Triple Epidemic: Pandemic Fatigue and Misinformation as Possible Causes

“Triple Epidemic” is a term that has been thrown around in the media since late 2022. It seems to have peaked, but what is it, and what should every industry, health system, and other companies do to mitigate the damage the triple epidemic continues to cause? What should these institutions do to prevent another one? Did vaccine misinformation lead to the current triple epidemic? Did nurse burnout?

Recently, Infection Control Today^® (ICT^®) recently spoke with Maureen Hennessey, PhD, CPCC, CPHQ, SVP, director of value transformation of Precision Value, and Cynthia Miller, MD, MPH, vice president and medical director of the Access Experience Team of Precision Value to give the answers. This is the first of 3 installments of that interview.

This triple epidemic (or “tripledemic”) is the confluence of influenza, COVID-19, and respiratory syncytial virus (RSV). Hennessey explains: “One of the first things we need to do is we need to acknowledge that this just tremendous pandemic fatigue and associated with that is denial that we still have COVID-19 as a serious illness in this country; it's likely to be the third leading cause of death in this country this year, and that would be for the third year in a row. We need to acknowledge this. And it has also contributed to a decline in our life expectancy. Then influenza and RSV further strain our health system, which is why this is sometimes called the triple epidemic.”

Miller discussed how scientific knowledge is constantly changing and can cause confusion and distrust and could have led to this triple epidemic. Individuals “hear one thing, and then the next day, they hear something different. And it leads to them questioning, “Is what I heard before true? How can I trust what I'm hearing? We have many different thoughts about herd immunity now for COVID-19. I mean, this was traditional thinking around measles and polio. These are viruses that don’t mutate, so 1 vaccine is good for that [virus] because that vaccine lasts a long time. And we know that we can reach vaccination levels in a community that prevent strep spread.

“[However] for the COVID-19,” Miller continued. “As a virus, it's very different. And we've seen this with influenza as well. It's constantly mutating, so we must keep up with new vaccinations. We don't have a sustained immune response to the COVID-19 vaccine that we [must keep] getting boosted. And all these factors aren't favorable toward creating herd immunity as a strategy to prevent future infections. [Individuals] have heard that we want to get everybody vaccinated for herd immunity, but now we're saying, “Maybe herd immunity isn't what's going to help us with COVID-19. That's confusing and leads to mistrust and misinformation.”

Paradoxically, sometimes we think that because things have changed, we can't trust what's being told to us.

Hennessey also discussed the misinformation that led to this triple epidemic. “The misinformation piece certainly is a factor. We do find many individuals, less than half of the people in this country [United States], don't have an enduring relationship with a primary care doctor. They may not have a primary care physician, or if they do, it's been less than 5 years that they've had that relationship. So when they hear information about the vaccines, and they are skeptical in some way or may have questions, they may not have a trusted provider that they can go to get additional information.”

Hennessey continued and said that “As science has evolved [and] as our knowledge has evolved around the issue of the vaccines and of COVID-19, for example—and not just the COVID-19 vaccines, but also influenza vaccines, [individuals] sometimes don't recognize that the reason why they're being given different information, or direction and guidance is that our science is evolving as we learn more. Paradoxically, sometimes we think that because things have changed, we can't trust what's being told to us. Yet, the other side of it is because that very issue of our continuing to learn is why things change from that [new] perspective if I don't perceive that there's a risk. If I don't perceive that I've got a vulnerability here, I may not want to go and take the time to get the vaccines, which is unfortunate.”

These quotes have been slightly edited for clarity.

This is the first of 3 installments of this exclusive interview.