The rituals of the winter holidays are behind us. It’s cold and snowing in many places. And unfortunately, another annual tradition is upon us.
“Respiratory season is here,” says Dr. Brendan Jackson, an epidemiologist at the Centers for Disease Control and Prevention. “It’s starting to be in full swing now with a lot of people getting sick, a lot of people missing work, missing school, and just feeling lousy in general.”
People tend to travel and gather with family and friends during vacations. The bad news is that this often means they come home with a nasty bug. And we’re in the thick of it again right now.
“The situation is ugly right now,” says Katelyn Jetelina, an epidemiologist who writes the newsletter Your Local Epidemiologist.
Influenza, in particular, is at high or very high levels across the country, according to the CDC.
“We’re buried under the flu. Things are very, very busy and intense,” says Dr. William Schaffner, an infectious disease researcher at Vanderbilt University in Nashville, Tennessee. “The emergency room is full of people coughing and sneezing. We’ve had people waiting on stretchers – these stretchers – waiting to be admitted. We’re really full.”
And it’s not just the flu. RSV also continues to spread at very high levels. And now COVID-19 is starting to spread again.
“Before, we had two major viruses causing a lot of hospitalizations and deaths related to RSV and the flu,” Schaffner says. “Even though COVID is no longer in a state of emergency, it still causes more hospitalizations and deaths than the other two. And so you add that together, every respiratory season on average going forward will be worse than it is was before the pandemic due to the addition of COVID.
No one knows how much worse things could get this winter. The CDC says that unless a new, more highly transmissible COVID-19 variant emerges, it appears this winter will be like last year.
But that’s not great: It still means many children miss school, parents miss work, and grandparents and other vulnerable people end up in hospital and even die.
“We have three viruses that are going to hit with peaks relatively close together. So as one starts to wane, the other will start to peak,” says infectious disease researcher Dr. Andrew Pavia. at the University of Utah. “And we’re just not going to have a reprieve, like a series of snowstorms. What that means, I think, is that we’re going to have a pretty miserable January before things start to get worse. Stop.”
But even then, there will likely be a long tail, according to Caitlin Rivers, a Johns Hopkins University epidemiologist who wrote the book. Crisis avertedon pandemics.
“The winter season for respiratory viruses often peaks in December or January,” Rivers says. “But it persists through the spring months. And so I think we still have several weeks, if not several months, of this sick season left.”
Rivers and others recommend that people wash their hands frequently, wear a mask in crowded places and, of course, get vaccinated. The flu and COVID-19 vaccines aren’t perfect, but they both work to keep people from entering the hospital and dying, especially the elderly and other vulnerable people. Most people still haven’t received any of these shots, but it’s not too late.
It also can’t hurt to get tested to see what bug someone has. New tests available for the first time this year without a prescription allow people to check at home for the flu and COVID-19. This could help their doctors decide more quickly whether they need antiviral drugs.
This is all on top of other common infections, according to Dr. Sean O’Leary, a professor of pediatrics at the University of Colorado School of Medicine and chair of the American Academy of Pediatrics’ committee on infectious diseases. For example, mycoplasma pneumonia, which can cause “walking pneumonia,” and whooping cough are still widely spread.
“We’re unfortunately seeing a lot of that this year,” O’Leary says.
There is also another respiratory virus that is attracting attention: human metapneumovirus (HMPV). Indeed, China is reporting an upsurge in HMPV in the north.
But the World Health Organization said Tuesday that HMPV levels in China are not unusual and are not straining the health system.
“WHO is in contact with Chinese health authorities and has not received any reports of unusual outbreaks,” according to a WHO statement. “Chinese authorities report that the health system is not overwhelmed and there has been no emergency declaration or triggered response.”
Other infectious disease experts say they’re not very worried about HMPV. This virus, related to RSV, has been circulating for decades, so many people are immune to it.
Although HMPV can cause serious complications like pneumonia, it usually only causes a cold. HMPV is spreading at low levels in the United States. But experts emphasize that HMPV does not appear to pose a threat comparable to the threat posed by the flu and COVID-19, which still kill hundreds of people each week, according to a report released Tuesday by the CDC.
“We’re monitoring this closely,” says Jackson of the CDC’s HMPV. “I will say that the levels here in the United States are really at a typical level for this time of year. It’s nothing crazy compared to previous seasons.”
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