Dr. Tom Kurt
With family gatherings for the holidays approaching along with the beginning of the ski season, this is the time for respiratory-illness prevention.
The key respiratory viruses, of course, are flu, COVID and RSV. Each of these have updated immunizations available through local pharmacies, personal physicians and local community health centers such as Community Health Services, conveniently located in Pitkin County. These are free through most health insurances, Medicare and Medicaid.
Call or check websites for your coverage and an appointment. The general population is encouraged to receive flu and COVID vaccines, which can be administered at the same time. If an individual has spoken to their physician and would benefit from the RSV vaccine, as of fall 2024 they can receive their RSV, flu and COVID vaccines all at the same time.
While the general population is encouraged to seek seasonal-illness vaccinations, there are individuals who are at higher risk of suffering more severe illness who would specifically benefit from these vaccines. Individuals taking immuno-compromising medication, such as prednisone, and individuals undergoing cancer treatments or who have other complex medical histories, should consult with their physicians regarding vaccination.
Otherwise, individuals who are 65-plus years of age, young children, those who are pregnant and people with chronic heart and respiratory disease are all at particular risk for severe respiratory illness and are highly encouraged to seek vaccination to reduce those risks. As of this fall, the Centers for Disease Control and Prevention also recommends that people 65 years and older and those who are immuno-compromised receive a second dose of the COVID-19 vaccine six months after their first dose.
Acting now is the best way to lower the risk of co-infection with more than one of these viruses (the risk is greatest during the respiratory-illness season). These viruses can lead to hospitalization and more negative outcomes.
Being prepared is another factor: Each household should be stocked with a forehead touch thermometer, oximeter (many wearable fitness devices have this feature) and FDA-approved home-testing kits for viral respiratory illnesses. A recent FDA announcement noted the approval of a test kit for both COVID and flu; it can be purchased over the counter, online or at pharmacies. While CDC no longer mandates a quarantine for those who test positive, keeping N95 masks to wear in an exposed family protects them as well, or protects those not sick in public circumstances where coughing or sneezing is occurring.
If you can reach your physician within 48 hours of diagnosis, early prescriptive treatment with Paxlovid can be helpful in reducing the severity of COVID, as well as Tamiflu for flu (five meds are now available for early onset of flu). In addition, on Oct. 23, the Advisory Committee for Immunization Practice of CDC updated age-group dosing for adults and children for Pneumovax pneumococcal vaccines that markedly reduce pneumonia. This reduces risk of bacterial pneumonias that can otherwise complicate serious cases of COVID or flu.
Special considerations: Those with cancer need to consult with their oncologists; those with autoimmune conditions (such as SLE or systemic lupus, scleroderma or rheumatoid) and those with HIV need to consult with their treating physicians and check the CDC website. Those with adverse effects from the Pfizer or Moderna mRNA COVID vaccines should consider the Novavax recombinant spike protein SARS-Cov-2 Omicron variant vaccine.
While flu, RSV and COVID are the most common viruses during the respiratory-illness season, there are other illnesses which can cause persistent coughs. Adenoviruses, rhinoviruses/enteroviruses, parainfluenza, parvovirus B19, and Legionnaire’s may need consideration. If a cough is emergent, persists longer than a week or is accompanied by more severe symptoms, seek sophisticated diagnostic evaluation with a medical provider.
Remember these 5 keys to protecting respiratory health: Be prepared, get vaccinated, stay home when ill, mask and wash hands when appropriate, and follow safe health care measures if sick.
Tom Kurt M.D. is a member of the Pitkin County Board of Health.
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