You forgot about seasonal viruses right? If cold and flu season seems to be hitting your family the hardest this year, you’re not alone. This is the year that common viruses that have taken a back seat to Covid-19 “finally” make a comeback.
Positive tests for the flu stood at 25 percent at the end of November, according to the Centers for Disease Control and Prevention, up from 8 percent during the same time of year in 2019. Respiratory syncytial virus (RSV) it has pushed some children’s hospitals to capacity. And hospitalizations for Covid are on the rise again.
It’s the tripledemic that epidemiologists feared: Those viruses, with the help of a few other seasonal recurrents, are working together to fuel weeks of coughs, runny noses, and fevers. So if your children, your co-workers and everyone you know has been feeling sick, Here because.
“This season is truly unprecedented”, says Katelyn Jetelina, who writes Your Local Epidemiologist, a newsletter on the spread of infectious diseases. High rates of flu-like illnesses could be an early spike or early warning of a monumentally bad season.
“How high it will go, and how bad it will be, is unfortunately something we have to wait and see,” he says. “We are at the mercy of time”.
The problem goes beyond making everyone feel lazy and sick. CDC Director Rochelle Walensky confirmed that the flu, RSV and Covid they are putting strain on hospital systems.
It is the unintended consequence of measures that have tried to save lives: social distancing and mask wearing curbed the spread of influenza and RSV in 2020 and 2021. The seasonal increase during the summer, a indicator that things were changing in the wake of Covid.
Now these viruses are making a comeback, affecting a depleted healthcare system that spent three years treating Covid infections. These viruses are spreading in young children who have had no previous exposure to them and no immunity. Elderly people and the immunocompromised are also at higher risk.
Experts do not recommend dropping all guards to build immunity. But they note that social distancing and masking measures have played a role in purging other viruses from their historical patterns.
“That way, you prevent all these other things that are typically less contagious”says Mary Krauland, a research assistant professor at the University of Pittsburgh’s School of Public Health. “Over time, people are a little more susceptible.”
RSV typically causes mild illness, but can prove especially dangerous for young children whose tiny lungs can’t cough hard enough to clear the mucus. Almost all children contract the virus before the age of 2.
Seasonal viruses: little ones at risk
But now more children are getting sick at the same time, and children’s hospitals have been overwhelmed in recent weeks by the sudden surge. In the United States, hospitalizations for children agedand at 4 years they rose to 61 per 100,000 in mid-November, according to data from the CDC.
That rate peaked at 26 young children per 100,000 in the 2019-2020 RSV season. And some hospitals are now short on pediatric beds. As Covid has largely spared children from serious illness, some hospitals have pivoted, opening up designated spaces for children all the way up to adults. Some of those beds never came back.
Eric Biondi, director of the children’s hospital division of medicine at Johns Hopkins Children’s Center in Maryland, says the beds are full. The center also opened emergency beds, but now those too are full. Children’s hospital is no stranger to fielding serious illnesses from RSV and the flu, but this year they struck at the same time.
“It has been difficult”Biondi says. “The peak [RSV] it happened quickly. There has been no flattening of the curve. He just went up. Now, those cases have dropped; Hospitalizations for RSV in the US dropped sharply by the end of November to about 18 young children per 100,000, but that number is still high for November and December, compared to previous years.”
But the flu continues to circulate. The flu has already caused 78,000 hospitalizations and killed 4,500 people this year, according to CDC estimates. It killed about 25,000 people in the United States during the flu season from winter 2019 to spring 2020.
“Minimum Influenza Activity” left the CDC with no estimates in the winter of 2020 and spring of 2021, but the agency noted that fewer than 1 in 100,000 people were hospitalized with the flu, compared with 66 people out of 100,000 the previous year.
Threats are also visible in Europe, where the World Health Organization notes that the flu season has also started early. England is also seeing more than a quarter of flu tests come back positive and RSV hospitalization rates are on the rise.
German hospitals are reeling from RSV infections. But children in countries without robust medical systems are most at risk. Once in the spotlight, Covid is still circulating all over the worldalthough many people may have let their guard down when schools returned and the holiday season has now begun.
During the last week of November, hospitalizations for Covid-19 in the United States averaged 4,200 per day, a 17% increase from the previous week, according to the CDC. Across Europe, Covid-19 cases recorded a slight decline of 3.5% in late November.
Low vaccination rates exacerbate the problem. As of mid-November, only 40 percent of children in the United States had received a flu shot, according to the CDC. Only 12% of people 5 years of age or older in the US it received updated booster injections targeting the Omicron Covid variant.
Just under 15% of people in Canada have received a Covid booster since August. There is no RSV vaccine, although Pfizer is working on one and plans to submit it for approval by the US Food and Drug Administration later this year.
GSK has also submitted an RSV vaccine for older adults for review by regulators in Europe and the United States. Even though some hospitals are under stress, widespread closures of businesses and schools seem unlikely.
Lockdowns keep medical systems from being overwhelmed, but can lead to losses in education and income and negatively affect mental health. But getting winter viruses to circulate has its economic costs.
“We know that illness reduces productivity”says Nicholas Papageorge, an associate professor of economics at Johns Hopkins University. A study examining the economic costs of flu in 2015 found that led to $8 billion in indirect costs related to unemployment in the United States.
“We know these diseases are expensive and can be really dangerous, but we also know there are trade-offs,” he says. “If we’re particularly cautious about health, it means we’re incurring costs elsewhere.”
Now that there are fewer masking and distancing requirements, virus mitigation efforts fall largely on individuals. Wearing a mask, isolating yourself, testing for Covid and avoiding large crowds still helps people avoid getting sick and are especially important for those who they are vulnerable to serious disease.
In the United States, the CDC it’s encouraging people to start wearing masks again, and keeping kids from getting RSV until they’re older can help them fight it better.
Yet when individual mitigation efforts are undertaken by many, they can have a collective effect. “Infectious diseases violate the assumption of independence”says Jetelina. “What you do affects those around you. I really wish we approached not just Covid-19, but all these respiratory viruses, as a team effort.”
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