With COVID-19, flu and RSV in Delaware, here's when to go to the ER

Three respiratory illnesses are affecting Delawareans right now − COVID-19, flu, and the respiratory syncytial virus or RSV − and state officials are concerned the combination could impact an “already strained hospital system” in the state.

For the week of Oct. 16 through Oct. 22, the state Division of Public Health reported 44 laboratory-confirmed cases of the flu, compared to 19 cases the week before. Since the season started on Oct. 2, the state has seen a total of 69 flu cases.

For the same week, there were 98 cases of RSV, for a season total of 250, according to DPH.

While public health officials and hospitals like Nemours Children’s Health said that RSV is a well-known virus among children under the age of two, it has arrived earlier this year, and more children who have not been infected in the past couple years − due to pandemic restrictions and mask mandates − may be at risk.

Since these illnesses can all affect the respiratory system, the state’s Division of Public Health provided information on how to distinguish between the three, and how to know when to visit the emergency department − advice that is especially key as emergency departments experience long wait times.

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Is it the flu or COVID-19?

The flu and COVID-19 have many similar symptoms, according to DPH, including:

Fever or feeling feverish/chills
Cough
Shortness of breath or difficulty breathing
Fatigue (tiredness)
Sore throat
Runny or stuffy nose
Muscle pain or body aches
Headaches

Because these symptoms can overlap, public health officials said the best thing people can do is call their health care provider to see if they should get tested for COVID-19 or come in for a visit.

Even if someone takes a home COVID-19 test and it’s negative, DPH asks people to consider re-testing in two days or consult their provider to see if they need a flu test.

It is also wise to stick to the recommendations that persisted throughout the pandemic: If you feel sick, try to stay home and mask up if you need to be around other people. While there is no vaccine for RSV, the state agency also recommends people stay up to date with COVID-19 vaccines, boosters and flu shots.

What are the symptoms of RSV?

People usually show symptoms for respiratory syncytial virus, or RSV, within four to six days of being infected, according to the Centers for Disease Control and Prevention.

Those first symptoms usually look like mild, cold-like symptoms, and many people will only experience these less severe symptoms, according to public health officials. Here are a list of symptoms from Nemours Children’s Health:

runny nose and sneezing
cough
fever
wheezing and trouble breathing
decrease in appetite

For infants, these symptoms can include fussiness and poor feeding.

After these initial symptoms, the illness can progress to more severe symptoms like fast or short breathing or wheezing, according to DPH. In infants and young children, RSV may lead to grunting noises when breathing, chest caving in during breathing and skin turning purple or blue due to lack of oxygen.

While people of any age can develop RSV, it is most common in children under two years old and can be severe, especially for infants and older adults. Nemours points out that RSV is the most common cause of bronchiolitis and pneumonia among children less than a year old.

Most people will recover in one to two weeks, according to state public health officials.

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When to visit the emergency department

People throughout the health care industry often emphasize the importance of not burdening already strained emergency departments with symptoms or concerns that can be treated elsewhere.

This is especially true amid the continued spread of COVID-19 and seasonal viruses like influenza and RSV.

Here are some symptoms that the state public health officials said may warrant a visit to the emergency department:

Trouble breathing or wheezing that is not well-controlled by asthma medications
Unusual sleepiness or confusion
A stiff neck and a fever
A cut that won’t stop bleeding
A broken bone
Tightness in the chest or pain
Elevated blood pressure with other symptoms, such as chest pain or severe headache
Drug overdose
A head injury with vomiting, sleepiness, fainting or seizure
An eye injury
A serious burn
At risk of harming themselves or others

When NOT to visit the emergency department

Here is a list of health concerns that would not require a visit to the emergency department, according to DPH:

Need a COVID-19 test
Don’t feel well but can manage symptoms with over-the-counter medications
Elevated blood pressure without other symptoms
Runny nose/cough without trouble breathing
Fever with mild symptoms
Muscle soreness or backaches
Minor cuts or scrapes
Nausea or diarrhea without abdominal pain

Emily Lytle covers Sussex County from the inland towns to the beaches, with a focus on health-related issues. Got a story she should tell? Contact her at elytle@delmarvanow.com or 302-332-0370. Follow her on Twitter at @emily3lytle.

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With COVID-19, flu and RSV in Delaware, here’s when to go to the ER

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