How to protect yourself against the winter virus QUAD-DEMIC (and what you should NEVER do)

We’re all too familiar with the term ‘pandemic’, but experts fear Britain could face a ‘quad-demic’ this winter – with a surge in cases of four winter bugs, which could leave us all bedridden – all of which strike at once.

According to the UK Health Security Agency (UKHSA), numbers of noroviruses (also known as winter vomiting disease) – which can cause severe vomiting and diarrhea – have already risen by 40 percent in recent weeks.

But experts fear that infections with flu, Covid and respiratory syncytial virus (RSV), a bug that usually causes a mild cold or cough but can also lead to severe pneumonia (pneumonia), will also rise in the coming weeks. colder weather forces more of us indoors, making it easier for viruses to spread.

This not only makes many people feel terrible, but could also lead to excessive winter pressure on the NHS due to extra workload and staff illness.

Meanwhile, the elderly and people with weakened immune systems (including cancer patients undergoing chemotherapy) may be at risk of one infection after another, which in some cases can be life-threatening. Around 12,000, mainly older, people in Britain are admitted to hospital every year due to the effects of norovirus symptoms, such as severe dehydration, which can sometimes be fatal.

In January, at the height of the winter season, there were 688 patients in hospital every day with severe norovirus, almost 4,000 with Covid and 2,226 with flu, according to NHS England figures. This winter, the fear is that it could be even worse.

Not only has there been an unusual cold snap, but the pattern of disease in Australia last winter – which runs from June to late August and appears to foreshadow what is happening here – suggests the worst is yet to come in Britain.

Figures from Australia’s National Notifiable Disease Surveillance System – a database of infectious diseases – show that the winter season peaked later and lasted longer than 2023, when flu infections, for example, peaked in May at around 220,000 cases per month. This year they didn’t peak until July, peaking at 316,000 for the month.

And the rise coincided with a rise in other winter infections, including Covid, RSV and an outbreak of whooping cough in children. This is a highly contagious bacterial infection, also called whooping cough or 100-day cough (because of how long it takes to recover from it).

The Royal Australian College of General Practitioners said many people there spent the winter fighting one bug after another.

Dr. Anju Aggarwal, vice-president of the college, recently said: ‘It starts with one infection and then your immune system is a bit compromised. Then the second takes over – and then the third. So people get a little better and then worse again.”

The UKHSA has renewed its call for everyone eligible for vaccines against winter infections to get them as soon as possible.

There is no NHS jab against norovirus (although an experimental vaccine will soon be tested in a trial at the Royal Free Hospital in London), but there are vaccines available against flu, Covid and RSV (for the latter only for pregnant women and those who turn 75 on or after September 1, 2024, as older adults are at greatest risk for serious complications).

Although the symptoms of norovirus are normally obvious, it is often less easy to determine which respiratory virus you have.

“RSV tends to affect the lower respiratory tract (tissue deep within the lungs),” says Eleanor Riley, professor of immunology and infectious diseases at the University of Edinburgh. ‘Classic symptoms are coughing and shortness of breath. But flu and Covid tend to affect the upper respiratory tract, or the throat, nose and mouth, with symptoms including sneezing, coughing and sore throat.”

Professor Riley says that when patients who have been vaccinated against Covid do contract the infection, it usually looks like a mild upper respiratory infection – making it difficult to distinguish from flu or a cold. “It can be very difficult to tell these three apart,” she says.

The chance of contracting all three respiratory infections at the same time is incredibly small, she adds. ‘That’s because we know that viruses tend to compete with each other when they enter the body to reproduce.

‘For example, when you get a cold, the immune system triggers an inflammatory response to flush out the virus. It is this inflammation that gives you a bit of a fever and a runny nose.

‘That inflammation then makes it much more difficult for another virus to successfully enter the body. You would have to be exposed to all the viruses at almost exactly the same time, which is extremely unlikely.”

But there is a real risk of cascading infections – or one bug right after another – as happened in Australia.

“For example, say you get Covid and it causes temporary damage to your upper respiratory tract,” she says. ‘During the recovery period, the resulting inflammation gradually dies.

‘If you are exposed to a second virus during that time – let’s say flu – there is no inflammation in the airways to stop it, and it is also more likely to infect your airways because you are still causing damage there suffer from the Covid infection. ‘

Professor Riley says this is why taking it easy during recovery is so crucial. Overdoing it too quickly is more likely to weaken the body’s immune response to a second or third attack.

She adds: ‘It’s important not to rush back to work or long runs. Take it easy and you will actually recover faster.’

And for some people, it’s not just exposure to a second or third virus that poses a threat if they get sick.

Winter insects can also cause an abnormal reaction in bacteria that, when we are healthy, live harmlessly in or on our bodies.

This is often why viral bugs, such as the flu or even a bad cold, can in some cases lead to a bacterial respiratory infection that needs to be treated with antibiotics.

‘It’s almost as if these bacteria, which normally don’t cause harm,

feel that the body is being attacked by a virus and seize the opportunity to try to start growing and spreading,” says professor

Riley. ‘That is why GPs will often prescribe antibiotics for patients with a history of respiratory infections, even though they are almost certain that it is a virus causing the primary infection – this is called ‘antibiotic coverage’.’

How to protect yourself

• Wear a face mask when traveling on planes, trains and buses, or in crowded indoor areas; it may not provide complete protection, but can reduce the risk of especially airborne bugs such as flu, Covid and RSV, the UKHSA says.

• Wash your hands thoroughly with soap several times a day. Not only does it remove norovirus that might be on your skin, but it also expels flu or Covid particles that you might accidentally rub into your eyes or spread to your mouth or nose by touching them . Hand sanitizer is better than nothing if that’s all you have access to, but it won’t be as effective at removing bugs on the hands.

• At work, use alcohol wipes to regularly clean shared surfaces such as doorknobs, light switches and keyboards.

• If someone you live with has a respiratory or stomach infection, do the same at home, including using the TV remote. Kitchen countertops should be wiped down with bleach-based products if someone you live with has norovirus.

• Do not share towels with anyone who has signs of flu, Covid, RSV or norovirus.

• Rinse all fruits and vegetables thoroughly, even before cooking, as they may contain infected particles.

• If someone in your household is sick, wash all clothing and bedding in a 60 degree Celsius program.

• If you have the stomach flu, avoid cooking or preparing meals for others until at least 48 hours after all symptoms have disappeared.

• Lock yourself in your bedroom if you have a contagious bug, especially norovirus. Dr. Marion Sloan, a GP in Sheffield and chair of the Primary Care Society for Gastroenterology, says: ‘It is best to self-isolate until you feel better and have someone else bring your food and drink to your door.’