What Is a Tripledemic and Why Should Employers Be Concerned?

As fall approaches, there is a risk this year that influenza (flu), COVID-19 and respiratory syncytial virus (RSV) will all circulate and peak at the same time (hence the term “tripledemic”) likely causing excess hospitalizations and deaths. If a tripledemic occurs, it will disrupt the healthcare system’s ability, including urgent care facilities and emergency rooms, to handle the patient volume, much like the peaks of the COVID-19 pandemic. If a tripledemic does occur, workplaces may be disrupted, and employers will experience absence, short- or longterm disability and productivity losses.

How Are These Three Viruses Spread, and What Is the Severity of Disease They Cause?

The tripledemic viruses are respiratory and spread by breathing, speaking and coughing. All can cause severe disease and death. During the 2022-2023 peak season, 100,000 to 200,000 people were hospitalized with RSV, 300,000 to 650,000 with the flu, and 700,000 with COVID-19.¹ In the United States, COVID-19-related deaths increased by approximately 18% between July 8, 2023, and August 26, 2023 and COVID-19-related hospitalizations increased by about 16% within a similar timeframe.² In 2022, more than 245,000 people died of COVID-19 or COVID-19-related illness in the U.S., making it the fourth most common cause of death.³ Additionally, “long COVID” has also impacted the workforce, with many individuals reducing hours or leaving the workforce altogether.⁴

How Can Severe Disease and Deaths Be Prevented?

Vaccination is the most effective way to mitigate severe disease and death from tripledemic diseases. This is the first year vaccines are available in early fall for each virus (the RSV vaccine is new this year). The flu and COVID-19 vaccines have been modified to target this year’s prevalent circulating strains. Private insurance companies are mandated to cover the COVID-19 vaccine with no copay. However, insurers are no longer required to pay for “out-of-network” vaccines. This means that individuals may need to get their vaccine at a doctor’s office if their pharmacy is not in-network with their insurance plan.

1. https://time.com/6314785/how-to-avoid-the-tripledemic-of-respiratory-diseases/
2. https://covid.cdc.gov/covid-data-tracker/#trends_weeklyhospitaladmissions_select_00
3. https://www.cnn.com/2023/05/04/health/covid-fourth-leading-cause-of-death/index.html
4. https://www.nytimes.com/2023/01/24/health/long-covid-work.html

Louise Short, MD, MSc FACOEM

National Clinical Leader

Rachel Piccolino, MPH

National Senior Population Health and Well-Being Analyst