Government health officials warned Friday of an early and severe start to the cold and flu season in the United States, saying they were closely monitoring hospital capacity and medical supplies and were ready to send help if needed. .
“We suspect that many children are being exposed to some respiratory viruses now for the first time, having avoided these viruses during the height of the pandemic,” said Dr. José Romero, director of the National Center for Disease Prevention at the Centers for Disease Control and Prevention. the U.S. Immunization and Respiratory Diseases Prevention and Control Agency, said on a call with reporters.
In the United States, cases of respiratory syncytial virus, or RSV, and influenza are increasing. At the same time, Covid-19 cases, which had been declining, appear to have plateaued in the last three weeks, Romero said. Cases have plateaued as a number of new variants have gained ground against BA.5, the Omicron sub-variant that caused a wave of illnesses over the summer.
Spikes in viral illnesses have already begun to affect hospitals.
Dawn O’Connell, assistant secretary for preparedness and response, said Friday that her agency was in close contact with health care systems and states.
“We are monitoring capacity across the country sharing best practices to reduce strain on systems and waiting to deploy additional personnel and supplies as needed,” he said, noting that so far no states have requested this help.
“There is no question that we will face some challenges this winter,” O’Connell said.
Seventeen states, Washington, DC and New York City are reporting high or very high respiratory illness activity amid a flu season that is hitting harder and earlier than usual, according to data released Friday by the US Centers for Disease Control and Prevention.
Influenza activity continues to increase in the US, with the number of influenza illnesses, hospitalizations, and deaths so far this season nearly doubling in the past week. The CDC now estimates that there have been at least 1.6 million illnesses, 13,000 hospitalizations and 730 deaths from influenza, including two reported deaths among children so far this season. About one in 11 flu tests came back positive last week.
“In fact, we are seeing the highest rates of influenza hospitalization in a decade,” Romero said.
The last time flu hospitalization rates have been this high at this point in the season was during the H1N1 pandemic. The latest CDC update tracks data through October 29.
There’s no real mystery as to why viral illnesses are on the rise, said Dr. Michael Mina, an epidemiologist and chief scientific officer at eMed, a company that offers test-to-treat telehealth services.
“We have enjoyed the benefit of not having influenza for the last few years, mainly due to SARS-CoV-2. Additional mitigation measures like social distancing, wearing masks, and not going out for about a year have only delayed the inevitable. Now that we have released the pressures put in place to keep viruses at bay and move into this first real flu season, sadly we feel its impact,” he said.
RSV cases are also increasing nationally, although there are regional differences in the circulation of these viruses, Romero said. It is a common respiratory infection that usually causes mild cold-like symptoms but can cause severe illness, especially in older adults and infants.
In the south and mountainous west, RSV cases appear to have peaked in October. In those regions, RSV cases are declining, even as influenza is on the rise.
Influenza activity is highest in the South, followed by the Mid-Atlantic and parts of the West Coast. Walgreens data tracking prescriptions for antiviral treatments, such as Tamiflu, suggests there are hotspots in Mississippi and Alabama, as well as the Gulf Coast area, including Houston and New Orleans.
Hospitalizations for RSV were also significantly higher than usual, according to another weekly to update released by the CDC on Thursday.
Cumulative RSV hospitalization rates have already reached levels not normally seen until December in the US. They are increasing among all age groups, but especially among children.
About four in 1,000 babies under 6 months of age have been hospitalized with RSV so far this season, nearly a month later. More than two in 1,000 babies between the ages of 6 months and one year have been hospitalized with RSV so far this season, as have more than one in 1,000 children between the ages of one and two.
Overall, in the US, nearly one in five RSV PCR tests were positive during the week ending October 29, nearly doubling over the course of the month.
Weekly case counts are less complete for more recent weeks, but more RSV cases were detected by PCR testing each week in October 2022 than any other week in at least the past two years. Weekly case counts for the week ending Oct. 22 were more than double any other week in 2020 or 2021.
There are signs that RSV cases are slowing in the southern US, but test positivity rates and cases continue to rise in other regions, especially the Midwest.
And pediatric hospitals continue to be more crowded than average with RSV patients and other conditions. According to data from the US Department of Health and Human Services, more than three-quarters of pediatric hospital beds and pediatric ICU beds are currently in use nationwide, compared to an average of about two-thirds full in the last two years.
As of Friday, seventeen states have fewer than one in five available beds. Five of them are more than 90% full: Rhode Island, Arizona, Maine, Minnesota, and Delaware, along with Washington, DC.
Romero stressed that with Christmas gatherings just around the corner, vaccination is the best protection against these infections.
“We have vaccines for two of the three viruses that we talked about in influenza and COVID 19,” he said, urging Americans to take advantage of them, though not enough.
According to the CDC data tracker, only 8.4% of eligible Americans have received an updated new Covid-19 booster.
Vaccines are also lower than usual for influenza. Based on insurance claims data, adult flu vaccinations are down about 5 million compared to the same time last year, said Lynnette Brammer, who leads surveillance for the CDC’s influenza division.
For children, coverage looks about the same as last year, but those levels represent a 6% drop from what flu shots in children were like before the pandemic, Brammer said.
Romero emphasized that while most adults only need a single annual flu shot, children getting a flu shot for the first time need two shots.
He also advised people not to try to guess what they had based on their symptoms alone, as many of these viruses can cause similar symptoms.
Going to the doctor for a test as soon as you start to feel unwell could help you take advantage of the early antiviral treatments that are available for influenza and Covid-19.
Romero said the CDC was preparing to send doctors more information about who should qualify for these test-to-treat strategies.
In addition to vaccination, Romero reminded people to cover their coughs and sneezes, avoid other sick people, wash their hands frequently and use alcohol-based hand sanitizers.
“People who can also choose to wear a well-fitting mask as an extra precaution,” Romero said.