CDC warns of tough winter as flu, RSV and COVID collide

The United States continues to experience an unusually high and early uptick in flu and respiratory syncytial virus infections, straining a health care system trying to recover from the worst of the coronavirus pandemic.

While new coronavirus cases leveled off in recent weeks, federal health officials warned Friday they are confronting elevated levels of other viruses that are roaring back as pre-pandemic life returns and many Americans, particularly children, lack immunity. The Centers for Disease Control and Prevention said it soon plans to issue an alert about respiratory viruses to thousands of health care providers in an attempt to bolster testing, treatment and vaccination.

At least 4,300 influenza patients were admitted to hospitals in the week ending Oct. 29, the highest for that time period in a decade and nearly double the prior week, according to data released Friday. The flu season began six weeks early this year, at a level not seen since the 2009 H1N1 swine flu pandemic.

After enduring two consecutive winters crushed by an influx of COVID-19 patients, American hospitals face the prospect of a third COVID winter - this time, slammed on three fronts.

“With increased RSV infections, a rising number of flu cases and the ongoing burden of COVID-19 in our communities, there’s no doubt we will face some challenges this winter,” said Dawn O’Connell, assistant Health and Human Services secretary for preparedness and response, told reporters Friday. “But it’s important to remember . . . that RSV and flu are not new, and we have safe and effective vaccines for COVID-19 and the flu.”

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; RSV appears to be receding in the southeast and mountain west as influenza surges.

Health officials are bracing for the possibility that coronavirus again overwhelms hospitals, depending on which new variants become dominant, because governments have abandoned efforts to limit transmission and few senior citizens who are most susceptible to severe disease are up to date on their shots.

O’Connell said the U.S. government has medical supplies including personal protective equipment and ventilators available in its stockpile, but no state has yet to request additional personnel or supplies.

[So far, this U.S. flu season is the most severe in over a decade]

“State and territorial public health officials urge parents and families to take precautions now in order to be healthy and to avoid putting strain on hospital systems,” said Anne Zink, a top Alaska public health official and president of the Association of State and Territorial Health Officials, in a written statement.

Those precautions including staying up to date on vaccines, staying home while sick and washing hands regularly. Often missing or downplayed in government recommendations is mask-wearing, a measure rarely adopted during past respiratory virus seasons but proven effective at blunting the spread of coronavirus.

Lynn Goldman, dean of the Milken Institute School of Public Health at George Washington University who serves on a committee that advises CDC Director Rochelle Walensky, asked at a meeting Thursday why agency officials were not recommending masking given the strain on hospitals.

“At this point, nothing can be mandatory,” Brendan Jackson, the CDC’s incident manager on COVID-19, replied Thursday.

José Romero, director of the CDC’s National Center for Immunization and Respiratory Diseases, mentioned well-fitted masks at the end of a list of recommended precautionary measures during the agency’s press briefing Friday.

“If a family wishes, they can use masks,” Romero said.

The lack of exposure to other viruses when people practiced social distancing and wore masks to avoid coronavirus has contributed to the current situation, experts say.

“All of that regular exposure that usually happens that bolsters immunity year after year didn’t happen,” Walensky said Tuesday during an appearance before the U.S. Chamber of Commerce. “If you go two years without getting that infection, without getting that protection from infection and then all of a sudden, boom, everybody from zero to three years gets RSV, you see the impact on health care.”

The strain on hospitals may not be as debilitating to the health care system if the cases are fairly mild and patients are discharged quickly. Lynnette Brammer, an epidemiologist who heads the CDC’s domestic influenza surveillance team, said officials have yet to see evidence of a more virulent strain of influenza.

“Right now we are not seeing anything that would lead us to believe it’s more severe,” Brammer said Friday. “It’s just early.”