A simultaneous surge of COVID-19, influenza, and RSV (respiratory syncytial virus) is leading to a “tripledemic” this winter. Hospitals and health officials urge vaccination and caution as cases tick upward across the country.
COVID-19 Cases Rebound Though Vaccines Blunt Severity
After a lull in cases over the summer and fall, COVID-19 is widely circulating again. The Omicron subvariants BQ.1 and BQ.1.1 make up over 70% of cases and are more immune-evasive than past variants. However, vaccines continue to provide protection against severe disease.
“The good news is that while the variants circulating now are good at evading immunity, vaccination still protects quite well against serious disease,” said Dr. Peter Chin-Hong, a UCSF infectious disease expert.
Los Angeles County is seeing high community transmission, with about 1 in 10 hospitalized patients admitted for COVID-19. Officials urge masking and vaccination, though no new restrictions are currently planned.
Nationwide, hospitalizations peaked in December 2022 at around 4,000 per day – much lower than the 20,000 per day seen in January 2022. Deaths have also remained relatively low compared to past waves.
Flu Activity High For This Time of Year
While COVID-19 trends down from December highs, flu activity remains elevated and continues to increase. The CDC reports high levels of flu in 33 states so far this season. Hospitalization rates are nearing the peaks seen over the past decade.
“Flu season has not peaked yet nationally,” said Lynnette Brammer, who leads the CDC’s domestic influenza surveillance team. She noted activity could remain elevated for several more weeks at least.
The H3N2 flu strain is dominant so far, tending to cause more severe illness in the elderly. Flu vaccination rates are only running slightly ahead of last season’s low levels, leaving many vulnerable. Health officials emphasize it’s not too late to get a flu shot.
RSV Surge Stressing Children’s Hospitals
RSV emerged early this season, driving a surge in pediatric hospitalizations this fall. Cases peaked around Thanksgiving, but some locations are seeing a January resurgence.
Dr. Juan Salazar, physician-in-chief at Connecticut Children’s Hospital said they continue to see high demand: “We are worried that we are going to have a second surge with RSV and influenza on top of the COVID surge we saw through December.”
|Total RSV Cases Reported
|January 7, 2023
|January 14, 2023
RSV can be life-threatening for infants and the elderly. A vaccine is in development after decades of difficulties, potentially available in 2024. For now, preventing exposure remains crucial.
Harsh Flu Season Could Last Through March
Colder weather drove people indoors, allowing respiratory viruses to spread readily. While illnesses may plateau briefly, some experts warn the flu season could drag on through March this year.
“Going into March we’re still going to be seeing a lot of flu, RSV, and COVID,” predicted Dr. Amy Edwards, associate medical director for pediatric infection control at UH Rainbow Babies and Children’s Hospital.
She advised it may take until April or May for activity to return to minimal levels.
The timing and duration of flu seasons are unpredictable. But persistently high circulation of multiple viruses suggests more complications lie ahead this winter and spring.
Officials Urge Vaccination As Immunity Wanes
To limit spread and severity of illness, health organizations strongly promote vaccination against COVID-19 and flu. Immunity from previous infection wanes over time. New immune-evasive variants also lower protection from past vaccination.
Los Angeles County health director Dr Barbara Ferrer said “Given both the unpredictability and high case rates of flu and COVID-19, continuing some sensible safety precautions makes good sense.” This includes masking around vulnerable people when case rates are high.
For RSV, basic precautions like hand hygiene and avoiding exposure when sick are critical. Those most at risk should avoid crowded indoor spaces during peak virus activity.
Home Testing Complicates Tracking of COVID-19 and Flu
Widespread home testing makes tracking COVID-19 and flu more difficult this season. Many positive results go unreported, complicating measurement of case rates and trends.
“It’s clear that the rates of [reportable illnesses] are substantial undercounts of the actual rates,” said Dr. Jeff Pothof, chief quality and safety officer at UW Health.
Despite limitations, health agencies integrate available data to gauge seasonal virus risk. They track emergency room visits and wastewater sampling to fill gaps from unreported home test results.
Mutations Could Fuel Further Waves Into 2024
Viral evolution remains an ongoing wild card. If more mutated variants of concern emerge, additional case spikes could occur through 2024 and beyond.
So far, no radically different flu strains are circulating this year. But experts warn each season brings potential for uncontrolled spread if vaccines mismatch updated viral genetics.
Similarly, new SARS-CoV-2 subvariants continue arising globally. Further COVID-19 surges may transpire even in regions recently hit hard. Experts emphasize vaccination and flexibility to manage unpredictable virus changes over the long term.
Conclusion: Exercise Caution Through an Unpredictable Viral Winter
Health agencies foresee an extended battle with flu, COVID-19 and RSV as the system confronts a triple whammy of threats. Cases ebb and flow based on human behavior, viral mutations, vaccine efficacy and seasonality.
Experts say to remain vigilant and proactive. Seek testing and treatment promptly when sick. Get up-to-date on vaccinations. Wear high quality masks in crowded public settings if vulnerable. Avoid contact with symptomatic people when feasible.
With flexibility and shared responsibility, the country can weather this challenging viral phase with minimal societal disruption. But individuals must also make smart choices to protect themselves and each other. Staying informed and acting prudently remains key to managing personal risk.
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