Dr. Joseph S. Cervia, HCP’s Senior Medical Director, an infectious diseases physician and Clinical Professor of Medicine and Pediatrics at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, shares the following important points.

Seasonal Influenza (Flu)

Flu leads to an estimated 650,000 deaths worldwide each year, according to the World Health Organization.

• Influenza viruses can be detected in most infected persons beginning one day before symptoms develop and up to 5 – 7 days after becoming ill.
• People with the flu are most contagious in the first 3 – 4 days after their illness begins. However, infants and people with weakened immune systems may be contagious for 7+ days.
• Symptoms typically begin between 1 – 4 days after flu viruses infect a person’s respiratory tract. Thus, an infected person can spread the virus to their close contacts before symptoms begin to manifest themselves.

Coronavirus-19 (COVID-19)

COVID-19 has caused over 6.3 million hospitalizations and 1.1 million deaths in the US since its inception in 2019. An infected person can transmit this virus up to 2 days prior to the appearance of symptoms, as well as while showing symptoms.

• Available data indicate that adults with mild to moderate COVID-19 remain infectious no longer than 10 days after symptoms begin. This estimate has been the same for variants of concern, such as Delta and Omicron. Many adults with severe to critical illness or severe immune suppression may remain infectious for up to 20 days after symptoms begin.
• Evidence shows that fully-vaccinated individuals who become sick with COVID-19 (referred to as ‘breakthrough infections’) can carry comparable amounts of virus as non-vaccinated people.

Respiratory Syncytial Virus (RSV)

RSV causes approximately 60,000 – 160,000 hospitalizations and 6,000 – 10,000 deaths among older adults, according to CDC estimates.

• Adults at the highest risk for severe RSV illness include older adults, and those with chronic heart or lung disease, weakened immune systems, or living in nursing homes or long-term care facilities.
• People infected with RSV are usually contagious for 3 – 8 days and may become contagious a day or two before symptoms appear. However, some infants, and people with weakened immune systems, can continue to spread the virus even after they stop showing symptoms, for as long as 4 weeks.
• Children are often exposed to and infected with this virus outside the home, such as in school or childcare centers. They can then transmit the virus to other members of the family.

Here’s what you can do to protect you, your patients, and your colleagues from getting sick

• Regular, correct use of masks and respirators. NIOSH-approved respirators, (including well-fitting disposable surgical masks and KN95s) offer the highest level of protection. Masks may be particularly helpful in crowded indoor settings, as well as if you have a high risk of getting severely ill from respiratory viral infections.
• Clean your hands. Washing your hands regularly with an alcohol-based hand sanitizer or soap and water is a simple yet effective tool to stop the spread of germs.
• Clean and disinfect. Regular environmental cleaning is a necessity. Lobby areas, cafeterias, and waiting rooms are all high-traffic spaces. Disinfect reusable devices and do not reuse disposable items.
• Practice physical distancing. To limit the spread of germs, encourage physical distancing – particularly in shared spaces. Take advantage of telemedicine and use telehealth appointments for patient care, when appropriate. These strategies substantially decrease the risk of spreading illness.
• Get vaccinated. Encourage everyone in your practice to get vaccinated against flu, COVID-19, and RSV (if eligible) to reduce spread and absenteeism. Recent studies show that flu vaccination reduces the risk of illness between 40-60% among the overall population during the season.
• Ensure HVAC maintenance is up-to-date. Consult with facilities management to ensure the heating, ventilation, and air conditioning, or HVAC, system is working efficiently for proper ventilation in your facility. Consider using high-efficiency particulate air, or HEPA filters in small spaces for an added layer of protection

Vaccine Information

COVID-19 vaccines currently authorized by the U.S. Food and Drug Administration (FDA)

The CDC recommends everyone 6 months and older get an updated COVID-19 vaccine to protect against the potentially serious outcomes of the virus during the fall and winter.

• Pfizer-BioNTech and Moderna COVID-19 vaccines (mRNA vaccines) – updated vaccines became available in September 2023
• Novavax COVID-19 vaccine (a protein subunit vaccine)

RSV vaccines

The CDC Advisory Committee on Immunization Practices recommends use of new vaccines from GSK and Pfizer for people ages 60 years and older, using shared clinical decision-making. This means that these individuals may receive a single dose of the vaccine based on discussions with their healthcare provider about whether an RSV vaccine is right for them.