By November, it’s in full force already in most places. Coughing. Sneezing. Sniffling. Fever. Aches and chills. Respiratory virus season is here, and the risk of respiratory syncytial virus (RSV), influenza, and COVID-19 spreading is real. As many as 170,000 older adults in the United States are hospitalized due to RSV infection annually. In recent years, seasonal flu has been related to about 50%–70% of hospitalizations and an estimated 70%–85% of deaths among people 65 years and older in the United States. And although the impact of the pandemic has been drastically reduced in recent years, those over age 75 infected with COVID-19 are still about 9 times as likely to die when compared with those ages 18–39 years. 

All of these viruses can be significantly threatening for long-term care residents, particularly those with multiple comorbidities and weakened immune systems. 

Because RSV, flu, and COVID-19 share some similar symptoms and characteristics, it is important for staff to understand what makes each virus unique, to ensure prompt and accurate diagnosis and effective management. 

It can be challenging, as these viruses are similar in several ways:

• They share some common signs/symptoms, including coughing and fever.
• All viruses can be detected through molecular and antigen testing.
• Symptoms appear within a few days: 4–6 days for RSV, 1–4 for the flu, and 2–5 for COVID-19. However, it’s important to note that symptom onset of COVID-19 may take up to 14 days. 
• They are spread via airborne virus droplets and/or contact with a contaminated surface.
• Vaccines are available for all three. 

However, there are subtle differences in symptomatology. While all three viruses affect the respiratory system, people with RSV may exhibit wheezing and runny nose, while those with COVID-19 may experience shortness of breath or difficulty breathing, congestion, loss of taste or smell, or runny nose. The flu may present with a runny or stuffy nose. Discomfort – such as muscle/body aches or headache — is common with COVID and the flu, but not generally RSV. 

Certain populations present a greater risk, and although symptom management is often the primary treatment, it is important that care providers understand which residents may be the most vulnerable, as well as what to watch for.

Training staff on the differentiation and management of the major respiratory viruses threatening LTC residents can contribute to better outcomes and fewer hospitalizations.

For a comprehensive guide to Differential Diagnosis & Management of Major Respiratory Viruses in Long-Term Care, download our free Tip Sheet here.