Flu, COVID, and RSV Update

November 14, 2022

Paul Hunter, MD

Respiratory syncytial virus (RSV), influenza, and Covid are circulating at high levels. RSV and flu are increasing rapidly. See CDC Health Alert from 11/4/22.


  • Vaccinate patients against influenza and Covid
  • For 29 week or earlier premature infants and children under 2 years old with certain severe heart, lung, and neurologic diseases, order the monoclonal antibody palivizumab.


  • When testing would result in
    • prescription of antiviral medications
    • isolation of ill patients to protect high risk contacts


  • Flu: Oseltamivir within 48 hours of symptom onset. 
    • Later can help severely ill and high-risk patients. 
    • Treat based on fever plus cough or sore throat, while waiting for test results.
  • Covid: Paxlovid within 5 days of symptom onset.
    • Wait for positive test before treating
    • Free telehealth service from state for uninsured.
  • RSV: Reserve ribavirin for very severely ill and very high risk
    • Ribavirin in pregnant people causes birth defects.


Here is a recorded 22 minute Zoom video on this topic and reviewing the attached slides: Zoom Link

Password: 1CFh@Y1T


You will be required to sign into your Zoom account and enter the password.

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