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If it’s not COVID, what is it?
Jan. 10, 2022
Sick woman
Whether it was masking or social distancing, closed businesses or virtual education, we were collectively thrilled to see COVID-19 precautions lift in 2021 as vaccinations increased and case numbers dropped.

Unfortunately, the emergence of the omicron variant has led to a new surge of COVID-19 cases, along with the return of some safety measures. And the time in between may have led to a rise in other respiratory illnesses as well.

“We are definitely seeing an increase in upper respiratory illness,” says Dr. Phil Yphantides, medical director for Sharp Rees-Stealy Urgent Care Centers. “While it was expected that we would see an increase in illness when mask use dropped, it is concerning now that many of these respiratory cases are COVID-19, as well as influenza, rhinovirus and respiratory syncytial virus, known as RSV, which can cause severe disease, such as pneumonia, in infants under 1 year of age.”

The rise of flu and RSV
While COVID-19 is the most common viral infection causing illness severe enough to require hospitalization for those who are not vaccinated, Dr. Yphantides says they are seeing a rash of other respiratory illnesses, including the flu, RSV and the common cold, in their offices and urgent care clinics.

According to the Centers for Disease Control and Prevention (CDC), the circulation of respiratory viruses other than COVID-19 drastically slowed, and flu viruses and RSV circulated at historically low levels during the first year of the pandemic. This was largely due to prevention measures, such as masking, social distancing, reduced travel and isolation.

However, in 2021, influenza and other respiratory virus activity increased later in the year at an unusually rapid pace. This rise in flu and RSV cases — both of which can lead to hospitalization for acutely ill young children, people with compromised immune systems and older adults — paired with the latest COVID-19 surge, is leaving some hospitals concerned that ICUs will once again become overwhelmed. Some are calling the possibility a “surge upon surge.”

Isolation’s effect on the immune system
This raises the question of whether our immune systems may have weakened during the several months we isolated and wore face masks while in public. According to Dr. Yphantides, it’s less likely that COVID prevention measures led to later increases in illness, and more likely that our immune systems were negatively affected in other ways.

“There is no evidence to suggest that avoidance of infections negatively affects the immune system's ability to fight off illness,” he says. “The immune system develops rapidly in early childhood and provides remarkable lifelong protection against most infections. Yet there are known psychological risks of isolation that can negatively impact immune function.”

According to Dr. Yphantides, stress and loneliness have been associated with decreased immune function. So, if social distancing produces significant stress or loneliness, this can adversely affect the immune system.

“Even if isolating from others, it is important to maintain a healthy diet and healthy routines, such as exercising and connecting with others,” he says. “In this digital age, this is fairly easy to do online or in outdoor settings with appropriate distancing.”

Steps to take to prevent illness
Common sense tells us that being among more people in public spaces will lead to increased exposure to germs. To avoid becoming sick with any of the currently spreading viruses, the CDC recommends:

Washing hands often with soap and water or using a hand sanitizer that contains at least 60% alcohol
Avoiding touching the eyes, nose and mouth with unwashed hands
Staying away from people who are sick
Disinfecting frequently touched surfaces, including toys and doorknobs
To avoid catching the flu and COVID-19, Dr. Yphantides reports that current efforts to reduce the spread, especially vaccination, are working. “The best way to prevent influenza and COVID-19 is to get your annual flu shot, a COVID-19 vaccine and your COVID-19 vaccine booster shot when eligible,” he says.

He also encourages everyone — whether vaccinated or unvaccinated — to follow California’s requirement to wear a face mask in indoor public spaces. People should also avoid large crowds, both in indoor and outdoor locations.

How to respond to respiratory illness
So, what should people do if they begin to experience respiratory symptoms, but are unsure whether it’s a common cold, COVID-19 or something in between? Dr. Yphantides recommends they start by reaching out to their doctor.

“With the rapid increase of new COVID-19 cases in San Diego, it is a good idea to contact your physician and get tested for COVID if you develop cold or flu symptoms,” he says. “If you test positive, you should isolate at home to stop the further spread of the virus.”

Dr. Yphantides also advises people to seek immediate medical care if they develop any of the following symptoms after a positive COVID-19 test result:

Trouble breathing
Persistent pain or pressure in the chest
Confusion or altered mental state
Inability to wake up or stay awake
Pale, gray or blue-colored skin, lips or nail beds
Doctors may also test for other illnesses, such as strep throat and the flu, and will treat patients accordingly if their results are positive. If you are diagnosed with any of these illnesses, the CDC recommends you take any prescribed medications and stay home while you have symptoms — and at least 24 hours after your fever is gone — except to get medical care. Your fever is only considered truly gone if it goes down without the use of fever-reducing medication.

If you test negative for COVID-19 or other illnesses and don't require further medical care, you can likely treat any symptoms causing you discomfort at home.

“Rest, stay hydrated, eat a healthy diet with plenty of vegetables and fruit, and give it time,” Dr. Yphantides says. “Most colds run their course within a few days to a couple of weeks. If needed, you may take over-the-counter medications to ease fever, aches, cough or congestion.”