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I work at a very small pediatric office in Alaska. This past week we have been inundated with sick kids, most all of them testing positive for RSV. I want to know if RSV is transmitted on surfaces. When Covid first started and no one was giving us correct information about how it spreads (even though they knew)there was a lot of hints that it spread on surfaces and we were wiping down everything. In the beginning we would see one family at a time and when they left I would wipe down and sanitize every surface I could. When it became clear that it was transmitted mostly through the air all that cleaning mostly went away. I’m wondering if I should start sanitizing everything again to prevent the spread of RSV in our office. I’m so overwhelmed with regular work, Covid vaccine stuff, and phone calls about sick kids, but I am more worried than ever about someone getting sick just coming into our office. it should be a safe place not a place where you get sick when you come in for a routine check up or something else not related to a respiratory virus. I am not a nurse or a trained professional, but I’ve been working for my boss for 14 years and have a lot of on the job experience.

I feel isolated most of the time as I really haven’t changed my routine since the pandemic started. I still wear a mask everywhere (even though most people don’t anymore). I don’t go to the movie theater, bars. or restaurants. I really only have one contact that I do not wear a mask around. I really want to connect with people like me if there are any to share experiences and gain knowledge.  Any help or advice would be very appreciated. 

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My wife and I continue to wear masks indoors (except at home) and when around many people outdoors (e.g., farmers market). We, too, are passing on indoor dining, theaters (movie or live), concerts, etc. The isolation has been bothering my wife more than me, but I do feel it at times, too. Living in California, we have the advantage of being able to do outdoor activities pretty much year-round, and that's helped. And some of our social activities have moved online, like the weekly book group that my wife participates in, and a monthly movie group that I belong to. I don't know that I have much in the way of help or advice to offer, but if you'd like details about the above or want to ask things like "how do you handle XYZ", let me know.

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I’m wondering too what precautions are in order for RSV. YLE says it’s transmitted by fomites — which are little blobs of virus-containing junk on surfaces — so it does seem to me like wiping surfaces maes sense again. I wish there was more info about that though. For some pathogens there is actual research about how long it stays alive and active once it’s in a surface, also what kind of surfaces you’re likely to pick up the virus from. For instance, when I read about this stuff in the early Covid era, I read that viruses die quickly on copper. Also that it’s easier to pick them up from fomites on a hard, smooth surface than from something like clothing. Wish I knew more about RSV fomites. I think I’m going to go back to washing groceries. Doesn’t take long anyhow.

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Excellent article, thank you. There is often a significant toll taken on adults with RSV, too. One example from my practice - a single Mom with two kids feeling very sick with RSV, one of whom is in the hospital right now. She also feels quite ill, with flu-like cough, body aches, and fever.

On the Covid front, I'm sure you saw the VA study this week about Paxlovid helping to reduce Long Covid. Dr. Topol had a great run down, and I did my best from a primary care perspective:

https://mccormickmd.substack.com/p/to-paxlovid-or-not-to-paxlovid

Drop us your thoughts when you have a moment sometime, as your advocacy for the antiviral swiss cheese layer has been very helpful this whole time!

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Paxlovid is SO HARD TO GET. Even for 50 and older crowd. Doctors steer their patients away due to rebound and metal mouth. Hopefully now that research is being done of benefits of reducing long covid, Paxlovid usage will increase.

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So true, that's what I'm seeing with a lot of colleagues/prescribers' behavior. Med school curriculum is pretty consistent, but once we're out on our own, the self-education is variable in terms of quality, sources, and time spent keeping up.

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From a Head of School and childcare perspective in south east Michigan, all of our toddlers, babies, many in the pre-school, and many staff, including me currently, have had either Covid and/or RSV. It is interesting that so far none of our elementary children have had either virus or been sick so far! Three weeks into the school year, in late September, we saw a lot of Covid, now over the last few weeks it is RSV. We are also seeing a resistance from pediatricians offices to test for RSV, they say the test is too expensive to run. This is especially frustrating from our perspective in informing parents what illnesses we have circulating in our community. It seems if you go to an urgent care they test for all three viruses. I would also say that as a relatively healthy adult in my 50's RSV has hit hard! So yes it is potentially life threatening on infants, young children and older adults but man it can also kick a punch for others who get infected too! Now we are waiting for flu to hit next!

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Our whole family spent October sick with a "chest cold" that may have been RSV, but did not even attempt to test for RSV precisely because tests for it seem so scarce.

We have adult asthmatics in the family, and whatever this "chest cold" was hit them hard.

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Same.

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Yes, a friend of mine is just recovering from RSV, and she said it was a miserable five days or so.

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I commented in an earlier article that mentioned RSV that I would like to know more about it and am very happy to read this excellent and very informative article. My husband and I are 72 and in good shape with zero health issues. Thank God, because we got sick 4 days after a verified exposure and it kicked our butts. We are on day 8 and finally feeling like we are over the hump although the cough is hanging on. You don't want this and you sure don't want your grandkids to get it. To read that the antibodies don't last long is very disheartening. We will take precautions. And thanks once again, YLE, for helping us to navigate through the contagion!

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Yes but getting it several times in one season and “ the severity of infection didn’t decline until the children had RSV at least three times. ” that’s a bit disheartening, as I said.

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I'm at home nursing a toddler with RSV in a state where there are currently zero pediatric hospital beds available. I thought COVID had caused us to increase hospital capacity. Did we not increase capacity for children or is the current RSV outbreak really just that bad?

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It’s both. Rsv really is that bad, and pediatrics hospital capacity was decreased over the past several years. (“Kids don’t get seriously Ill with Covid”). Kids’ hospital beds don’t make money across the year because their hospitalization needs are seasonal, fueled by RSV

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I see other articles -- yours is the best, by far --that talk about the lack of immunity we’ve developed because we were masking up and assiduously washing our hands for so long. Makes sense. However, masking and hand-washing still seem to be the recommendation, especially with flu and RSV arriving earlier and harder. Are we prolonging or exacerbating the immunity problem because of this? Believe me, I had a nasty upper respiratory infection a few weeks ago and do NOT want to get sick again -- with anything. But it seems like we’re in a damned-if-you-do, damned-if-you-don’t situation.

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founding

From an employer perspective, we are seeing a major wave of Covid and a strong resistance to testing. Unfortunately it would seem that CDC is increasingly turning blind eye to Covid issues (especially as weather turns cooler)...so we are seeing families with RSV, Flu and Covid.....my bet is we will start to see some major spikes by Thanksgiving.

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founding

The other issue is that Covid data now is based on "reported" tests. Very few are reporting home tests and frankly the home tests have issues with current variants. It may take several days for people to turn "positive" with the home tests but many people just go with the early readings. So it is very hard to really know the scale of what is happening right now other than observations in groups of people--in our case 200 employees with increasing numbers reporting covid like symptoms and people resisting testing or doing the home tests. We are close to going back to masking in common areas as well implementing PCR testing programs again in the factory. Frankly the cases are as bad as they were last year---in terms of numbers. Most of them report having young families with sick children--or having recently been at "group" events.

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Thanks YLE! Is there extensive research being put behind WHY these surges are happening so that we can make more informed decisions down the road?

1. Did prior COVID infections weaken our immune systems?

2. Did the COVID vaccine weaken our immune systems?

3. Did the social distance and masking weaken our immune systems?

4. Is this strain of RSV and Flu just more potent and it's a mere coincidence that it happened at the same time as 1-3 above?

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founding

good points...agree on the miscommunication and political issue. However, I do find getting good solid info on cases and more with the CDC is just more difficult....

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I'm just coming home from an ER visit with my 2 yr old for RSV symptoms she likely got from her older sister who is in daycare. Given all the media attention to RSV I was thinking about asking her daycare to consider reinstating the mask policy we had for covid - would this be effective at minimizing the transmission. I saw that they can also get it off hard surfaces so perhaps this isn't a great solution. Just curious if we have any data on mask wearing and transmission for RSV. Thanks

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Thank you for this informative piece! I’ve been sniffling and coughing (a bit) for over a week now after spending the afternoon of Halloween handing out candy to lots of kids and parents at a big community celebration. I suspect I may have RSV, since I keep testing negative for COVID, and usually with a cold I run a low grade fever (which isn’t happening with this). And a friend (whom I hadn’t been in contact with lately) is just recovering from a nasty bout of confirmed RSV herself, so I know it’s circulating locally. I had thought of it as something that kids mainly got, but now I know that’s wrong. It’s very good news that effective vaccines are in development. I’m a healthy 61-year-old and haven’t experienced any severe symptoms, but we have many vulnerable elders in our community.

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Idle question - the picture is now very different than it was a year ago, and thanks for the extensive posts about RSV vaccine. Any thoughts about the monoclonal antibody for newborns (nirsevimab)?

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I am 63 year asthmatic grandma and I frequently babysit my toddler/preschool grandchildren; I am anxiously awaiting the RSV vaccine. They've given it to me twice this calendar year (once lab confirmed and the second time suspected as that was what everyone else at the preschool had) The first time was full out misery, the second not quite as bad, but both required prednisone and multiple inhalers.

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Several questions come to mind.

1. If a person has a coinfection of RSV and covid 19, can the two viruses swap RNA?

2. Covid has a pretty large zoonotic reservoir. Does the same apply to RSV?

3. Why do not some states (including mine) do active surveillance of RSV?

4. Does RSV in older adults ever have "long haul" consequences?

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