The holiday season could collide with the heaviest flu season in more than 13 years. There were more than 7,900 new lab-confirmed flu cases reported by the state as of Nov. 5. That’s more than double the 3,455 cases reported during the same time period in 2009-10, and dwarfs any other year since then.
Pairing a busy flu season with an increase in hospitalized children battling respiratory syncytial virus (RSV) and a possible winter COVID-19 surge could be a "triple threat" that state Health Commissioner Mary T. Bassett has warned New Yorkers about.
But not everyone needs to visit already-crowded and busy doctor’s offices, urgent care centers and hospital emergency rooms.
Newsday asked local health experts about symptoms and treatments to help people sort out when to stay home, when to get tested and when to seek emergency medical care.
Q: Is it important to know whether I am sick with the flu, COVID-19 or other viruses? How can I find out?
A: Knowing whether you have flu or COVID-19 is important for several reasons. It can help with early treatment and prevent further spread of the illness within your family and the community, experts said. Doctors can test for COVID-19 or flu in their offices.
"COVID-19, you always want to know so you are not spreading it within the home and the classroom, so it's important to test for," said Dr. Eve Meltzer Krief of Huntington Village Pediatrics.
Dr. Chid Iloabachie, an associate chair of emergency medicine at Long Island Jewish Valley Stream, said there are specific treatments that target the flu virus and COVID-19, which is caused by the SARS CoV-2 virus. For example, Tamiflu can be prescribed for people with influenza A and B within the first 48 hours of the illness and Paxlovid for those in the early days of a COVID-19 infection.
“We have various treatments that can be initiated right at the time of the first symptoms and can really help decrease the course of the illness or even prevent you from being hospitalized,” Iloabachie said.
In some cases, doctors might decide to take a sample and ask the laboratory to run a viral panel to see if an individual has one of a number of other respiratory viruses, including RSV. But Meltzer Krief pointed out that kind of testing is not usually needed. Most children will only get a cold from RSV and there is no specific medicine to treat it. Those who develop more serious symptoms from RSV - usually babies and young children - can receive special treatments at the hospital.
Q: My child is sick but should I take them to the doctor?
A: Parents might want to start by giving them a home COVID-19 test and contacting their doctor if they have a positive result. Whether or not they need to see a doctor, however, depends on how serious their symptoms are, Meltzer Krief said.
“Parents need to distinguish between an uncomfortable child and a child that’s distressed,” she said.
If they have congestion, are coughing and just generally don’t feel well, they probably don’t need to go to the doctor’s office. But if they have a fever for more than 48 hours, seem lethargic, have difficulty breathing and are not drinking enough fluids, they should be seen by a doctor, she said.
In addition, high fevers, such as 104 degrees, also should be checked by a doctor to make sure the child doesn’t have pneumonia or an ear infection. If they are coughing for a week, children should be seen by a doctor to make sure they don’t have wheezing in their lungs.
“Parents should never hesitate to call their pediatricians with any questions at all,” Meltzer Krief said. “There are no silly questions.”
Q: When should an adult go to the doctor or just stay home and treat symptoms of a cold or virus?
Most healthy adults infected with a virus will experience mild to moderate cold symptoms such as a sore throat, cough and aches.
But some groups of people should be evaluated and tested right away after becoming sick. That includes adults over the age of 65, people with chronic health conditions, including heart disease and diabetes, as well as cancer patients and others with compromised immune systems.
For example, elderly patients who have a fever can become dehydrated, which can lead to serious problems.
“There are a lot of factors that could put you at high risk,” he said. “You should discuss it with your regular doctor. But people who are in high-risk groups should come in for testing as early as possible.”
In addition, anyone with serious symptoms, such as difficulty breathing, problems with cognition, persistent vomiting and diarrhea and fevers that do not subside should immediately seek medical care, Iloabachie said.
Q: Should I still get the COVID-19 booster and the flu shot?
A: Yes. “They can keep you out of the hospital, keep you out of the Intensive Care Unit and off oxygen,” Iloabachie said. “They also decrease the likelihood of long COVID. The real true benefit of the vaccines is preventing getting the worst-case scenario."
Q: How can I protect myself against getting sick this winter?
A: Following basic healthy habits such as eating well, exercising and getting plenty of sleep is important, Iloabachie said. “Paying attention to your physical and emotional needs, I think, is key,” he said.
But you may not be able to avoid illness. “Viruses are a part of our world,” he said. “Getting sick is often inevitable, despite our very best efforts.”
Iloabachie also pointed out that masks are an effective way to keep away from viruses, as well as protecting others from viruses you might be carrying. He suggested that all eligible people receive their annual flu shot and COVID-19 booster, because while they may not prevent someone from getting sick, it will lessen the severity of the illness.