FP Essentials™ #569 Viral Respiratory Infections

Viral respiratory infections have affected us all in professional and personal ways. We have all experienced these infections ourselves, we have supported family members through viral respiratory illness, and we have dealt with staff absences due to these conditions.

In 2020, at the dinner table on New Year’s with my brother, who has a doctorate in public health, and my father and sister-in-law, who are family physicians, we discussed the respiratory illness in China. The public health practitioner was concerned about what it might mean for us. Having cared for patients through severe acute respiratory syndrome (SARS) and H1N1 influenza, I was much less concerned. At the time, I could not have imagined how wrong I was. By March, the world had completely shut down. As a small practice that remained open for in-person visits throughout the COVID-19 pandemic, we struggled with how to keep ourselves, our family, our staff, and our patients safe when guidance and evidence were scarce and supplies were extremely limited.

Although the early pandemic was hard, what followed was much worse. Practicing in rural Ohio, many of my patients had very strong beliefs related to COVID-19. It was devastating to have patients who had trusted me through life-and-death decisions yell at me when I asked them about COVID-19 vaccination or asked that they wear a mask in our office. For 2 years, I worried that at any moment I would need to run my practice myself for 2 weeks if my staff came down with COVID-19. When it became clear that my staff was unwilling to consider vaccination, I chose to leave the practice that I founded.

As a direct result of my experience through the pandemic, I have chosen to move to and practice in Ontario, Canada. Although I doubt that the COVID-19 pandemic resulted in such drastic changes for most of you, I suspect that your experience with viral respiratory infections in the last several years has altered the way that you approach your practice, your relationship with patients, or your view of your community.

Section One of this edition reviews upper and lower respiratory tract infections, including prevention, diagnosis, treatment, and complications. Sections Two, Three, and Four review key viral respiratory infections: influenza, COVID-19, and respiratory syncytial virus infection, respectively. Each infection section includes discussion of the epidemiology; societal effects, including health disparities; prevention, including the best evidence on vaccination; diagnostic evaluation; and treatment options for patients in outpatient and inpatient settings.

We all regularly see viral respiratory infections in our practices. I am sure that you also have had a lot of questions and comments from patients about the science behind how we prevent, diagnose, and treat these conditions. This edition will provide you with the evidence to support the care that you give and some ideas about how to move those conversations from frustrating exchanges to opportunities to positively affect the health of your patients and your community.

Ryan D. Kauffman, MD, FAAFP, CCFP
Associate Medical Editor
Family Medicine Physician
Erie Shores Family Health Team
Leamington, Ontario, Canada

Heli Naik, DO, CAQSM, is assistant director of the Family Medicine Residency Program at Rutgers University/Robert Wood Johnson University Hospital Somerset in Somerville, New Jersey. She is also a clinical assistant professor in the Department of Family Medicine and Department of Sports Medicine at Robert Wood Johnson Medical School in New Brunswick. Dr. Naik earned her doctor of osteopathic medicine degree from Midwestern University Arizona College of Osteopathic Medicine at Glendale. She holds a certificate of added qualification in primary care sports medicine. Her clinical interests include preventive care in family medicine and sports medicine.

Aysha Azam, DO, is a clinical faculty physician in the Department of Family Medicine at Rutgers University/Robert Wood Johnson University Hospital Somerset. She earned her doctor of osteopathic medicine degree from the Philadelphia College of Osteopathic Medicine in Philadelphia, Pennsylvania. Dr. Azam completed advanced training in integrative medicine remotely via the University of Arizona, and serves as an Advanced Life Support in Obstetrics instructor. Dr. Azam’s clinical and academic interests include women’s health and integrative and obesity medicine.

No relevant financial relationships.