Will Thanksgiving make a bad respiratory disease season even worse? : Blows

From left to right: 1) Stained scanning electron micrograph (SEM) of a human cell infected with the H3N2 influenza virus (filamentous gold particles). 2) Scanning electron micrograph of human respiratory syncytial virus (RSV) virions (colorized blue) shedding from the surface of human lung epithelial cells. 3) Transmission electron micrograph of SARS-CoV-2 Omicron virus particles (gold).

Scientific Source / NIAID

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Scientific Source / NIAID

From left to right: 1) Stained scanning electron micrograph (SEM) of a human cell infected with the H3N2 influenza virus (filamentous gold particles). 2) Scanning electron micrograph of human respiratory syncytial virus (RSV) virions (colorized blue) shedding from the surface of human lung epithelial cells. 3) Transmission electron micrograph of SARS-CoV-2 Omicron virus particles (gold).

Scientific Source / NIAID

In each of the past two years, Thanksgiving has contributed to the arrival of some very unwanted guests: devastating waves of COVID-19.

No one thinks this year will look like the last two dark winters of the pandemic, at least when it comes to COVID-19. But the country now faces a different kind of threat – an unpredictable confluence of old and new respiratory pathogens.

“We are facing an onslaught of three viruses – COVID, RSV and influenza. All simultaneously,” says Dr. William Schaffner, an infectious disease specialist at Vanderbilt University. “We call it a triple epidemic.”

Influenza and RSV are back, with great fanfare

Respiratory syncytial virus (RSV) began to rise uncharacteristically early this year, infecting babies and young children who had little or no immunity to the virus, which hasn’t been circulating much for the past two years. , in part due to COVID-19 precautions.

The resurgence of RSV continues to flood pediatric emergency rooms and intensive care units across the country. Some parents are forced to wait more than eight hours in emergency rooms for the treatment of their very sick children.

“Intensive care units are at or above capacity in every children’s hospital in the United States right now,” said Amy Knight, president of the Children’s Hospital Association. “It’s very, very scary for the parents.”

At the same time, an unusually early and severe flu season is emerging, dominated by the H3N2 strain, which often hits children and the elderly particularly hard.

“The flu hit the southeastern United States. It moved into the southwest. It moved up the east coast and into the Midwest with some ferocity,” Schaffner said.

Coast to coast, flu hospitalizations are at their highest for this time of year in a decade, according to the Centers for Disease Control and Prevention.

“Influenza activity is high right now and continues to increase,” says Lynnette Brammer, an epidemiologist with the CDC’s influenza division. “The good news is that this year’s vaccines are well–corresponds to the viruses currently circulating, and there is still time to get vaccinated. »

But now comes another Thanksgiving.

“These holiday celebrations with all their travel and close contact usually work like virus accelerators,” Schaffner says. “We spend a lot of time with each other. We laugh and breathe deeply. And it’s an ideal environment for these respiratory viruses to spread to others.”

What will COVID do this time?

Of course, COVID-19 is still sickening tens of thousands and killing hundreds every day. And new, even more contagious omicron subvariants, particularly adept at infecting people – even if they’ve been vaccinated or already infected – are taking over.

“There are a lot of moving parts here,” says Dr. David Rubin, who has been tracking the pandemic at the PolicyLab at Children’s Hospital of Philadelphia..

“What’s all this going to mean for COVID? Are we going to see a resurgence of COVID in January/February that’s going to be big enough? It could still happen.”

Many infectious disease specialists say that people’s immunity to vaccinations and infections should prevent any new outbreaks of COVID-19 infections from causing a sharp increase in hospitalizations and deaths.

“I hope, given where we are with COVID, that we’re not looking at something like last winter. But ultimately Mother Nature has the final say on these things,” Dr Ashish said. Jha, the White House COVID-19 coordinator, told NPR.

“We’re in new territory here” with three viruses all circulating at high levels simultaneously, he says.

“I think it’s a really worrisome situation for the coming weeks,” says Jennifer Nuzzo, an epidemiologist who directs Brown University’s Pandemic Center.

Nuzzo is worried because an exhausted nation has abandoned many of the precautions people used to take to protect themselves and others. Flu vaccination rates are down about 10-15% from previous years. Only about 11% of people eligible for the new omicron bivalent boosters were boosted.

“We can’t resign ourselves to assuming this will happen no matter what,” she says. “We can definitely take steps to prevent an increase in hospitalizations and deaths.”

Nuzzo and other experts say Americans can get vaccinated and boosted, especially if they are at high risk due to age or other health conditions.

People should consider zooming in for Thanksgiving if they’re sick, testing for COVID-19 before gatherings (especially those involving older friends and relatives and other vulnerable people), and even consider putting that mask back on. as much as possible.

“If you don’t eat or drink, it’s probably a good idea to protect immunocompromised people, infants, as well as the elderly in the home,” says Dr. Tina Tan, infectious disease specialist at Northwestern. University Feinberg School of Medicine.

There are hints that RSV may already be peaking, and the flu may also peak early, before a new outbreak of COVID-19 emerges. This would help relieve at least some of the pressure on hospitals.

There is even a theoretical possibility that influenza and RSV could dampen any new surge of COVID-19 in the same way that the coronavirus has crowded out these viruses for the past two years. One possibility is a phenomenon called “viral interference”, which involves the presence of one virus reducing the risk of catching another.

“COVID could be overtaken, which is potentially good news,” says Rubin.