Research has demonstrated that 50% of infections are from pre or non-symptomatic carriers. Ya that advice kills people.

I'm but a humble pediatrics nurse. There's no proper RSV vaccine where you get immunity for a long long time, you can get a prophylactic monoclonal antibody (that they'll call a vaccine usually) that lasts a few months but they usually only prescribe those to people with really bad lungs and poor immunities (for me that's mostly preemie babies). It's also expensive as fuck.

For most healthy adults, a bout of RSV is basically just an annoying cough - not fun, not deadly. For the 60+ crowd, it can be quite hard. For babies up to maybe 3, it makes them so stuff they can't breathe and fills up their bronchioles (bronchiolitis).

You should get a covid and flu shot yearly though.

The thing that was pretty spooky to see this winter was IGAS where relatively health people would get influenza b and strep throat then the strep goes septic and they end up in the icu. Like a healthy 30 year old with what feels like a kind of shitty flu going from emerg to ICU in a couple days. IGAS (invasive group a strep) seems like it's calmed down but we're probably going to see these random weird things yearly from now on. Covid infections damage immune systems in ways we don't really predict - like we keep getting really gross ruptured appys and swathes of newly diagnosed type 1 diabetic 12 year olds in DKA in amounts that just never used to happen before 2020.

HVAC is a big one, putting in HEPA filtration but also turning over air. Might as well maintain/improve AC while it's being done I guess - but all that costs money and so many nursing homes are for-profit so they'd rather not spend money on capital improvements when it can go to ownership. Otherwise, they could be stricter with PPE and not letting people in with symptoms but there's just so much fucked up shit that's happening to make workers feel okay or even needing to come in when they're sick.