The United States continues to experience unusually high and early increases in flu and respiratory syncytial virus infections, straining a health care system struggling to recover from the worst coronavirus outbreak.
While new coronavirus cases have been declining in recent weeks, federal health officials warned Friday that pre-pandemic life is returning and that many Americans, especially children, are facing other viruses with heightened immunity. The Centers for Disease Control and Prevention has provided advice to thousands of health care providers about respiratory viruses to strengthen testing, treatment, and vaccination.
At least 4,300 flu patients were hospitalized by the end of Oct. 29, the most for that period in a decade and nearly double the number from the previous week, data released Friday showed. The flu season started in six weeks earlier this year, at a rate not seen since the 2009 H1N1 swine flu pandemic.
After enduring a flood of Covid-19 patients for two consecutive winters, US hospitals are facing the prospect of a third Covid winter – this time being hit on three fronts.
“There’s no doubt we’re going to face some challenges this winter with additional RSV infections, the increasing number of influenza cases and the burden of Covid-19 in our community,” Dawn O’Connell, Assistant Secretary for Preparedness and Health and Human Services, told reporters Friday. It’s important… RSV and flu are not new and we have safe and effective vaccines for both covid-19 and flu.
The common respiratory syncytial virus, known as RSV, is on the rise nationwide in children with cold-like symptoms, stressing children’s hospitals. Trends vary by region; RSV appears to be declining in the Southeast and Mountain West as influenza outbreaks increase. There is no vaccine for RSV, but Pfizer plans to seek approval for a treatment during pregnancy.
Health officials are scrambling to figure out which new variants to prevent Covid from crowding hospitals again, as governments abandon efforts to limit the spread and fewer elderly people, who are most vulnerable to the disease, are up to speed on their attacks.
Some health officials have called the combination of influenza, RSV and the coronavirus a “triple.”
“Covid has affected all of these respiratory conditions at the moment,” said Tina Tan, a pediatric infectious disease specialist at the Ann and Robert H. Lurie Children’s Hospital in Chicago, as RSV cases worsen and flu cases start to rise. “I don’t think the system will go back to how it was before Covid. I don’t think anyone knows, but when you have three viruses that can cause serious diseases, it makes it more complicated to give people the care they need at the same time.”
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David Rubin, who tracks respiratory viruses for policy at the Children’s Hospital of Philadelphia, said declaring a hospital crisis is premature. A youth mental health crisis and a nationwide shortage of pediatric beds have made it difficult for the health care system to deal with respiratory issues, he said. But adult hospitals are better at responding.
“It depends on when these spikes occur and how big we see a comeback of Covid this winter,” Rubin said. “We haven’t seen a real acceleration this year in terms of Covid hospitalizations. If you’re looking for a silver lining, that’s it.”
The U.S. government has medical supplies, including personal protective equipment and ventilators, but officials said no country has yet requested additional personnel or supplies.
“State and local public health officials are urging parents and families to take precautions now to stay healthy and not strain hospital systems,” said Anne Zink, Alaska’s top public health official and president of the State and Territory Health Association. Officials in a written statement.
Those precautions include staying up-to-date on vaccinations, staying home when sick, and washing hands regularly. Often missing or downplayed in government recommendations is the wearing of masks, a measure that was rarely implemented in past respiratory virus seasons but has proven to be effective in curbing 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 Walnsky, asked at a meeting Thursday why agency officials are not recommending masks given the pressure on hospitals.
Brendan Jackson, the CDC’s incident manager on Covid-19, responded Thursday: “Nothing can be mandated at this point.”
Jose Romero, the CDC’s national director of immunizations and respiratory diseases, cited well-fitting masks at the end of a list of recommended precautions during a press conference at the agency on Friday.
“If a family wants to, they can use a mask,” Romero said.
As people practice social distancing and wear masks to protect against the coronavirus, not being exposed to other viruses has contributed to the current situation, experts said.
“Not all of the normal exposures that occur year after year that encourage immunity have occurred,” Welensky said Tuesday in an appearance before the U.S. Chamber of Commerce. “If you go two years without getting that infection, without getting that infection prevention, and all of a sudden, boom, everybody gets RSV from zero to three years, you see the impact on health care.”
While RSV is one of the leading causes of hospitalization in young children, the virus poses a greater threat to the elderly and immunocompromised adults. Although the number of coronavirus cases is decreasing, doctors say that those who are medically vulnerable should take extra precautions due to the spread of other respiratory viruses.
“If you’re at high risk, don’t go into those high-risk areas, or if you have to go into those areas with an N95, don’t wear a mask,” said Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau in New York.
For flu season, the strain on hospitals may not overwhelm the health care system if cases are mild and patients are discharged quickly. Epidemiologist Lynette Brammer, who leads the CDC’s household influenza surveillance team, said officials have yet to see evidence of a more dangerous strain of influenza.
“We’re not seeing anything that would lead us to believe it’s more severe now,” Bremer said Friday. “It’s Christmas.”
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