The CDC warns of a difficult winter in which flu, RSV and covid collide

The CDC warns of a difficult winter in which flu, RSV and covid collide

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

While new cases of the coronavirus have declined in recent weeks, federal health officials warned Friday that they are facing elevated levels of other viruses returning as pre-pandemic life returns and many Americans, especially children, lack immunity. The Centers for Disease Control and Prevention has issued respiratory virus advisories to thousands of health care providers in an effort to encourage testing, treatment and vaccination.

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At least 4,300 flu patients were admitted to hospitals in the week ending Oct. 29, the most for that period in a decade and nearly double the previous week, according to data released Friday. The flu season started six weeks earlier this year, at a level not seen since the 2009 H1N1 swine flu pandemic.

After enduring two consecutive winters overwhelmed by an influx of Covid-19 patients, American hospitals are facing the possibility of a third Covid winter – this time, hit on three fronts.

“With RSV infections on the rise, flu cases on the rise, and the ongoing burden of covid-19 in our communities, there’s no doubt we’ll face some challenges this winter,” Dawn O’Connell, Health and Human Services Assistant Secretary for Preparedness and the answer, he told reporters on Friday. “But it’s important to remember … that RSV and influenza are not new and that we have safe and effective vaccines for covid-19 and influenza.”

Respiratory syncytial virus, a common cause of cold-like symptoms in children known as RSV, continues to rise nationally and strain children’s hospitals. Trends differ regionally; RSV appears to be receding in the Southeast and Mountain West as influenza grows. There is no vaccine for RSV, but Pfizer plans to seek approval for a vaccine given during pregnancy.

Health officials are bracing for the possibility that Covid could once again overwhelm hospitals, depending on which new variants become dominant, as governments have given up efforts to limit transmission and few senior citizens, who are most vulnerable to severe disease, are underway.

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

“Covid has affected 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 rising and flu cases are starting to rise. “I don’t think anyone really knows if the pattern will go back to the way it was before covid, but it complicates giving people the care they need when you have three viruses that can cause serious illness at the same time.”

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David Rubin, who tracks respiratory viruses for the PolicyLab at the Children’s Hospital of Philadelphia, said it is premature to declare a hospital crisis. A youth mental health crisis and a nationwide shortage of pediatric beds have made it difficult for the health system to cope with the rise in respiratory cases, he said. But adult hospitals are better positioned to respond.

“It depends on when those peaks happen and how significantly we see a return of covid this winter,” Rubin said. “We have yet to see a real acceleration in covid hospitalizations this year. If you’re looking for the best, this is one.”

The US government is stockpiling medical supplies, including personal protective equipment and respirators, but officials say no country has yet requested additional personnel or supplies.

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

These precautions include keeping up with vaccinations, staying home when sick, and washing your hands regularly. Wearing masks is often missing or downplayed in government recommendations, a measure that was rarely adopted during past respiratory virus seasons but has proven effective in curbing the spread of the coronavirus.

Lynn Goldman, dean of the Milken Institute School of Public Health at George Washington University who serves on a committee that advises CDC Director Rochelle Walensky, asked at a meeting Thursday why agency officials are not recommending masks given the pressure on hospitals.

“Nothing can be mandated at this point,” Brendan Jackson, the CDC’s incident manager for Covid-19, responded on Thursday.

José Romero, director of the CDC’s National Center for Immunization and Respiratory Diseases, mentioned well-fitting masks at the end of a list of recommended precautions during an agency briefing Friday.

“If the family wants, they can use masks,” Romero said.

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 that regular exposure that usually happens and the stronger immunity from year to year didn’t happen,” Walensky said Tuesday during an appearance before the U.S. Chamber of Commerce. “If you go two years without that infection, without protection against the infection, and then all of a sudden, boom, everybody from zero to three years old gets RSV, you’re going to see an impact on health care.”

Although RSV is among the leading causes of hospitalization in young children, the virus also poses a greater threat to senior citizens and immunocompromised adults. Despite the drop in coronavirus cases, doctors say medically sensitive people should consider taking extra precautions because of the circulation of other respiratory viruses.

“If you’re at higher risk, don’t go into high-risk areas or wear a mask if you have to go into those areas with an N95,” said Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau in New York.

During flu season, the strain on hospitals may not be as draining on the health care system if cases are fairly mild and patients are discharged quickly. Lynnette Brammer, an epidemiologist who leads the CDC’s domestic flu surveillance team, said officials have yet to see evidence of a more virulent flu strain.

“We’re not seeing anything right now that would lead us to believe it’s more serious,” Brammer said Friday. – It’s just early.

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