[caption id="attachment_210119" align="aligncenter" width="1024"] The Delaware Department of Health vaccinated more than 100 people at a clinic event in Smyrna back in 2021. Doctors are once again urging people to practice caution and receive updated COVID-19 booster shots and flu vaccines to head off the "tripledemic”" this winter. | PHOTO COURTESY OF DHSS[/caption] WILMINGTON — With three highly contagious respiratory viruses spreading quickly, Delaware’s health care officials are urging businesses and residents to mask up and exercise the same protocols in place for the past two years of the pandemic. For weeks, Delaware officials have been warning of a surge in COVID-19, as historically seen, but also record-setting cases of the flu and respiratory syncytial virus (RSV).The “tripledemic” is sickening millions of Americans — and causing a chain reaction in the workforce. Working parents are also facing the brunt of RSV, a virus that has cold-like symptoms but can provoke breathing problems in young children and older adults.  [caption id="attachment_228274" align="alignleft" width="200"] Dr. Eva Geracimos. | PHOTO COURTESY OF CHRISTIANACARE[/caption] Nationwide, 104,00 people called out of work due to child care issues, including a sick child in October, according to the Bureau of Labor Statistics. In November, that number fell to 59,000 workers. “RSV has been on the rise, and it has been problematic for parents with children,” said Dr. Eva Geracimos, who practices family medicine at ChristianaCare’s Lantana Square location. “We have seen child care centers not shut down like they did in the early years of the pandemic, but there are outbreaks. And parents may not be sending in their children, depending on what’s going on. It’s challenging.” As the state has seen historically, COVID-19 continues to surge in the colder months when people are staying indoors although now, people have enjoyed relaxed precautions two years since the pandemic began. There are 3,402 cases of COVID-19 per 10,000 people in the First State as of Dec. 8, according to the state COVID-19 tracker. The seven-day positive test average is hovering around 8.3%, and there are 146 people hospitalized with COVID-19. But on top of RSV and the returning high rates of COVID-19 is a climbing flu case rate.There are 4,274 flu cases as of Dec. 3, and 27% of those cases were reported that week. The first flu case was reported in October, weeks earlier than expected. “Most of the people I’m seeing at my practice with flu or COVID are in their 30s and 40s,” Geracimos said. “Flu numbers are exploding, and I have a feeling we haven’t reached our peak yet. It hits the country earlier than it does, and people get their flu vaccine typically in October. So people who normally get vaccinated weren’t at that point, got the flu.” Flu cases were lower in previous years, due in part to the masking, social distancing and general caution out in the community. The Delaware Department of Public Health reported there were more than 2,700 cases between October 2021 and June 2022. Geracimos said that may be lulling people into a false sense of security, as well as general fatigue over getting vaccine shots. Some patients may have received as many as five shots over the past two years for COVID-19, including the bivalent COVID-19 booster shot, and may be putting off receiving yet another one. “The question I get asked at least 50% of the day is, ‘Do I really need to get it?’ And the answer is absolutely yes,” she said. “If you get the flu and the COVID vaccine, and catch it, your symptoms are less severe, and it shortens recovery time.” In addition to getting up-to-date on the vaccines, Delawareans are encouraged to call out sick and stay at home if feeling unwell, and keep children home if ill. Geracimos also recommends masking up when leaving the house, but, especially in crowded areas, as well as washing your hands throughout the day. For working parents of younger children, she recommends talking with their daycare centers and asking about the hygiene practices, including and not limited to, wiping down surfaces and offering hand sanitizer to kids before snack time. “All this has been ramped up since COVID started, but it’s never a bad thing to ask questions and revisit procedures,” Geracimos added.