CDC warns of severe winter as flu, RSV and covid collide
The United States continues to experience an unusually high and early rise in influenza and respiratory syncytial virus infections, straining a health care system trying to recover from the worst of the coronavirus pandemic.
While new cases of the coronavirus have declined in recent weeks, federal health officials warned Friday that they are facing elevated levels of other viruses returning as pre-pandemic life returns and many Americans, especially children, lack immunity. The Centers for Disease Control and Prevention has issued respiratory virus advisories to thousands of health care workers in an effort to encourage testing, treatment and vaccination.
At least 4,300 flu patients were admitted to hospitals in the week ending Oct. 29, the most for that period in a decade and nearly double the previous week, according to data released Friday. The flu season started six weeks earlier this year, at a 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 the prospect of a third covid winter — this time, broken on three fronts.
“With the increased number of RSV infections, the rising number of influenza cases and the continued burden of covid-19 in our communities, there is no doubt that we will face some challenges this winter,” said Dawn O’Connell, Assistant Secretary for Health and Human Services for preparedness and response, he 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 receding in the southeast and west of the mountains due to the increase in influenza. There is no vaccine against RSV, but Pfizer plans to seek approval for a vaccine given during pregnancy.
Health officials are bracing for the possibility that Covid could once again overwhelm hospitals, depending on which new variants become dominant, as governments have abandoned efforts to limit transmission and few senior citizens most vulnerable to the severe disease are up to date on their vaccines.
Some health officials have described the combination of influenza, RSV and the 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 provide the care that people need when you have three viruses that can cause an increase in serious illness.” at the same time.”
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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. “We have yet to see a real acceleration in covid hospitalizations this year. If you’re looking for a silver lining, that’s one.”
The US government has medical supplies, including personal protective equipment and ventilators, available in its stockpiles, 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 has proven effective in curbing the spread of the coronavirus.
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, everybody 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 increased 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 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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