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The United States continues to experience an unusually high and early rise in flu and respiratory syncytial virus infections, straining a health care system trying to recover from the worst of the coronavirus pandemic.
Although new cases of the coronavirus have leveled off in recent weeks, federal health officials warned Friday that they are facing high levels of other viruses roaring back as pre-pandemic life returns and many Americans, especially children, lack immunity. The Centers for Disease Control and Prevention issued a respiratory virus advisory to thousands of health care providers in an effort to bolster testing, treatment and vaccination.
At least 4,300 flu patients were admitted to hospitals in the week ending Oct. 29, the highest for that period in a decade and nearly double the previous week, according to data released Friday. Flu season started six weeks earlier this year, at one level not seen since the 2009 H1N1 swine flu pandemic.
After enduring two consecutive winters crushed by an influx of covid-19 patients, US hospitals face the prospect of a third covid winter: this time, it was hit on three fronts.
“With the rise in RSV infections, a growing number of flu cases and the continued burden of covid-19 on our communities, there’s no doubt we’re going to face some challenges this winter,” said Dawn O’ Connell, Assistant Secretary of Health and Human Services for Preparedness and Human Services. response, he told reporters on Friday. “But it’s important to remember … that RSV and influenza are not new, and we have safe and effective vaccines for covid-19 and influenza.”
So far, this flu season is more severe than in 13 years
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 vary regionally; The RSV seems to be pulling back southeast and west of the mountains as the flu increases. There is no vaccine against RSV, but Pfizer plans to seek approval for one given during pregnancy.
Health officials are bracing for the possibility that covid will once again overwhelm hospitals, depending on which new variants become dominant, because governments have abandoned efforts to limit transmission and few older citizens who are more susceptible to illness serious are up to date with their vaccinations.
Some health officials have described the confluence of flu, 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 they start to increase. “Whether the pattern will go back to how it was before covid, I don’t think anyone really knows, but it makes it more complicated to provide the care that people need when you have three viruses that can cause serious illness at the same time.”
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 care system to handle the surge in respiratory cases, he said. But adult hospitals are better positioned to respond.
“It depends on when those spikes occur and how much we’ll see covid come back this winter,” Rubin said. “We should see a real acceleration in covid hospitalizations this year. If you’re looking for a silver lining, this is one.”
The US government has medical supplies including personal protective equipment and ventilators available in its stockpile, but officials say no state has yet called for additional personnel or supplies.
“State and territory public health officials are urging parents and families to take precautions now to stay healthy and to avoid straining hospital systems,” said Anne Zink, one of Alaska’s top public health officials and president of the State and Territorial Health Association. Officials, in a written statement.
These precautions include staying up-to-date on vaccinations, staying home when sick, and washing your hands regularly. Government recommendations often omit or downplay the use of masks, a measure rarely adopted during past respiratory virus seasons but proven effective in slowing the spread of the coronavirus.
Lynn Goldman, dean of the School of Public Health at George Washington University’s Milken Institute who serves on a committee advising CDC Director Rochelle Walensky, asked at a meeting Thursday why officials at the The agency did not recommend masking due to the strain on hospitals.
“At this point, nothing can be mandated,” Brendan Jackson, the CDC’s incident manager for covid-19, responded Thursday.
José Romero, director of the CDC’s National Center for Immunization and Respiratory Diseases, mentioned tight-fitting masks at the end of a list of recommended precautions during Press conference of the agency on Friday.
“If a family wishes, they can use masks,” Romero said.
RSV, other viruses that make it difficult to find a bed in children’s hospitals
Lack of exposure to other viruses when people practiced social distancing and wore masks to avoid the coronavirus has contributed to the current situation, experts say.
“All this regular exposure that usually happens that builds immunity year after year didn’t happen,” Walensky said Tuesday during an appearance before the US Chamber of Commerce. “If you go two years without having that infection, without getting that protection against infection, and all of a sudden, boom, everybody from zero to three years old has RSV, you’re going to see the impact on health care.”
Although RSV is among the leading causes of hospitalization in young children, the virus also poses a greater threat to the elderly and immunocompromised adults. Despite the decline in coronavirus cases, doctors say the medically vulnerable should consider taking extra precautions because of the circulation of other respiratory viruses.
“If you’re at higher risk, don’t go into those high-risk areas and don’t wear masks if you have to go into those areas with an N95,” said Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau in Nova York.
For flu season, the strain on hospitals may not be as debilitating to 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.
“Right now we’re not seeing anything that would lead us to believe it’s more serious,” Brammer said Friday. “It’s early.”