As covid, flu and RSV cases collide, CDC warms up from tough winter ahead


The United States continues to experience an unusually high and early rise in influenza and respiratory syncytial virus infections, straining a health care system that is trying to recover from the worst of the coronavirus pandemic.

As new cases of coronavirus stabilized in recent weeks, federal health officials warned Friday that they face high levels of other resurgent viruses as pre-pandemic life returns and many Americans, especially children, lack immunity. The Centers for Disease Control and Prevention has issued a respiratory virus advisory to thousands of health care providers in an effort to strengthen testing, treatment and vaccination.

According data released Friday. The flu season started six weeks ago this year, at a level not seen since the 2009 H1N1 swine flu pandemic.

After enduring two consecutive winters crushed by an influx of covid-19 patients, American hospitals face the prospect of a third covid winter – this time slammed on three fronts.

“With increase in RSV infections, an increasing number of flu cases and the continued burden of covid-19 in our communities, there is no doubt that we will face challenges this winter,” Dawn O’Connell, assistant secretary for the Health and Social Services for preparedness and response. . “But it’s important to remember…RSV and influenza are not new, and we have safe and effective vaccines for covid-19 and influenza.”

So far this flu season is more severe than it has been in 13 years

Respiratory syncytial virus, a common cause of cold-like symptoms in children known as RSV, continues to rise nationwide and strain children’s hospitals. Trends vary from region to region; RSV appears to be receding in the southeast and the mountains in the west as the flu increases. There is no RSV vaccine, but Pfizer plans to seek approval for that administered during pregnancy.

Health officials are bracing for the possibility of covid overwhelming hospitals again, saying new variants become dominant as governments have abandoned efforts to limit transmission and few of the older people most at risk of serious illness are up to date on their shots.

Some health officials have described the confluence of influenza, RSV and coronavirus as a “triple epidemic”.

“Covid has impacted 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 increasing and flu cases begin to rise. “I don’t think anyone really knows if the model will go back to how it was before covid, but it makes it harder to provide the care people need when you have three viruses that can cause serious illness. at a time.”

David Rubin, who tracks respiratory viruses for the PolicyLab at Children’s Hospital of Philadelphia, said it was premature to declare a hospital crisis. A mental health crisis among young people and a national shortage of pediatric beds have made it harder for the health system to manage the rise in respiratory cases, he said. But adult hospitals are better placed to respond.

“It depends on when those spikes happen and how big covid comes back this winter,” Rubin said. “We have yet to see a real acceleration this year in terms of covid hospitalizations. If you’re looking for a silver liner, this is it.

The US government has medical supplies, including personal protective equipment and ventilators available in its stockpile, but officials say no state has yet requested additional personnel or supplies.

“State and territory public health officials are urging parents and families to take precautions now in order to stay healthy and avoid straining hospital systems,” said Anne Zink, a Alaska’s top public health official and president of the Association of State and Territorial Health. The officials, in a written statement.

These precautions include staying up to date on vaccines, staying home when sick, and washing your hands regularly. Mask-wearing is often absent or minimized in government recommendations, a measure rarely adopted in recent respiratory virus seasons, but proven effectiveness to curb the spread of the coronavirus.

Lynn Goldman, dean of George Washington University’s Milken Institute School of Public Health who sits on a committee that advises CDC director Rochelle Walensky, asked at a meeting Thursday why agency officials weren’t recommending masking given the pressure on hospitals.

“At this point, nothing can be mandatory,” CDC covid-19 incident manager Brendan Jackson responded Thursday.

José Romero, director of the CDC’s National Center for Immunization and Respiratory Diseases, mentioned properly fitting masks at the end of a list of recommended precautionary measures during agency press briefing on Friday.

“If a family wishes, they can use masks,” Romero said.

RSV, other viruses making it difficult to find a bed in children’s hospitals

The 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 of this regular exposure that usually happens and builds immunity year after year didn’t happen,” Walensky said Tuesday during an appearance before the U.S. Chamber of Commerce. “If you go two years without getting this infection, not getting this infection protection and all of a sudden, boom, everyone from zero to three gets RSV, you see the impact on the care of health.”

While RSV is a leading cause of hospitalization in young children, the virus also poses a greater threat to the elderly and immunocompromised adults. Despite declining coronavirus cases, doctors say medically vulnerable people should consider taking heightened precautions due to the circulation of other respiratory viruses.

“If you are at high risk, do not enter these high risk areas or mask if you must go to these areas with an N95,” Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau told New York.

For flu season, the strain on hospitals may not be as debilitating to the healthcare system if cases are mild enough and patients are discharged quickly. Lynnette Brammer, an epidemiologist who leads the CDC’s national flu surveillance team, said officials have yet to see evidence of a more virulent flu strain.

“Right now, we don’t see anything that would lead us to believe it’s more serious,” Brammer said Friday. “It’s just early.”

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