Leonard Friedland, MD is vice president and director of scientific affairs and public health for GSK in North America. He is GSK’s primary medical and public health representative and spokesperson for U.S. vaccine topics at the Centers for Disease Control and Prevention, other public health venues, congresses, and media outlets.
Dr. Friedland joined GSK in 2003 to focus his efforts on vaccination and public health with a passion to help people understand the science of vaccines and how they improve public health. Dr. Friedland brought to industry a distinguished academic background in pediatrics and emergency medicine, clinical and bench research, teaching, and patient care.
In this episode, Dr. Friedland discusses a recent surge of RSV, respiratory syncytial virus, how it affects the older population and what this means for healthcare providers across the U.S.
Listen to the full episode below.
Healthcare Insider Podcast: What healthcare providers need to know about RSV in older adults
Camille Baxter: Hello, and welcome to Healthcare Insider, a sponsored content podcast series from Modern Healthcare Custom Media. I'm your host, Camille Baxter. And today, I'm speaking with Dr. Leonard Friedland, Vice President and Director of Scientific Affairs and Public Health at US GSK Vaccines. Dr. Friedland joined GSK in 2003 to focus his efforts on vaccination and public health with a passion to help people understand the science of vaccines and how vaccines help to improve public health. As part of his role, he's involved in the development of vaccines for use in children, adolescents, adults, and pregnant women. He's an advocate for public health and is passionate about building healthier communities. Before we dive into our questions for Dr. Friedland, we'd like to thank the sponsor of this episode GSK. GSK is a global biopharma company with the purpose to unite science, technology, and talent to get ahead of disease together.
GSK prioritizes innovation in vaccines and specialty medicines, maximizing the increasing opportunities to prevent and treat disease. The company's vaccine portfolio tackles some of the world's most devastating diseases. To learn more about GSK and its portfolio and science, please visit www.gsk.com. We are very aware of the potential dangers of this season's flu and cold season, and the unseasonal early surge of RSV. In this episode, we are talking to Dr. Friedland about the rise in cases of RSV and what this means for older adults and their physicians. We'll discuss what healthcare practitioners can do to protect patients from RSV specifically, and how they can ensure they are keeping our communities healthy. Dr. Friedland, welcome, and thank you so much for being here today.
Dr. Leonard Friedland: Well, thank you very much, Camille, for having me on the podcast today. I'm really looking forward to this conversation.
Camille Baxter: Great. Well, before we jump into our questions about RSV and vaccines, I'd like to ask you to share a little bit about being a pediatrician and a research scientist.
Dr. Leonard Friedland: Well, thank you. It's something I love to talk about because it's an absolutely fascinating career, and I've had so many opportunities to impact both patients and population health. So, I am a pediatrician. I trained in Philadelphia at the Children's Hospital of Philadelphia about 35 years ago, and I started my career both as a pediatrician and an emergency medicine pediatrician in a traditional academic practice, clinical practice, research, and teaching. And over time, I gravitated to learning more about the power of immunization and preventing disease, trained in this treatment paradigm, and I became more interested in prevention as a paradigm. And I found the science of immunology and vaccinology absolutely fascinating.
I had a really transformational moment back in 1987 when I was a first year resident, when virtually every week in the hospital we would have a few children under the age of five, especially under the age of two, admitted with a disease called Hemophilus Influenza type B, which caused sepsis and meningitis. Virtually every family in the United States knew somebody who had a child who was infected with this type of meningitis. And in 1987, at the end of the year, the FDA licensed the world's first vaccine in the United States to prevent Hemophilus Influenza type B. And within a very short period of time, the disease was virtually gone from the hospital. And so, that was my first experience in seeing the power of vaccination, the power of prevention, and how a technological innovation just completely changed the course of public health. It was tremendous. And so, that's really what spurred me to think about prevention.
And ultimately, I learned more on my own and then wanted to devote my career to doing vaccine research. And I had the opportunity to join GSK 20 years ago. In addition, I still continue to see patients here in Philadelphia at a nonprofit clinic. And I also do international medical work twice a year caring as a pediatrician on an international medical team. But my work in the field of vaccinology and vaccine research is just absolutely fascinating because we can take today's science, our knowledge of human immunology and biology, innovative technologies, and are focused on the patient and create opportunities that can address problems, create solutions, and improve public health.
Camille Baxter: That really is amazing, and thank you for sharing that. It really provides even more of a framework to what you're doing at GSK and how you're also still seeing patients and kind of bringing those two pieces together. Let's talk about RSV a little bit more. We're seeing a recent surge in RSV in the US. Can you share what this means for healthcare providers across the country?
Dr. Leonard Friedland: Yeah, absolutely. The surge in RSV is in the news every day now. So RSV stands for respiratory syncytial virus. We call it RSV. And RSV is a common and actually very contagious seasonal respiratory virus that affects people of all ages, and it affects both the upper airway and the lower airway, the lungs, and the breathing passages. Now this virus typically circulates in the fall, winter, and early spring, but we have seen that that epidemiology has changed, especially during the period of COVID. And though while peak season for RSV is typically in December or January, this year, the CDC reported that some regions in the United States were seeing near seasonal peaks as early as October.
So, the disease started earlier this year in the United States, and this surge in RSV along with COVID and influenza, it's affecting the entire healthcare system. We're all aware that hospitalization rates are rising, office visits are increasing, and our medical facilities all across the United States are doing their absolute best to keep up with the demand care for these patients with RSV, people of all ages, children, and of course also adults. And on top of that, we have shortages of healthcare providers all across the country, which makes it even more difficult to keep up with this increasing demand and caring for our patients.
Camille Baxter: Yeah, I always thought of it myself as being something that affected infants. In fact, my son actually had RSV when he was six months old. But now we're really hearing more about the impact to older adults. So, you talked a little bit about how older adults are at risk for RSV. Can you share what healthcare providers should be paying attention to this winter season?
Dr. Leonard Friedland: Yeah, absolutely, Camille. I mean, I'm a pediatrician, as we spoke about. And of course, I knew of RSV as a pediatric disease. And so, typically when healthcare providers across all spectrums think of RSV, they think of it as for infants and young children. But the reality is that older adults can also contract the virus. The older adults can be at higher risk than the younger adults because of complications due to their immune systems, which are declining with age. As we get older, our immune systems decline with age, putting us at risk for various infectious diseases, which also includes RSV. So what is it about RSV in adults? How does the disease present? Well, adults who get infected with RSV, they typically have mild or perhaps even no symptoms. They may have signs, but even no symptoms. So, it can be a mild illness.
But when there are symptoms, they're usually consistent with an upper respiratory tract infection with runny nose, or pharyngitis, cough, headache, fatigue, fever. And the disease typically lasts about five days. Most people will recover within one to two weeks. But adults who are at risk for severe illness from RSV, they may have more severe symptoms that would be consistent with the lower respiratory tract infection, such as pneumonia. And RSV can sometimes lead to exacerbation of serious underlying medical conditions, such as asthma, chronic obstructive pulmonary disease, and congestive heart failure. And so, we have a disease that occurs commonly in adults.
It typically presents as an upper respiratory tract illness, but it can present with lower respiratory tract illness. Adults, especially over age 65 as our immune systems are declining, are at increased risk, including adults with underlying medical conditions such as asthma, COPD, and congestive heart failure. And so, I think it's just increasingly important that physicians across all specialties that are caring for adults, they have a conversation with their patients about RSV and the ways that their patients could protect themselves.
Camille Baxter: So, the CDC is calling this respiratory season a triple-demic with COVID, flu, and RSV cases surging. What more can physicians do to proactively protect patients?
Dr. Leonard Friedland: Well, thank you, Camille. That's a really important thing to talk about. And I think, first and foremost, physicians should be encouraging our patients of all ages to be up-to-date on their vaccinations, which include COVID boosters and influenza. Vaccination is the absolute best protection from vaccine preventable diseases. And vaccination plays a really critical role in keeping our communities healthy. I know as a physician, and also the literature absolutely back up what I'm saying right now, which is that a primary driver in patients being vaccinated is a recommendation from the healthcare provider for vaccination. So, it's really important to also, as physicians, to speak to our patients about the importance of vaccination in preventing vaccine preventable infectious diseases.
Camille Baxter: Why are we just now hearing more about RSV? And how can physicians best educate their patients about it so they can help protect themselves? Should physicians be testing their patients for RSV?
Dr. Leonard Friedland: That's a really good question. RSV's always been around. This is not a new virus. But people and healthcare providers, we may just think of RSV as the disease primarily affecting infants and young children. But as mentioned earlier, RSV affects adults and can be quite serious. And RSV circulates typically during the fall, winter, and early spring. Now this year, due to the pandemic and the COVID lockdowns that occurred actually in the last three years, people were staying inside. They were doing remote work or they were just socially distancing and isolating, and therefore we weren't seeing as many RSV cases in the last two years just because people weren't circulating. There was less people to people contact. But this year, of course, many of the pandemic measures, they've been lifted.
Were going back to work. Our children are back in school and their after school activities. We're in the office, we're on the subways, we're walking on the streets, we're going into the markets and the stores, restaurants, et cetera. And because of all of this, more people are being exposed to RSV. But to your question specifically, healthy adults don't need to be tested for RSV. Most RSV infections only cause mild symptoms such as what was mentioned earlier, runny nose, sneezing, coughing, headaches. But adults, especially those over 65, may need an RSV test if they have symptoms that are becoming moderate or serious.
Camille Baxter: Thank you for that. Before we end our discussion, what would you like to leave our audience with?
Dr. Leonard Friedland: Yeah, so focusing in on RSV in adults, it's really important to mention that there is no vaccine or specific treatment for RSV in older adults. So, it's really important as healthcare providers that we have conversations with our patients about risks and preventative measures because that's what we have in our toolbox. Now, while RSV may be quite common in young children, just to reinforce, adults can contract the virus also. And some adults may have even more severe symptoms that could be consistent with the lower respiratory tract infection, such as pneumonia. Just to reinforce that older adults are more likely than younger adults to get a serious RSV infection because our immune systems decline with age.
And so, who's at especially increased risk for severe illness from RSV? Which adults? Well, these would be the older adults, especially those who are 65 and older, adults with chronic lung disease or heart disease, and adults with weakened immune systems. And so, I know that we're short on time, so I'll just finish up by saying that with the holiday season around the corner, it's really important, as healthcare providers, that we remind our patients to be smart during this time and to monitor their symptoms before going to any gatherings. If you're sick, stay home because you don't want to spread this disease. And know that if you have an underlying medical condition or you're at advanced age, you're at increased risk for getting serious disease.
Camille Baxter: This is such an important and timely message, like you said, with the holidays right around the corner. And I really appreciate you helping our audience to just really focus on this and be more vigilant about all of our behavior as we go to enjoy time with our families and friends. Dr. Friedland, thank you so much for this conversation. And thank you to GSK for sponsoring this episode of Healthcare Insider.
Dr. Leonard Friedland: Oh, you're so welcome, Camille. And thank you for having me take the opportunity to talk about RSV and appeal to my healthcare provider colleagues. There are things that we can do right now to help educate our patients so that they can be smart heading into this crowded holiday season and monitor their symptoms before going out to any of these gatherings and knowing their risk factors, advanced age, underlying medical conditions, weakened immune systems, as examples.
One other thing. We have some more information, if anybody's interested. We have a website, RSVinadults.com. I'll spell it. R-S-V-I-N-A-D-U-L-T-S.com. So, RSVinadults.com to get some more information here for healthcare providers about what is RSV in adults. And again, thank you very much, Camille, for having me on the podcast today.
Camille Baxter: Great. Thank you again. To our audience, thank you for tuning in today. To hear more episodes of Healthcare Insider, you can go to the multimedia section on modernhealthcare.com or subscribe at your preferred pod catcher. I'm your host, Camille Baxter. Thank you. Take care, and have a wonderful holiday season.
- CDC. RSV-NET Interactive Dashboard. Available at: https://www.cdc.gov/rsv/research/rsv-net/dashboard.html
- CDC. Respiratory Syncytial Virus Infection. Available at: https://www.cdc.gov/rsv/index.html
- CDC. Emergency Preparedness and Response. Available at: https://emergency.cdc.gov/han/2022/han00479.asp
- CDC. For Healthcare Providers. Available at: https://www.cdc.gov/rsv/clinical/index.html
- CDC. RSV Prevention. Available at: https://www.cdc.gov/rsv/about/prevention.html
