Ohio health officials are urging caution again this winter. But entering our third holiday season with COVID-19, the nature of those warnings is a bit different.

Three at once

As Ohio Department of Health Director Dr. Bruce Vanderhoff explained, this year the threat is multiple respiratory viruses at once.

“Unlike the last two winters, it’s not just about COVID,” he said. “But the combination of COVID, influenza, and RSV, especially for those whose health is more vulnerable or who have not been adequately vaccinated against flu and COVID-19.”

RSV, or respiratory syncytial virus, often feels like a common cold for adults and otherwise healthy children. But for infants, the elderly or immunocompromised people it can be dangerous. According to the CDC, RSV is the most common cause of bronchitis and pneumonia among kids 12 months old and younger.

Unlike COVID-19 and flu, RSV has no vaccine.

Precautions and metrics

As ever, Vanderhoff’s chief precautionary recommendations are for people feeling ill to stay home and for everyone to wash their hands regularly. In situations where people must leave the house, officials recommend wearing an N95 mask.

He also urged those who haven’t gotten vaccinated for the flu or COVID-19 to do so.

“Vaccination is the safest and most dependable way to assure that you’re maximizing that cellular immunity I talked about,” Vanderhoff explained. “It gives your immune system its best opportunity to confront and beat the virus.”

According to the CDC, the COVID-19 community level — a statistic based on number of hospital admissions and number of cases per 100k population — is low in many Ohio counties. Twelve rank as ‘high’ based on those metrics.

Dr. Joe Gastaldo, OhioHealth medical director for infectious diseases, said people should be especially cautious in those counties.

“In those scenarios, regardless of vaccination status, the recommendation is to wear a mask,” he said. “If you’re not feeling well wear a mask. I think specifically if you have an at-risk condition, or are immunocompromised, I would advise you as an infectious disease doctor to wear a mask indoors in public.”

The CDC’s more familiar community transmission metric, based on cases per 100k population and percentage of positive tests, remains high throughout the state. All but nine of the Ohio’s 88 counties rank high for community transmission and none are low.

As for RSV and the flu, Vanderhoff noted this year both started earlier and rose more rapidly than in past years. Both viruses have receded from their peak, he explained, but remain dangerous for some populations.