“Triple Threat: Flu, COVID, and RSV Surge This Season”

The winter holiday customs are now in the past. It’s chilly and snowy in numerous regions. Additionally, regrettably, another yearly tradition has arrived.

“Respiratory season has commenced,” mentions Dr. Brendan Jackson, an epidemiologist at the Centers for Disease Control and Prevention. “It is really getting underway now with many individuals falling ill, many missing work, absent from school, generally feeling unwell.”

People usually travel and gather with family and friends during the holidays. The unfortunate part is that this frequently results in them returning home with some unpleasant virus. Currently, we are in the midst of that again.

“It’s pretty rough out there right now,” observes Katelyn Jetelina, an epidemiologist who authors the Your Local Epidemiologist newsletter.

The flu, in particular, is at high or extremely high levels nationally, as per the CDC.

“We are overwhelmed with influenza. The activity is extremely, extremely busy and intense,” states Dr. William Schaffner, an infectious disease specialist at Vanderbilt University in Nashville, Tennessee. “The emergency room is filled with individuals who are coughing and sneezing. We have had patients waiting on gurneys — those stretchers — waiting for admission. We are indeed at capacity.”

RSV and COVID-19 are increasing

Moreover, it’s not solely the flu. RSV continues to spread at very high levels as well. Additionally, COVID-19 is beginning to escalate once more.

“Previously, we had two significant viruses leading to numerous hospitalizations and fatalities — RSV and flu,” Schaffner explains. “Even though COVID is no longer classified as a health emergency, it still results in more hospitalizations and deaths compared to the other two. Therefore, when combined, each respiratory season on average from now on is likely to be more severe than it was prior to the pandemic due to the inclusion of COVID.”

No one can predict how severe conditions may become this winter. The CDC indicates that unless a more transmissible new COVID-19 variant arises, the outlook for this winter appears similar to the previous year.

However, that isn’t positive — it still signifies many children missing school, parents missing work, and grandparents along with other vulnerable individuals ending up in the hospital and potentially dying.

“We have three viruses that will strike with peaks expected to be relatively close together. Therefore, as one begins to decline, another will start to peak,” says Dr. Andrew Pavia, an infectious disease expert at the University of Utah. “And we won’t get a pause, similar to a succession of snowstorms. What this implies, I believe, is that we are heading towards a rather unpleasant January before things start to ease up.”

Yet even at that point, there will likely be a lingering tail, as stated by Caitlin Rivers, an epidemiologist from Johns Hopkins University who authored the book Crisis Averted regarding pandemics.

“The winter respiratory virus season typically reaches its peak in December or January,” Rivers explains. “Yet it persists through the spring months. Hence, I do believe we still have several weeks, if not months, remaining in this season of illness.”

Take precautions, including vaccination

Rivers and other experts advise that people frequently wash their hands, wear masks in crowded environments, and, naturally, get vaccinated. Though the flu and COVID-19 vaccines are not flawless, they still prove effective at keeping individuals out of the hospital and reducing fatalities, particularly among older adults and others who are susceptible. The majority of individuals still haven’t received either of those vaccines, but it’s not too late.

It may also be worthwhile to get tested to determine which illness someone has. New tests available this year without a prescription empower people to check at home for flu and COVID-19. This could assist their doctors in making quicker decisions regarding whether antiviral medications are necessary.

All these complications arise alongside other common infections, as pointed out by Dr. Sean O’Leary, a professor of pediatrics at the University of Colorado School of Medicine and chair of the committee on infectious diseases for the American Academy of Pediatrics. For instance, mycoplasma pneumonia, which can result in “walking pneumonia,” and whooping cough continue to circulate widely.

“We’re observing a considerable amount of that this year, unfortunately,” O’Leary notes.

HMPV cases in China aren’t unusual

There’s also another respiratory virus that has been gaining attention: the human metapneumovirus (HMPV). This is due to China reporting an uptick of HMPV in the northern regions.

However, the World Health Organization stated on Tuesday that the levels of HMPV in China are not abnormal nor straining the healthcare system.

“WHO is communicating with Chinese health authorities and has received no reports of unusual outbreak patterns,” as per a WHO statement. “Chinese officials report that the healthcare system is not overwhelmed and there have been no declarations of emergency or responses triggered.”

Other infectious disease specialists assert that they are not particularly concerned about HMPV. This virus, which is related to RSV, has been circulating for decades, meaning that many individuals have developed immunity to it.

While HMPV can lead to serious complications, such as pneumonia, it generally only produces cold-like symptoms. HMPV is spreading at low levels in the United States. Nevertheless, experts emphasize that HMPV does not appear to be nearly as threatening as the flu and COVID-19, which continues to claim hundreds of lives each week, according to a report released Tuesday by the CDC.

“We are monitoring that closely,” remarks the CDC’s Jackson regarding HMPV. “I would say the levels here in the U.S. are truly at a typical level for this time of year. It’s nothing out of the ordinary compared to previous seasons.”