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Health
21 July 2024

Are We Ready for the Triple Threat of COVID, Flu, RSV?

Experts express concerns as COVID-19, flu, and RSV cases rise across the United States but vaccinations remain low.

The United States is once again grappling with a resurgence in respiratory illnesses as various variants of COVID-19, flu, and respiratory syncytial virus (RSV) make their presence felt. This combined viral wave has significant implications for public health, particularly with the arrival of the holiday season prompting increased social gatherings and travel.

Data from the Centers for Disease Control and Prevention (CDC) reveals that 15 states and New York City are currently experiencing 'high' or 'very high' levels of respiratory illness, defined as individuals visiting healthcare facilities with symptoms such as flu, COVID-19, and RSV. Weekly COVID-19 hospitalizations have soared to numbers not seen since February 2023, with 22,513 recorded cases for the week ending December 2. Fortunately, these hospitalization rates, although elevated, remain below the levels seen at the same time last year. COVID-19's impact is most severe among infants, young children, and senior citizens.

The rise in respiratory illness isn’t limited to COVID-19. Flu activity is escalating, particularly in the southeastern and south-central regions of the country. The CDC estimates there have been at least 2.6 million flu cases, resulting in 26,000 hospitalizations and 1,600 deaths so far this season. RSV hospitalizations have also remained high, especially among children under four and adults over 65. This trend prompted the White House to request increased production of RSV immunizations for vulnerable groups.

Adding to the mix of circulating viruses, various subvariants of Omicron are causing concern among public health officials. The EG.5 variant, also known as 'Eris,' has become the most dominant strain, accounting for 24.5% of COVID-19 cases. Furthermore, a highly mutated variant, BA.2.86, is being closely monitored due to its potential for transmission and evasion of existing immunity. Although real-world cases of BA.2.86 are currently limited, it has been detected across multiple continents, indicating its capacity to spread globally.

The summer saw the introduction of the FLiRT variants, including the dominant KP.3 strain, which contributed to a summer wave of COVID-19 infections. Test positivity rates and COVID-19 related emergency room visits spiked nationwide, with 42 states showing rising or likely rising infection rates. The FLiRT variants are notable for their ability to escape prior immunity, making them particularly concerning as we head into colder months.

Despite the surge in cases, the current wave has not led to hospitalization levels comparable to the peak periods of the pandemic. Death rates remain lower, with the CDC reporting 615 COVID-19 related deaths from September 10-16. Health experts warn, however, that even mild COVID-19 cases can lead to long-term complications, known as long COVID, which underscores the importance of continued vigilance.

The public's response to vaccinations remains tepid. As of December, only 40.8% of adults and 41.6% of children have received the flu vaccine, while updated COVID-19 vaccine uptake stands at 17.2% for adults and 7.7% for children. Dr. Philip Huang from Dallas County Health and Human Services highlights the importance of maintaining preventive measures. He stresses, 'Stay home if you're sick, wash your hands, cough into your sleeve, don't rub your eyes, nose, and mouth, and keep up with vaccinations.'

In regional responses, some healthcare facilities in Washington state have reinstated mask mandates to control the spread of these respiratory viruses. Hospitals, like Mary Bridge Children’s Hospital in Tacoma, have seen RSV and flu cases rise to levels necessitating stricter protocols.

The increasing cases coincide with a return to routine activities such as school and work, raising potential for higher transmission rates. While President Biden's recent positive COVID-19 test highlights the virus’s pervasive reach, his mild symptoms emphasize the benefit of vaccinations and early treatment with antiviral medications like Paxlovid.

Medical professionals emphasize the importance of updated vaccines tailored to combating the current strains. The CDC and FDA have promoted new vaccine formulations designed to protect against prevalent variants. 'The new vaccines are crucial in mitigating the spread and severity of the illness,' stated Dr. Jesse Goodman, a professor of medicine at Georgetown University Medical Center.

Another aspect complicating the current viral season is the climate. As people flock indoors due to colder weather and continued travel, the conditions are ripe for viral transmission. Data from wastewater tracking has indicated high levels of virus particles, which often precede clinical case surges.

Overall, while COVID-19, flu, and RSV remain significant threats, the combination of vaccination, public health measures, and proper hygiene can help manage their impact. Dr. William Schaffner of Vanderbilt University Medical Center advises a pragmatic approach: 'We need to be cautious, follow the data, and continue our preventive practices to keep these viruses in check.'

With the holiday season upon us, experts urge the public to be mindful of health guidelines to protect themselves and their loved ones. The cumulative lesson from the past few years remains: staying informed, vaccinated, and vigilant are key strategies to navigating this challenging respiratory virus season.

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