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For more than two years, closed schools and offices, social distancing and masks have given Americans relief from the flu and other respiratory infections. This winter would possibly be different.
With few to no restrictions on position and socialization in full swing, an expected accumulation of COVID-19 cases in winter appears poised to collide with a resurgent flu season, causing the so-called doubledemic, or even a tripledemic, with a third virus, respiratory syncytial virus, or RSV, in the mix.
Flu cases appeared earlier than the same and are expected to skyrocket in the coming weeks. Children infected with RSV (which has flu-like symptoms and COVID-19), rhinoviruses, and enteroviruses are already affecting pediatric hospitals in several states.
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“We’re seeing everything come back in force,” said Dr. Brown. Alpana Waghmare, an infectious disease at Fred Hutchinson Cancer Center and physician at Seattle Children’s Hospital.
Most cases of COVID-19, flu and RSV are likely mild, but in combination they can sicken millions of Americans and flood hospitals, public fitness experts warned.
“You have this waning COVID immunity, which matches the effect of flu coming here and RSV,” said Andrew Read, an evolutionary microbiologist at Pennsylvania State University. “We’re in uncharted territory here. “
COVID-19 and flu vaccines, while not preventing infection, still offer coverage against serious illness and death, Mavens said. They suggested that everyone, especially those most at risk, get vaccinated as soon as possible.
The elderly, immunocompromised women, and pregnant women are most at risk, and young people are highly vulnerable to influenza and RSV. Many inflamed young people become seriously ill because they have poor immunity, either because it has declined or because they were not exposed to those viruses before the pandemic.
RSV causes approximately 14,000 deaths in adults 6 years of age and older and up to 300 deaths in children under five years of age. No vaccine is available, however, at least two applicants are in complex stages of clinical trials and appear to be highly effective in the elderly. Pfizer is also preparing an antiviral drug.
“To date, we’re seeing an equivalent amount of COVID, flu and RSV, and that’s concerning because it’s too early for flu and RSV activity,” said Dr. Diego Hijano, a pediatric infectious disease specialist at St. S. SJude Children’s Research. Hospital.
“It’s going to be a tough winter,” he said.
Another wave of COVID-19?
Coronavirus cases are low, but they are starting to do so in some parts of the country. Several European countries, in addition to France, Germany and Britain, are experiencing increases in hospitalizations and deaths, raising fears that the U. S. will be able to increase the economy.
Some of the coronavirus variants in development are adept at circumventing immunity and drugs like Evusheld and Bebtelovimab, which are specifically for protective immunocompromised people.
People with weakened immune systems “remain at risk even though they get all doses of the vaccine or even more,” Waghmare said.
Public fitness experts are involved in a constellation of omicron variants that appear to elude immunity to vaccines and even a recent infection greater than previous variants.
The latest booster vaccines made by Pfizer and Moderna were designed for the variants that ruled last summer, but not for those new variants. Still, they develop overall antibody levels and help stave off severe symptoms and shorten the duration of illness, Aubree Gordon said. , public fitness researcher at the University of Michigan.
The BA. 5 variant, the maximum evasive variant until recently, however, is being temporarily replaced by others, adding two that show an even greater ability for pass-through immunity.
One of them, known as BQ. 1. 1, is the prime candidate for causing a winter wave, and has already skyrocketed cases in Europe. Although he and a very similar variant called BQ. 1 in combination account for only about 11 percent of cases in the United States, their percentage rose just 3 percent two weeks ago.
A mixture of two subvariants of omicron called XBB has fueled a wave of cases in Singapore, one of the countries with the highest number of vaccines in the world. Another variant, called BA. 2. 75. 2, is also highly immune and causes more severe disease, but is just as guilty of less than 2% of cases nationwide.
Most of the other variants don’t appear to cause more severe symptoms than previous versions of the virus, but the trend of immune evasion is expected to continue, Mavens said.
“Now things have been replaced with the high degree of immunity that other people have opposed to previous variants,” said Cornelius Roemer, a computational biologist at Richard Neher’s organization at the University of Basel.
The Food and Drug Administration has legal reinforcements designed for BA. 5 for all Americans over the age of five, but so far, only a small fraction of other people who qualify for a vaccine have earned one. Less than a third of children aged five to 11 have even completed the first COVID-19 vaccine circular.
That could replace other people who see an immediate backlog of cases, Gordon said.
Sign of a flu season
Before the coronavirus hit the world, flu viruses sickened millions of people each winter and killed tens of thousands of Americans. During the 2018-19 season, influenza was responsible for thirteen million medical visits, 380,000 hospitalizations, and 28,000 deaths.
The flu season in the southern hemisphere, between May and October, is very predictive of winters in the northern hemisphere. This year, the flu started weeks earlier than in Australia and New Zealand, and the number of cases and hospitalizations was particularly higher. .
Gordon tracks flu rates in children in Nicaragua, which has a flu season from June to July and a higher one last fall. More than 90% of the population was considered fully vaccinated against COVID-19 last January, and many other people had also gained immunity to one or more infections.
However, the country experienced peak rates of COVID-19 and flu in the early part of this year. Flu rates among youth were higher than those of the 2009 flu pandemic, and on average, youth were sicker than in previous years. of hospitalizations,” Gordon said.
In the United States, the flu begins to manifest in October and continues until March, with a peak between December and February. But in some states, the season is already underway.
About 3 percent of national tests were for flu as of Oct. 8, according to the Centers for Disease Control and Prevention, but rates are above 10 percent in some southeastern states and above 5 percent in the south-central region. In Texas, the proportion of flu testing jumped to 5. 3% in early October from 3. 7% last week.
Some southern states are also reporting an increase in fan use. In York, fitness officials said this month that the flu has already become widespread in the state.
Public fitness experts have suggested Americans, especially those most at risk, get a flu shot before cases spike further. It roughly halves the threat of hospitalization in youth and adults.
The antibodies are activated about two weeks after an injection, so a vaccine can now actually have greater coverage in the winter wave than a vaccine won in September.
Last year, flu vaccination rates declined across all age teams compared to last year, according to a CDC analysis. The vaccination rate of 6-monthly- to four-year-olds, who are most at risk, showed the biggest drop: 67%. compared to 75% before the arrival of the coronavirus.
The rate of decline is likely because distrust of COVID-19 vaccines has spread to flu shots, or simply because parents have forgotten the danger the flu poses to young children. It’s too early to say whether the numbers will rise this year.
Seniors and other immunocompromised people deserve to get vaccinated against COVID-19 and the flu, public fitness experts said. Healthy young adults may also need to opt for either vaccine if they don’t want to be physically fit or can’t take time off. work, or to protect others around you who are most at risk.
Some communities have a higher threat of severe illness and hospitalization for influenza. During the 2009-22 flu seasons, hospitalization rates were 80 percent higher among black adults, 30 percent higher among American Native/Alaska Native adults, and 20 percent higher among Hispanic adults than white adults, according to a CDC report released last week.
However, flu vaccination rates declined greatly in those groups. Immunization policy also declined by about nine percentage points from last year among pregnant women of all racial and ethnic groups.
In February 2020, Gordon was preparing to talk about the coronavirus to the elegance of his 7-year-old daughter when a boy of elegance died of an influenza B infection.
“Most of the time it doesn’t make you very sick, but it can,” Gordon said of the flu. “We have an effective flu vaccine, so I urge other people to get vaccinated. “
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