Before widespread PCR testing became common during the pandemic, researchers estimated that RSV was up to seven times under-detected in adults over 60.
That means for every older adult officially diagnosed with RSV, roughly six more had it and never knew.
They were told it was a cold. Or bronchitis. Or "something going around." They were given cough syrup and sent home while a virus capable of triggering pneumonia quietly settled into their lower airways.
The under-detection problem hasn't fully gone away. Many urgent care facilities test for flu and COVID but not RSV.
Many primary care offices don't routinely test for it in adults. If you go to your doctor with a cough, congestion, and a low fever, the most likely outcome is still: rest, fluids, call back if it gets worse.
Meanwhile, RSV is doing what it does — replicating in the nasal passages for days before anyone thinks to test for it.