Covid no longer plays the dominant role it once did in most of our lives. But the risk of Covid – and other viruses – persists. This winter, experts expect cases, hospitalizations and deaths from viral illnesses to rise again.
The increase may have already started. Covid cases, hospitalizations and deaths are on the rise over the past two weeks. The recovery resembles the trend we’ve seen in recent years after Thanksgiving, typically continuing through the holiday season and into the year after. (Check the number of cases in your area with the Times tracker.)
Flu cases are also on the rise. The CDC classifies the vast majority of states as having “high” or “very high” activity for influenza and related illnesses. “Flu hospitalizations continue to be the highest we’ve seen at this time of year in a decade,” agency director Rochelle Walensky said last week.
Cases and hospitalizations due to RSV, which usually causes cold symptoms but can sometimes be more severe, also increased earlier this fall. But they seem to have already peaked.
The infectious disease climate in the United States right now is not a picture of the departure of Covid, but of its alignment alongside other endemic respiratory diseases in the fall and winter. In some years, Covid might be the worst of the bunch. In others, the flu or RSV might be. “That’s the reality we’re going to live with going forward,” said Dr. Celine Gounder, senior researcher at the Kaiser Family Foundation.
Today’s newsletter will look at this new normal for Covid and other viruses.
A viral season
Now, fall and winter disease trends might sound familiar: As people gather for the holidays, and generally indoors to avoid the cold, respiratory viruses are spreading more easily — true for Covid, but also for flu and RSV
The greatest risks are for the very old and very young.
Covid is still a threat, in large part because many people are not recently immune to vaccines or infections. But the virus is now largely a disease of the elderly, as David Wallace-Wells explained in Times Opinion: Americans 65 and older now account for 90% of deaths. (Some younger groups, especially the immunocompromised, also remain vulnerable.)
RSV and influenza often afflict an additional population, hitting the very young and old the hardest.
Influenza and RSV have been around for a long time. They have been tamed in recent years, largely because widespread actions to prevent Covid, such as masking and social distancing, have also worked against them. But since many people have never been recently exposed to influenza or RSV, they are also more vulnerable. This allowed a return of the two viruses.
“The combination of flu and Covid for the elderly is going to mean a pretty tough winter for hospitals,” Gounder said. “People talk about patients in the hallway – it wasn’t uncommon, actually, before Covid. We will see more.
What to do
You probably now know how to reduce your risk of Covid: Get vaccinated and boosted. When the virus is spreading rapidly, hide indoors and get tested regularly. If you get sick, self-isolate to avoid spreading the virus and try to get a prescription for Paxlovid to reduce the risk of hospitalization or worse.
“It’s all the obvious stuff,” Gounder said. “It’s really a question of whether people want to do them or not.”
Similar advice applies to the other two viruses, as they spread in similar ways. You can get your annual flu shot with a Covid booster at your local pharmacy. No vaccine exists for RSV, although some are in development.
The spread of viruses is a mixed picture. The bad news is that all three pathogens will likely be part of our lives, especially in fall and winter. The good news is that we are not totally powerless against them.
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