October 25, 2022 — Just when we thought this holiday season, at last, would be the season of return to normal, some infectious disease experts are warning that a so-called triple pandemic — influenza, COVID-19, RSV — may be in the forecast.
The warning is not without merit.
- Flu season started early. As of October 21, early increases in seasonal flu activity have been reported across much of the country, the CDC says, with the highest levels of activity in the southeast and south central regions.
- Children’s hospitals and emergency departments are seeing an increase in the number of children infected with RSV.
- according to CDC, But epidemiologists – the scientists who study disease outbreaks – always have their eyes on emerging variables.
Predicting exactly when cases will peak is difficult, says Justin Lessler, PhD, professor of epidemiology at the University of North Carolina at Chapel Hill. Lessler is a member of the . coordinating team COVID-19 Scenario Modeling Center, which aims to predict the course of COVID-19 and Influenza Scenario Modeling Center, Which does the same for the flu.
For COVID-19, some models predict some spikes before Christmas, he says, while others see a new wave in 2023. For influenza, the model predicts an earlier onset than usual, the CDC reports.
While flu activity is relatively low, the Centers for Disease Control and Prevention says, the season is off to an early start. For the week ending October 21, 1674 patients They were hospitalized with influenza, higher than in the summer months but less than 2,675 hospitalizations in the week of May 15, 2022.
As of October 20, COVID-19 cases are down 12% over the past two weeks, nationwide. But hospitalizations rose by 10% in most areas of the Northeast, The New York Times reported, The improvement in cases and deaths was slowing.
As of October 15, 15th% Of RSV tests reported nationwide have been positive, compared to about 11% at that time in 2021, the CDC says. The watch collects information from 75 counties in 12 states.
Experts point out that viruses – and all are respiratory viruses – are simply catching up.
“They spread the same way and with a lot of other viruses, and you tend to see an increase in them during the colder months,” says Timothy Brewer, MD, professor of medicine and epidemiology at the University of California, Los Angeles.
The increase in all three viruses is “almost predictable at this point in the epidemic,” says Dean Bloomberg, professor and chair of the division of pediatric infectious diseases at UC Davis Health. “All respiratory viruses are out of control.”
In the past year, RSV cases have also spiked, starting to appear earlier, he says, in the summer rather than the cooler months. The flu also appeared in early 2021, as it did this year.
This contrasts with the 2020-2021 flu season, when COVID reserves were nearly global, and cases were low. At UC Davis, “We didn’t have a single pediatric admission due to influenza in 2020-2021 [flu] season,” says Bloomberg.
The number of childhood deaths from influenza typically ranges from 37 to 199 per year, according to CDC records. But in the 2020-2021 season, the CDC scored 1 child flu death in the United States
Bloomberg says that children and adults alike have had less contact with others in the past two seasons, and “didn’t get the immunity they got with those infections.” [previously]. That’s why we see the start of the season outside the season [viruses]. ”
Eventually, he says, cases of influenza and the respiratory cellular virus will return to previous levels. “That could be as soon as next year,” Bloomberg says. Hopefully, he adds, COVID-19 will become like the flu.
“RSV has always come into play in the fall and winter,” says Elizabeth Murray, MD, a pediatric emergency medicine physician at the University of Rochester Medical Center and a spokeswoman for the American Academy of Pediatrics. This year, she says, the children went back to school and for the most part did not hide. “It’s a perfect storm in which all germs are circulating right now. They have just been waiting for their chance to come back.”
Self-care vs. No
Respiratory syncytial virus can pose a risk to anyone, but children under five years of age are most at risk, especially children under 1 and adults over 65 years of age. There is no vaccine for it. Symptoms include a runny nose, decreased appetite, coughing, sneezing, fever, and wheezing. But in young children, there may just be low activity, crankiness, and breathing problems, the CDC says.
Murray told the parents to monitor breathing if RSV was suspected. If your child cannot breathe easily, is unable to lie down comfortably, cannot speak clearly, or sucks on the chest muscles to breathe, seek medical help. She says most children with RSV can stay home and recover, but often need to be seen by a medical professional.
She advises against getting an oximeter to measure oxygen levels for home use. “It’s often inaccurate,” she says. If you suspect the severity of your child’s symptoms, “don’t wait,” she says, and feel free to call 911.
Symptoms of influenza, COVID, and RSV can overlap. But all of them can involve breathing problems, which can be an emergency.
Mandy De Vries, MD, a respiratory therapist and director of education for the American Association for Respiratory Care. Treatment by inhalation or mechanical ventilation may be required for acute respiratory problems.
To avoid the spread of a triple epidemic — or any one infection — Timothy Brewer, professor of medicine and epidemiology at the University of California, suggests some familiar measures: “Stay home if you feel sick. Make sure you are up to date on your vaccinations. Wear a mask indoors.” .
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