Americans May Face a ‘Tripledemic’ This Winter With the Spread of Influenza, RSV...

At least three viruses—influenza, COVID-19, and respiratory syncytial virus (RSV)—are threatening to overwhelm the country this holiday season. Americans will grapple with multiple respiratory pathogens, both old and new.

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The last two years saw a dramatic increase in the spread of COVID-19 around the holidays. Experts are worried the trend will continue this year with the circulation of highly contagious variants such as Omicron. Dr. William Schaffer, an infectious disease specialist at Vanderbilt University, told NPR what this means for the coming winter season.

“We’re facing an onslaught of three viruses — COVID, RSV and influenza all simultaneously. We’re calling this a ‘tripledemic’….Influenza has hit the southeastern United States. It’s moved into the Southwest. It’s going up the East Coast and into the Midwest with some ferocity.”

According to the Centers for Disease Control and Prevention, flu hospitalizations are at their highest level for this time of year in a decade.

Respiratory Syncytial Virus (RSV) is also spreading at a rapid rate. Dr. Scott Roberts, an infectious diseases specialist, said “we are seeing record levels of RSV in young children.”

“Usually, we see a spike in December or January, but it’s earlier this year.”

The respiratory virus is infecting babies and toddlers with minimal immunity to pathogens. Because of COVID-19 precautions, RSV was not surging to this degree during the last two years. 

Amy Knight, president of the Children’s Hospital Association, shared that pediatric emergency rooms and intensive care units are becoming overcrowded across the country because of the outbreak. The wait time for treatment can be as long as eight hours.

“Intensive care units are at or above capacity in every children’s hospital in the United States right now. It’s very, very scary for parents.”

Older kids are able to fight off the infection more easily Dr. Thomas Murray, a pediatric infectious diseases specialist, says “for the average healthy child, being under age 2 increases the risk of hospitalization. But even having said that, the vast majority of kids do not get hospitalized.”

“Right now, the problem really is just the volume of sick children. Kids can get quite sick from it, but we know how to help them. Children are admitted to the hospital for extra oxygen or other supportive measures such as positive pressure to help with breathing and keep the lungs open.”

At the same time, the H3N2 strain is dominating the flu season, which frequently also affects children and the elderly. Lynnette Brammer, an epidemiologist in the CDC’s influenza division, says that “the good news is, the vaccines this year are well-matched to the viruses that are currently circulating, and there is still time to get vaccinated.”

According to Dr. Schaffner, however, these numbers will likely shift after Thanksgiving due to travel and indoor festivities.

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“These holiday celebrations with all their travel and their close contact usually function as virus accelerators. We’re spending a lot of time with each other. We’re laughing and breathing deeply. And that’s an ideal environment for these respiratory viruses to spread to others.”

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Though COVID-19 transmission has slowed because of widespread vaccination, hundreds of people are still dying, and thousands more are being infected every day. Omicron subvariants with a high propensity for transmission are rapidly becoming the norm.

According to Dr. David Rubin, who has been monitoring the pandemic at the PolicyLab at the Children’s Hospital of Philadelphia, said it is difficult to predict what will happen this holiday season.

“What is this all going to mean for COVID? Are we going to see a January/February resurgence of COVID that’s going to be fairly significant? That may yet be coming.”

The immunity from vaccinations will likely keep COVID-19 infection numbers from rising at an unprecedented rate. However, exhaustion from the pandemic has made people less diligent about taking measures to prevent its spread.

Among those who could receive the new bivalent omicron boosters, only 11% have done so. Meanwhile, the percentage of people getting vaccinated against the flu is also 10% to 15% lower than it has been in prior years. 

Dr. Tina Tan, an infectious disease specialist at the Northwestern University Feinberg School of Medicine, says Americans should consider virtual Thanksgiving if they are sick or at high risk of serious illness due to their age or health conditions.

People should also test for COVID-19 before gathering and use masks as often as possible if they will be around more vulnerable populations.

“If you’re not eating or drinking, it’s probably a smart idea to protect the immunocompromised, the infants, as well as the older individuals in the household.”

There are indicators that RSV and the flu could reach their peaks earlier than expected, well before the emergence of a new wave of COVID-19. They may even mitigate a new wave.

This phenomenon, known as viral interference, occurs when the presence of one virus decreases the probability of infection by another virus, alleviating some of the stress on medical facilities.

White House COVID-19 Coordinator Dr. Asish Jha told NPR, “we are in new territory here” due to three viruses circulating simultaneously. 

“I’m hopeful, given where we are with COVID, that we’re not looking at something like last winter. But at the end of the day, Mother Nature gets the final word on these things.”

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