It’s the headline no one wants to read: Hospitals are once again exceeding their capacity in many parts of the country as beds fill up with sick patients. Just when we thought we might be out of the woods with COVID-19, new strains are emerging, landing some of our most vulnerable, including young children and the elderly, in the hospital.

Simultaneously, we already are seeing an unusually large number of influenza cases for this time of year, and an influx of respiratory syncytial virus (RSV) is setting us up for a potentially dangerous “tripledemic” this fall and winter. Are senior living communities, such as continuing care retirement communities (CCRCs or life plan communities), ready?

COVID, and RSV, and flu, oh my!

You feel that first scratchy tickle in your throat and then a chill ripples through your body. You know some illness is about to hit you like a brick wall, but which one? Is it COVID, flu, or RSV? They are all respiratory viruses with some similar characteristics like cough, runny nose, and fever, but according to the Cleveland Clinic, each has unique tell-tale symptoms that can help you determine which virus you might be dealing with.

  • The flu often features a very high fever — as high as 103 or 104 degrees Fahrenheit. It also can include nausea and vomiting much more often than RSV or current strains of COVID.
  • COVID has a unique propensity to impact bodily systems outside of just the respiratory system, particularly as a long-term effect. A common example is brain fog.
  • RSV’s distinctive symptom is a wheezing sound — a rattle when you breathe in and out.

While each of these respiratory viruses has some shared symptoms as well as distinct characteristics, they also have one important common denominator: They can be particularly dangerous — even deadly — for older people. This is why CCRCs and other senior living communities are jumping into action as the cases of COVID, flu, and RSV increase across the country.

>> Related: How the Pandemic Has Impacted Thoughts About Senior Living

CCRCs are ready for a “tripledemic”

Resident and staff safety is priority number one at a CCRC. Even before the COVID pandemic began in early 2020, these communities were well-versed in effective illness prevention and containment measures as they had to guard their vulnerable residents against outbreaks of easily transmissible illnesses like influenza or norovirus (a highly contagious “stomach bug”).

Thus, with this emerging “tripledemic” threat, most CCRCs’ and other senior living organizations’ best practice approach will be to redouble illness prevention methods they already have in place and have fine-tuned throughout the COVID pandemic, according to a recent article. For example:

Environmental services’ diligence

The housekeeping and laundry team (sometimes called environmental services) is one of the first lines of defense for a CCRC to prevent or stop the spread of viruses like COVID, flu, and RSV. These team members were among the superheroes of the pandemic, frequently sanitizing high-contact surfaces like doorknobs, tables, stair rails, faucet handles, and more. Now with illness numbers on the rise, environmental services teams are once again jumping into action to double-down on their disinfection measures.

Air quality improvements

Airborne illnesses can be challenging to halt when people are indoors in shared spaces. But as we learned during the pandemic, better air circulation and ventilation — frequently bringing fresh outside air into an indoor space — can dramatically reduce the spread of viruses like COVID, flu, and RSV. HEPA filters, which are able to clean the air by trapping microscopic germs, are another line of defense some CCRCs have implemented.


Particularly when talking about COVID and flu, vaccination is one of the best ways to prevent severe illness, hospitalization, and death, particularly among vulnerable seniors. It’s why many CCRCs have mandated vaccination for residents and employees alike. If you haven’t already gotten your COVID vaccine (including the updated bivalent booster) and your annual flu shot, now is the time to do it! Find a vaccination location near you.

While there is not currently an approved RSV vaccination, two are currently in the clinical trial phase — one intended for people over the age of 60 and another one designed for pregnant women. Based on promising trial outcomes thus far, both are expected to be available late in 2023.


Hand hygiene is instrumental in stopping the spread of viruses, and most CCRCs and other senior living communities have robust handwashing protocols and education programs.

Although COVID, flu, and RSV are predominantly airborne — spread through droplets in the air — flu and RSV in particular can be transmitted through contact with contaminated surfaces (called surface transmission). Thus, handwashing is a critical component in stopping the spread of these viruses. When soap and water are not readily available, hand sanitizer is a good back-up option.


Some senior living communities have invested in technology to help keep their communities safe from illness. For instance, electrostatic sprayers work by hitting the cleaning chemical mist coming out of the sprayer with a positive static charge. When those positively charged particles hit a negatively charged surface, it enables those particles to spread into the miniscule nooks and crannies of that surface — places inaccessible with a standard rag or wipe.

>> Related: Surprising Findings Around CCRC Residents’ Pandemic Stress, Resilience

CDC virus surveillance
CDC COVID-19 map CDC flu mapCDC RSV dashboard

Lessons learned during the pandemic

As we saw in the early days of the COVID-19 pandemic, group home settings like nursing homes were particularly hard-hit as we learned just how contagious the virus is — much more so than the flu because COVID particles are smaller, can remain in the air for longer, and have a longer incubation period.

COVID-19 was indeed a “novel” virus, different than anything we’d experienced in our lifetime, and there was a learning curve to determine how best to battle it. Sadly, many people lost their lives as we determined the proper protocols to “flatten the curve” of illness and hospitalizations, but thankfully, we now have a number of arrows in our quiver, including vaccination and therapeutics, to help fight the battle.

Heading into this potentially dangerous fall and winter and the “tripledemic” confluence of COVID, flu, and RSV, some CCRCs and other senior living communities admittedly may be better prepared than others when it comes to learning the lessons of the pandemic and stopping the spread of contagions among residents. With this in mind, we have learned that infection prevention is another topic to inquire about during your CCRC research process. Consider asking management what protocols they have in place to keep residents safe from a pandemic or stop the spread of a virus outbreak.

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