Maggie McKay (Host): How much do you know about respiratory viruses? Well, today, we're going to find out with Dr. Sharon Welbel.

Welcome to Total Health Talks, your Cook County Health podcast, where we empower your journey to better health. I'm your host, Maggie McKay. And today, we're going to talk with Dr. Sharon Welbel about understanding respiratory viruses. Thank you so much for being here, doctor. Would you please introduce yourself?

Dr. Sharon Welbel: Yes, thank you, Maggie. Excited to be here. Dr. Sharon Welbel, I am the Chief of Epidemiology, Infection Control and Prevention at Cook County Health, as well as the Interim Chief of the Division of Infectious Disease.

Host: What are the main viral respiratory illnesses that'll be circulating in the fall and winter?

Dr. Sharon Welbel: The main viral illnesses that we'll be circulating are those that cause an influenza-like illness would be respiratory syncytial virus or RSV, influenza and SARS-CoV-2 virus, which causes COVID. Some less common, but still present would be adenovirus, metapneumovirus, and parainfluenza virus. And then, of course, we have the virus that causes the common cold, the rhinovirus.

Host: And what are the differences between cold, flu, and COVID-19?

Dr. Sharon Welbel: Yeah. So, there are a lot of overlapping symptoms, particularly with anything that causes the flu and or COVID. So, we bunch them all into an influenza-like illness or the flu. And those things are things like headache, fever, chills, muscle aches, weakness, fatigue, people feel pretty sick versus the cold again caused by rhinovirus. Generally, one has a more milder cough, sore throat, runny nose, and so forth.

Host: And as flu season is starting in many parts of the world, how would you know if you have the flu or COVID-19? And what do you do if you think you have a respiratory illness?

Dr. Sharon Welbel: Yeah. So, it's really, again, because of the overlapping symptoms, it's impossible to know if one has the flu caused by influenza or COVID. And the best way to tell is by getting tested. Of course, we have our home COVID tests that we can use, or we can go to our healthcare provider. And actually, you know, with one swab, we can tell if it's COVID, flu, or RSV. The most common viruses that are circulating, depending on the test that one's provider has.

And how do we tell if we have a cold or flu? You know, again, the symptoms that I've already talked about, and it's really important for certain people to contact their healthcare provider if they do think that they have something like COVID or influenza or RSV.

Host: So, maybe it's a good idea to keep a COVID test around your house that's not outdated.

Dr. Sharon Welbel: Exactly. Exactly.

Host: Speaking of COVID, can you talk about Paxlovid, and what it's recommended for and who should be taking it?

Dr. Sharon Welbel: Absolutely. So, Paxlovid is an oral medication. It's indicated for people ages 12 years old and older, one has to be at least 88 pounds. And it's for people of mild to moderate COVID, because we have different therapies for people who require hospitalizations, and those who are at risk for developing severe disease. And what does that mean, those who are at risk for developing severe disease? So, people with cancer who are on cancer chemotherapy, have heart disease, diabetes, 65 and older, and so forth.

Host: Dr. Welbel, what can someone do to prevent getting sick in the first place?

Dr. Sharon Welbel: Yeah. That's a great question because throughout COVID, we've learned so much about preventing respiratory viral illnesses. So, of course, staying away from crowded areas, if one is going to go into crowded areas, you know, of course, these are circulating in the fall and winter when school has started, they're more indoor activities. A well-fitted mask goes a really long way. It will really help protect one from getting sick. Good hand hygiene, keeping one's hands clean, not touching our mouth, nose, or eyes, unless you have to or prior to eating, I advise everybody to carry a little bottle of hand sanitizer with them, clean your hands before one's going to touch your nose, eyes, mouth, before one eats, and so forth.

And then, as this holiday season is coming and we're having people at our homes, there are ways that we can keep our air cleaner, and that also really helps. Things like keeping windows and doors open if we have screens and feel safe that it's to do so. One can use a HEPA filter, which is a high efficiency particulate air filter, if one has one or has access to one. And then, of course, all of those other things, like keeping our hands clean.

Host: And so, what do people need to do to continue protecting themselves against these illnesses? I mean, just do all of the above constantly, not just for flu season and the winter?

Dr. Sharon Welbel: Right. Because COVID so far really isn't seasonal. We saw this last summer, at least in Chicago, we had very high rates of COVID, as high as we did last winter. So, all of the same mitigation.

Host: And for people who do have access to the flu vaccine and the COVID-19 vaccine, is it safe to take? There's so much debate. And can they be given at the same time?

Dr. Sharon Welbel: There is a lot of debate and concern. They definitely can be given at the same time, and they are definitely safe. For the influenza vaccine, we have been using this for over 50 years. Hundreds of millions of Americans have received this vaccine, and there has been a lot of research looking at the safety. It is an incredibly safe vaccine. The COVID vaccine, much newer of course, but since December of 2020, when we started giving this vaccine, there's probably been more research into the safety and efficacy of the COVID vaccine than for other vaccines, because it was brand new and because we had to produce it so quickly.

And sure, people can have some, what we call adverse events or some people call them side effects. The most serious would be something called anaphylaxis, which is a severe allergic reaction that one can have to any vaccine or medication or just to some environmental insults. But that's rare. It's considered rare from the COVID vaccine. And then, we have seen an inflammation of the heart called myocarditis or the lining of the heart called pericarditis, mostly in younger males, really from like 12 to 17 years old, but it can happen to women and people of other ages. And what we found is that it's largely self-limited. Patients get better very quickly and do well. I feel like these are both safe vaccines.

Host: And how does the vaccine help protect others?

Dr. Sharon Welbel: Right. So, a vaccine is going to help protect one from getting COVID in the first place. And then, if they get COVID, it's going to protect you from being hospitalized and dying. So, that in and of itself is going to help your loved ones, help people around you. And if one doesn't get COVID, of course, or influenza, one isn't going to transmit it to those around them.

Host: How do you talk to parents and patients that might express vaccine hesitancy? Because there is a lot of that. And what are some of the biggest concerns people have?

Dr. Sharon Welbel: Yeah. People have a lot of concerns, particularly with the new COVID vaccine. You know, I think about vaccine hesitancy. Some people write about it in the context of something called the 3 C's, so it's compliance, confidence, and complacency. So, that's how I look at it. So, you know, some people just feel like, "Well, everybody else is vaccinated. I don't need to get vaccinated," or "If I get the disease, I'm not going to get sick or be hospitalized or die from it." confidence of people are confident in the people who develop the vaccine, the people who approve the vaccine in their own healthcare institution or their doctor. And then, convenience, you know, are there barriers to getting the vaccine?

So, in general, and I have to say that in the patients that I see in my ongoing clinic where I see patients every week, some I've seen for years and some are new patients, I don't see a lot of that, which when you're asking me this question makes me feel like my patients do feel confident in Cook County Health. They feel confident in me, and they feel like it's convenient for them to get their vaccines at Cook County Health, which makes me feel really good now that I'm thinking about this question. But in general, I really encourage people to talk to me about their concerns. And I just like to provide them with the facts, and these are the facts. And if you have some misconceptions and misunderstanding, I tend to try to clarify those.

Host: So, that is how you do it. And how do other doctors and medical institutions combat hesitancy? Do they send them to a website with the facts or?

Dr. Sharon Welbel: Yeah, that's a great question. I think it's such a heterogeneous practice. You know, everybody's going to have their own way of doing it. I think maybe I also always want to make sure that people understand what I'm saying and then, of course, welcome other questions. I just think having a great dialogue is the most important thing to do.

Host: So, you mentioned Cook County giving vaccines. Will they be doing that again this year?

Dr. Sharon Welbel: Absolutely. We have all the vaccines, COVID, influenza, RSV, for anybody who's eligible. For those who are already in Cook County Health, that's already a patient, they can just call their provider's office and make an appointment. They can come in as a walk-in. We prefer making an appointment. And for those who are not part of the Cook County community, they also can call. I can give you the telephone number if you'd like.

Host: Sure.

Dr. Sharon Welbel: Yeah. So, that's 312-864-0200.

Host: So, good news. That's got to be reassuring to people to know that Cook County Health will be offering vaccines this year.

Dr. Sharon Welbel: Yeah, we already are. We already are. I've already been getting lots of vaccines into my patients.

Host: And what's one thing you hope people take away from the last four years?

Dr. Sharon Welbel: Yeah. Something I think about all the time, Maggie, I really do. The thing to take away is that I do feel like people have suppressed, oppressed, or forgotten about sort of the devastation, the deaths, and the isolation that happened at the beginning of COVID. What I take away is how innovative we were, resilient we were, that we got through this. And we've learned so much from it. And I want to remind people that with global warming and increased movement around the world, we will continue to have epidemics and/or pandemics. So, we need to continue to be innovative and resilient.

Host: Well, thank you so much for sharing this invaluable information. We really appreciate you sharing your expertise.

Dr. Sharon Welbel: Thank you, Maggie. I look forward to speaking to you again.

Host: Again, that's Dr. Sharon Welbel. As we wrap up another insightful episode of Total Health Talks, make sure to visit cookcountyhealth.org/podcast and subscribe to our podcast, share, and connect with us on social media. Stay tuned for more engaging discussions. This is Maggie McKay signing off from Total Health Talks. Stay well.