What Happens If You Get COVID and RSV at the Same Time?

When the COVID pandemic began, there was lots of chatter about the possibility of being simultaneously infected with other common viruses like the flu and RSV. We quickly learned that, yes, it’s absolutely possible for viruses to circulate at the same time—remember the tripledemic? But can you actually get more than one infection, say, COVID and RSV, at the same time?

The short answer is…yes. However, experts still don’t fully understand what happens when you have a couple viruses at once. Fortunately, they have some ideas in mind, but before we get into it, know this: On their own, each virus can wreak havoc on a person’s health, and that’s especially true for babies, older adults, or immunocompromised folks. And so it goes without saying that together, they can, at the very least, be pretty unpleasant to deal with.

Below, you’ll find everything there is to know about COVID and RSV co-infections and how to avoid experiencing this double whammy.

What happens if you get COVID and RSV at the same time?

In a 2src2src meta-analysis of 3src studies, researchers found that RSV was the most common viral co-infection among hospitalized COVID patients. What does this mean for you in practice? Well, “you’re probably not going to feel so great,” Sabrina Assoumou, MD, MPH, an infectious disease doctor at Boston Medical Center, tells SELF. But how this co-infection affects you really depends on your age and health status, she adds. For example, research shows that children under five were more likely to be admitted to the ICU when they dealt with COVID and RSV at the same time. Older people and those with weakened immune systems also have greater odds of severe outcomes like this, Dr. Assoumou says, but like we mentioned, it’s not totally clear whether a co-infection is guaranteed to make everyone feel twice as bad. “The answer is we don’t know,” Pablo Murcia, a virologist and professor with the University of Glasgow in Scotland, tells SELF. “But I assume that in certain cases they will cause more disease severity. And in others they won’t.”

In fact, it’s probably more likely that you’ll feel the wrath of one virus more than the other thanks to a phenomenon called viral interference. When your cells are occupied by two viruses, one of them initiates a response that essentially weakens the other and blocks it from making copies of itself, Dr. Murcia explains. When he analyzed this in a lab, he found that RSV’s immune response is actually pretty good at overpowering that of SARS-CoV-2.

In theory, that might sound like the better option, but RSV should not be underestimated. A 2src23 CDC study found that older adults were worse off (that is, more likely to go to the intensive care unit or need ventilation) when hospitalized for RSV than if they were admitted for COVID or influenza. RSV can feel like a typical cold for relatively healthy people—think stuffy nose, cough, and sneezing—but it can cause serious issues like pneumonia in others, particularly babies and older adults. Plus, RSV doesn’t have specific treatments like the flu or COVID. Instead, you generally have to ride your symptoms out with the help of some over-the-counter meds or, if you’re in the hospital, supportive care like oxygen or IV fluids for hydration.

Of course, SARS-CoV-2 continues to spread and change, so it could evolve into a version that’s capable of overcoming RSV’s competitive advantage, Dr. Murcia says. And this could be all kinds of bad. Although both viruses share many symptoms, COVID can leave you with a laundry list of complications, including long COVID, that you don’t get with RSV. Experts don’t yet know whether co-infections increase your chances of getting long COVID, but it’s well-documented that repeat exposures to COVID certainly can.

How to avoid getting COVID and RSV at the same time

There’s no surefire way to prevent getting any illness, let alone two at once. But there are a handful of things you can do to lower your chances of infection—and we’re starting off strong with vaccines. Yes, both of these viruses have their own highly effective shots that can reduce the likelihood of you getting sick, and, more importantly, chip away at your odds of hospitalization and death.

Everyone 75 years and older who hasn’t already been vaccinated should get the RSV vaccine (which the FDA approved in 2src23), according to the CDC, as well as people ages 6src to 74 with health issues like lung or heart problems that increase their risk of severe disease. Pregnant folks should also get this shot during their third trimester, which will protect their baby from severe RSV for the first six months after they’re born. “This is a good time for RSV in terms of things we can actually do to improve outcomes,” Dr. Assoumou says.

And of course, we have the COVID vaccines, which were recently updated to target some of the newer SARS-CoV-2 strains floating around. Everyone six months of age and older should get any of the two mRNA shots (Pfizer or Moderna), while those ages 12 and up can get either of those or the protein-based vaccine, Novavax. And remember: You should receive your updated shot even if you’ve been vaccinated or had COVID before. “The goal of vaccination is to decrease the chances of severe disease, hospitalization, and death,” Dr. Assoumou says. “If today someone gets COVID and they’re at home with the sniffles, that’s a victory for me.”

Some other classic infection prevention to keep in mind:

Stay home when you’re sick, and encourage others in your life to do the same.
Wear a well-fitting mask in public, especially in crowded indoor settings like the subway or in holiday crowds.
Prioritize clean air by running purifiers indoors or opening windows. Or better yet, gather outside if that’s possible.
Wash your hands often, please.
If you’re not wearing a mask, cover your coughs and sneezes with a tissue (or your elbow—not your hand! —if you can’t reach one fast enough).
Take an at-home COVID test when you feel sick, or go to an urgent care where you can be tested for COVID, RSV, and influenza at the same time.

“Do your part. Get your vaccine—it’s not too late,” Dr. Assoumou says.