TRIPLEDEMIC- HERE’S WHY IT’S NOT AS BAD AS IT SOUNDS

COMMENTARY BY DR. MICHAEL MINA, MD, Ph.D.

When I saw that COVID-19, FLU, and RSV numbers were spiking all at once, I was, for the most part, unfazed. This is why when the New York Times coined this collision as a “Tripledemic,” I was largely annoyed. Here’s what’s actually happening and why the phrase “Tripledemic” shouldn’t have you preparing your doomsday bunker.

What is a ‘Tripledemic’?

Plainly, the ‘tripledemic’ is the convergence of COVID-19, influenza (flu), and respiratory syncytial virus (RSV). The term may be new, but this is far from unexpected. In fact, public health officials were preparing for this exact scenario since the early days of the COVID-19 pandemic. However, the fear of what a tripledemic is has masked the vastly more important part of this conversation- how it came to be.

To understand the “how,” we have to imagine a rubber band. When the COVID-19 pandemic started, the collective consciousness was very focused on mitigating the spread - from quarantining, to mask-wearing, to hand washing and sanitizing campaigns, to social distancing, and a public focus on disinfecting high-use surfaces like grocery carts and subway rails. Because of this, other respiratory illnesses like influenza and RSV were kept mostly at bay. However, all of those mitigation efforts add tension to our rubber band, and the longer we have them, the farther we pull that band back. So for nearly three years, we kept up that tension, pulling 10 inches…10 feet…10 yards, and now as we’ve released most of the practices and protocols, we’ve let that rubber band go. Therefore, what we’re seeing now is the widespread effect of a drained community immune system experiencing the respiratory illnesses of this “tripledemic” at high levels. It’s not magic; It’s predictable.
So, our immune systems can’t keep up with COVID-19 variants?

They absolutely can. The variants may stand strong against the immunity and vaccines we’ve developed over the pandemic, but that doesn't mean they’re unstoppable. When viruses, like COVID-19 variants, mutate, they change key pieces of their spike protein to disguise themselves from our antibodies. It’s like trying to open your phone with “Face ID” while covering your nose. The software has difficulty reading your face. This confusion is what our antibodies are facing with the new variants, which ultimately inhibits their ability to fight the variant. But here’s the good news: our bodies have other systems in place to attack the rest of the virus that didn’t change. For example, our T-cells don’t really care about the mutating part of the virus. The antibody recognition relies on the nose, so the software doesn’t recognize the virus protein, but the T-cell utilizes the entire “face” of the virus and thus, works just fine. Additionally, T-cells not only have the capability of killing the entire infected human cell, they also call on other parts of the body to elicit protective responses. Meaning, a massive reduction in infections and fatalities. The downside is, however, that they don’t respond fast enough to stop virus replication- which is key to someone getting COVID-19 then transmitting it. So when you read about transmission numbers going up this season, don’t fret.

But, what do we do now?

Given that we understand what’s happening, we can put in place the right tools to prepare for this possibility and mitigate the impact of this trifecta of acute respiratory illnesses. The main concern is that hospitals could be overwhelmed by a deluge of patients with severe respiratory illnesses. Hospitals and children’s hospitals can plan by stockpiling supplies and identifying capacity for adding additional beds. On an individual level there’s 3 things we can do to empower ourselves in the meantime:

1. Stay informed! The great news is that this isn’t happening in a world where nobody understands what’s going on. We can be proactive. Stay connected with local resources that keep you up to date and predict the infection rates happening in your community. For example, MiamiDadeMatters.org and FloridaHealth.gov update covid-19 and flu infection rates daily, giving both floridians and south floridians more peace of mind. Additionally, emed.com keeps you connected with the major health trends happening nationally.
2. Get to know your body! Be aware of and take seriously any symptoms you’re experiencing. Early intervention is key to lowering the infection rates and decreasing the chance of more severe illness. This is especially important for immunocompromised individuals and other vulnerable populations.
3. Keep home tests on hand. For those times when you do recognize symptoms, having a home test eliminates the “what if” when it comes to those coughs and sneezes. Putting you in line to get treatment faster and back to your everyday routine.

Being empowered means understanding how our bodies work from viruses to sniffles, both for our sake and our communities. I know it isn’t easy to stay calm, but arming yourself with knowledge and being prepared will help you feel more ready to tackle this “tripledemic” and beyond.