As cases of covid, flu and RSV collide, the CDC is warming up to a tough winter
At least 4,300 flu patients were admitted to hospitals in the week ending Oct. 29, the most for that time period in a decade and nearly double the previous week, according to data released on Friday. The flu season started six weeks earlier this year, at the level not seen since the 2009 H1N1 swine flu pandemic.
After enduring two consecutive winters overwhelmed by an influx of Covid-19 patients, America’s hospitals are facing a possibility the third covid winter — this time, broken on three fronts.
“With increased RSV infections, the increasing number of flu cases and the ongoing burden of covid-19 in our communities, there is no doubt that we will face some challenges this winter,” Dawn O’Connell, assistant secretary of Health and Human Services for preparedness and response, told reporters on Friday . “But it’s important to remember … that RSV and flu are not new, and we have safe and effective vaccines for covid-19 and flu.”
Respiratory syncytial virus, a common cause of cold-like symptoms in children known as RSV, continues to rise nationally and strain children’s hospitals. Trends vary by region; RSV appears to be retreating in the southeast and the mountainous west, flu is on the rise. There is no vaccine for RSV, but Pfizer plans to seek approval for one used during pregnancy.
Health officials are preparing for the possibility that Covid will once again overwhelm hospitals, depending on that new variants are becoming dominant, as governments have abandoned efforts to limit transmission and a few senior citizens who are most susceptible to severe disease are keep up with your shots.
Some health officials have described the combination of influenza, RSV and coronavirus as a “triple demy.”
“Covid has affected the seasonal patterns of all these respiratory infections,” said Tina Tan, a pediatric infectious disease specialist at Ann & Robert H. Lurie Children’s Hospital in Chicago, where RSV cases are rising and flu cases are starting to rise. “Whether the pattern will go back to the way it was before covid, I don’t think anyone really knows, but it makes it even more complicated to give people the care they need when you have three viruses that can cause an increase in serious illness at the same time.”
David Rubin, who tracks respiratory viruses for the PolicyLab at the Children’s Hospital of Philadelphia, said it is too early to declare a hospital crisis. A youth mental health crisis and a nationwide shortage of pediatric beds have made it difficult for the health system to cope with the rise in respiratory cases, he said. But adult hospitals are in a better position to respond.
“It depends on when these spikes occur and how significant a magnitude we’ll see Covid come back this winter,” Rubin said. “This year we have yet to see a real acceleration in hospitalizations for covid. If you’re looking for a silver lining, this is one.”
US Govt has medical supplies including personal protective equipment and respirators available in its stockpile, but officials say no country has yet requested additional personnel or supplies.
“State and territorial public health officials are urging parents and families to take precautions now to stay healthy and avoid straining hospital systems,” said Anne Zink, Alaska’s top public health official and president of the Association of State and Territorial Health Officials. in a written statement.
Those precautions, including keeping up with vaccinations, staying home when sick and washing your hands regularly. Government recommendations often lack or downplay the importance of wearing masks, a measure that was rarely adopted during past respiratory virus seasons, but proven effective to prevent the spread of the corona virus.
Lynn Goldman, dean of the Milken Institute School of Public Health at George Washington University, who serves on a committee that advises CDC Director Rochelle Walensky, asked at a meeting Thursday why agency officials are not recommending masks given the burden on hospitals.
“Nothing can be mandated at this point,” Brendan Jackson, the CDC’s incident manager for Covid-19, responded on Thursday.
José Romero, director of the CDC’s National Center for Immunization and Respiratory Diseases, mentioned well-fitting masks at the end of the list of recommended precautions during the agency’s press briefing on Friday.
“If the family wants, they can use masks,” Romero said.
Lack of exposure to other viruses when people practiced social distancing and wore masks to avoid the coronavirus contributed to the current situation, experts say.
“All that regular exposure that usually happens to build immunity year after year didn’t happen,” Walensky said Tuesday during an appearance before the US Chamber of Commerce. “If you go two years without that infection, without protection against the infection and then all of a sudden, boom, everyone from zero to three years old gets RSV, you see the impact on health care.”
Although RSV is among the leading causes of hospitalization in young children, the virus also poses a greater threat to senior citizens and immunocompromised adults. Despite the decline in the number of coronavirus cases, doctors say the medically vulnerable should consider taking extra precautions because of the circulation of other respiratory viruses.
“If you’re at higher risk, don’t go into those high-risk areas and don’t wear a mask if you have to go into those areas with an N95,” said Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau in New York.
During flu season, the burden on hospitals may not be as debilitating to the health system if cases are fairly mild and patients are discharged quickly. Lynnette Brammer, an epidemiologist who leads the CDC’s domestic flu surveillance team, said officials have yet to see evidence of a more virulent flu strain.
“We’re not seeing anything right now that would lead us to believe it’s more serious,” Brammer said Friday. “It’s just early.”
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