Getting vaccinated (photo: Michael Appleton/Mayoral Photography Office)

While COVID-19 has exhausted us, vigilance is critical as RSV and the flu also threaten our health, our loved ones, and our city.

Last year around the holiday season, many of us were gift shopping and preparing to see loved ones when we were alerted to news about the latest COVID-19 variant, the fast-spreading Omicron. We then had to access the latest information about the ever-evolving threat and reassess some of our plans and approach, trying to keep ourselves and our loved ones safe. One year later, we are fighting three battles: COVID-19, respiratory syncytial virus (RSV), and the flu season. All threaten to be the worst in years. However, unlike two years ago, we know how to combat these threats, have tools to do so, and must act before the case counts spiral out of control. 

Exposure to the flu decreased during the COVID-19 pandemic due to social distancing and masking. Most of the related mandates and restrictions are now gone, and people have been gathering more often throughout the holiday season, which can increase the transmission of covid, the flu, and other respiratory diseases. Experts are concerned that those who are not vaccinated and have not naturally been exposed to the flu for a few years could develop more severe symptoms from these illnesses.

Even with the current triple threat, precautions remain the same, and we urge all New Yorkers to take them: get fully vaccinated against COVID-19 and the flu, wash your hands regularly, stay at home if you’re feeling unwell, keep hydrated (especially when feeling unwell), and wear a mask in crowded indoor spaces.

It should come as no surprise that a September Kaiser Family Foundation survey found "that awareness of the updated [covid vaccine] boosters is relatively modest, with about half of adults saying they've heard ‘a lot’ (17%) or ‘some’ (33%) about the new shots.” At the same time, another National Foundation for Infectious Diseases (NFID) survey found that only 49% of U.S. adults planned to get a flu vaccine this season. This statistic is a  drop from last year when the Centers for Disease Control and Prevention estimated that 51% of Americans 6 months and older got the flu vaccine to pre-COVID levels at 48.4%. A world that no longer exists and cannot afford that luxury. 

Despite the rise in infection rates from seasonal illnesses, people tend to put these preventive measures on the backburner. In a 2022 study on public health attitudes, EmblemHealth found that people who generally adhere to public health behaviors – such as wearing a mask, testing, and quarantining, were slated to be much lower in an endemic versus pandemic classification.An endemic being a constant presence in a community differs from a pandemic because the virus is somewhat contained, not spreading out of control, and does not stress the healthcare infrastructure. Therefore we can more easily prevent and treat it.

When asked to describe an endemic to a friend or family member, the study found that the lack of understanding of the term endemic varied among respondents. Based on a general misunderstanding of the word, a majority expressed that they are more likely to reduce participation in preventive behaviors in an endemic, particularly the likelihood of getting a vaccine booster. Meanwhile, respondents also stated they were more likely to keep up and follow additional preventive measures when faced with a pandemic versus an endemic. As our understanding of the COVID-19 virus is constantly changing, we lag in our ability to gain more broad-based public support for vaccinations because we face a bombardment of information and must play our version of Dr. Anthony Fauci at home trying to discern the truth.

Too many have become tuned out. Why? Covid fatigue, information overload, the struggle to transition from a pandemic mindset to an endemic one, and the normal human desire to separate from the trauma and resume an everyday life not dominated by disease fear. Disassociation is how our brains cope with stress. The war in Ukraine, inflation, gun violence, the latest political antics, celebrity scandals, and more can crowd messages that support COVID and flu protection because they are attention-grabbing. 

We know that practicing good hygiene and getting vaccinated is how we get out of this mess. Masking up as public health officials advised in New York City works. Just as if you would not go outside when it's raining without an umbrella, avoid going into crowded public spaces without a mask while several respiratory viruses are running rampant in our area. 

Medical experts are already warning that this year's flu could be brutal and, coupled with a winter surge of covid risks, overwhelm our recovering healthcare system. The flu season began early this year in New York, with nearly 600 cases reported on October 1, 2022. The severity and timing of flu season vary each year. And we are seeing a surge in the 2022-2023 flu season —case numbers have been rising daily as this was written.

Trust us. We understand how exhausting and never-ending this saga seems. As medical professionals, we are not immune to fatigue. Our minds are also hardwired to stimulation and attention-grabbing, distracting headlines. But not keeping vigilance around health and safety protections is an ongoing recipe for disaster, especially during an international public health crisis. There have been plenty of reasons for us to feel anxious and exhausted, and justify people tuning out. But we need to make sure we are up to date on our vaccinations and following common-sense steps to protect ourselves and our loved ones. 

Staying vigilant is key to overcoming the seemingly ever-growing virus list. None of us seek to downplay the severity or impact of COVID-19. We lost too many friends, colleagues, and family members. As a country, we all have a story to tell about it. It wasn't long ago when streets were empty, stores shuttered, and the eerie sound of ambulance sirens filled the air for New Yorkers. Our healthcare workers, EMTs, and first responders still deal with the trauma of facing constant death. Studies have shown that the 2020 lockdown was a traumatic experience for us, with lingering effects to be studied and addressed by mental health specialists worldwide. Our children are still recovering from the backslide of online learning and its negative social-emotional impacts. 

As we reconvene for the holidays and into the new year, our bodies are relearning how to fight off common seasonal illnesses in addition to COVID-19. Let us focus not only on ourselves, but make sure we take steps to protect those around us with steps we know work. We've come too far to backslide now. It requires staying informed and vaccinated. If you or your loved ones are not up to date on your covid vaccines and boosters or your annual flu shot, make the necessary appointments today — you won’t be sorry.

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Dr. Navarra Rodriguez is the Chief Medical Officer at AdvantageCare Physicians (ACPNY), one of the largest primary and specialty care practices in the New York area. Indulekha Warrier is the Vice President and Chief Medical Officer at Connecticare, one of the leading health plans in Connecticut.