Santa Clara County prepares for possible ‘tripledemic,’ with mask mandates for health care settings next month

October typically marks the onset of flu season, and this year health officials are urging people to get immunized now to stay healthy and protect others from illness.

The updated COVID vaccine, recent availability of the flu shot and new options for RSV protection makes it a particularly opportune time to get vaccinated, according to a statement from the Santa Clara County Public Health Department.

“I encourage people to get their COVID and flu shots now,” said Daniel Shin, an infectious disease physician who sees patients at El Camino Health and Palo Alto Medical Foundation in Mountain View.

“And if you fit into a category for RSV vaccination, I would do that too. That’s for people over 59 years,” he said, adding that RSV typically affects newborns, the immunocompromised and the elderly more severely.

The county also recommended that pregnant women receive the RSV vaccine, available for the first time this year.

The symptoms of flu, COVID and RSV are different, although sometimes difficult to distinguish, Shin said. Acute influenza typically begins with an abrupt onset of a high fever of 100 to 103 degrees, accompanied by shaking chills, muscle aches and gastrointestinal symptoms like vomiting and diarrhea.

More recent COVID infections tend to present with high upper-respiratory symptoms, like a sore throat and runny nose, and fevers tend to be low-grade. RSV infections often show up as a cough and low-grade fever for infants and children while symptoms tend to be fairly mild for healthy adults, Shin said.

Because of the convergence of symptoms, diagnostic tests are the best option to determine whether someone has COVID, flu or RSV, Shin said. At-home antigen tests usually work well for COVID, while a flu or RSV test requires a visit to a doctor’s office, urgent care or the emergency room.

To prevent the spread of infection, sick individuals should isolate for a minimum of five days and be without fever – without using fever-reducing medications like Tylenol or Advil – for at least 24-hours, Shin said.

The county also is preparing for the possibility of a “tripledemic” – a convergence of COVID, flu and RSV – this winter. To protect the public, it has ordered a seasonal mask mandate in health care facilities that starts Nov. 1 and extends until next March.

Although local hospitals have not seen a swell of patients, there has been an increase in COVID infections lately, as evidenced by wastewater monitoring in Palo Alto, Shin said. The county also relaunched an influenza and RSV data dashboard that shows recent upticks in wastewater analysis.

“So, I would say the biggest impact in doing something as an individual is to get vaccinated,” Shin said.

How and where to get vaccinated?

The Center for Disease Control (CDC) and California Department of Public Health have websites, vaccines.gov and myturn.ca.gov, that can help people find and set up vaccination appointments with local providers.

Primary care physicians and retail pharmacies are another place to look, Shin said, adding that it is possible to get COVID and flu shots at the same time.

Health insurance should cover the updated COVID vaccine for most people without any out-of-pocket costs.

The county health department also said it will help uninsured and underinsured adults 19 years and older access the vaccine through the CDC Bridge Access Program. Children up to the age of 18 can get the vaccine for free through the federal Vaccines for Children Program, which provides other routine vaccinations.

Free flu vaccines are distributed each year to local non-profit organizations and public health care providers and agencies, the county said.

Below is a list of Mountain View clinics that offer COVID and flu vaccines:

El Camino Health Mountain View Outpatient Pharmacy

2500 Grant Rd., Suite 1B20, Mountain View, CA 94040

For adults and children aged 12 and older. By appointment only.

Sutter Immunization Clinic/Palo Alto Medical Foundation

701 East El Camino Real, Mountain View, CA 94040

For infants, children and adults aged 6 months and older. By appointment only.

Santa Clara Valley Health Care Multi-Specialty Clinic

Monday through Friday, 10 a.m. to 12 p.m. and 1:30 p.m. to 3:30 p.m.

2500 California Street, Suite D, Mountain View, CA 94040

For adults and children aged 3 and older. Appointment preferred.