For each of the past two years, Thanksgiving has helped usher in some very unwelcome guests: devastating waves of COVID-19.
No one thinks this year will be like the last two dark pandemic winters, at least when it comes to COVID-19. But now the country is facing a different kind of threat: an unpredictable confluence of old and new respiratory pathogens.
“We are facing an onslaught of three viruses: COVID, RSV and influenza. All at once,” says Dr. William Schaffner, an infectious disease specialist at Vanderbilt University. “We call it tripodemic.”
The flu and RSV are back, big time
Respiratory syncytial virus (rsv) Start off-season surge earlier this year, infecting infants and toddlers who had little or no immunity to that virus, which hasn’t been circulating much for the past two years, in part, due to COVID-19 precautions.
The resurgence of RSV is stalled flooding pediatric emergency room and intensive care unit across the country. Some parents are forced to wait more than eight hours in emergency rooms for their very ill children to be treated.
“Intensive care units are at or above capacity in all children’s hospitals in the United States right now,” he says Amy Knight, president of the Children’s Hospital Association. “It’s very, very scary for parents.”
At the same time, unusually early and severe flu season it is on the rise, dominated by the H3N2 strain, which often hits children and the elderly particularly hard.
“The flu hit the southeastern United States. He moved to the Southwest. It’s moving up the East Coast and into the Midwest with a certain ferocity,” Schaffner says.
Coast to coast, flu hospitalizations are at the highest level for this time of year in a decade. according to the Centers for Disease Control and Prevention.
“Flu activity is high right now and continues to increase,” she says Lynnette Brammer, an epidemiologist in the CDC’s influenza division. “The good news is that vaccines are doing well this year–matched to the viruses currently in circulation, and there is still time to get vaccinated”.
But now comes another Thanksgiving.
“These festive celebrations with all their travel and close contact usually work as virus accelerators,” says Schaffner. “We are spending a lot of time together. We are laughing and breathing deeply. And this is an ideal environment for these respiratory viruses to spread to others.”
What will COVID do this time?
Of course, COVID-19 it is still making tens of thousands ill and killing hundreds of people every day. And new, even more contagious omicrons subvariants who are particularly adept at infecting people, even if they have been vaccinated or previously infected, they are taking over.
“There are a lot of moving parts here,” he says Dr David Rubinwho monitored the pandemic at the PolicyLab of the Children’s Hospital of Philadelphia.
“What will all of this mean for COVID? Will we see a COVID resurgence in January/February that will be significant enough? It may still come.
Many infectious disease specialists say the immunity people have from vaccinations and infections should prevent any new wave of COVID-19 infections from causing a sharp increase in hospitalizations and deaths.
“I’m confident, given where we are with COVID, that we’re not looking at something like last winter. But in the end, Mother Nature has the final say on these things,” said Dr. Ashish Jhathe White House COVID-19 coordinator, told NPR.
“We’re in new territory here” with three viruses all circulating at high levels simultaneously, he says.
“I think it’s a really worrying situation looking at the next few weeks,” he says Jennifer Nuzzoan epidemiologist who runs the Brown University Pandemic Center.
Nuzzo is concerned that an exhausted nation has abandoned many of the precautions people were taking to protect themselves and others. Influenza vaccination rates have decreased by about 10-15% compared to previous years. Only about 11% of those eligible for the new bivalent omicron boosters have been upgraded.
“We can’t just resign ourselves to assuming that no matter what will happen,” he says. “There is a lot we can do to prevent an increase in hospitalizations and deaths.”
Nuzzo and other experts say Americans can be vaccinated and boosted, especially if they’re at high risk due to their age or other health issues.
People should consider zooming on Thanksgiving if they’re sick, testing for COVID-19 before gatherings (especially those involving older friends and family and other vulnerable people), and even considering putting that mask back on as much as possible.
“If you’re not eating or drinking, it’s probably a smart idea to protect the immunocompromised, infants, and the elderly in the family,” says Dr. Tina Taninfectious disease specialist at Northwestern University Feinberg School of Medicine.
There are hints that RSV may already be peaking, and influenza may also be peaking soon, before a new wave of COVID-19 emerges. This would help alleviate at least some of the pressure on hospitals.
There’s also a theoretical possibility that influenza and RSV could displace any new waves of COVID-19 in the same way that the coronavirus has displaced those viruses over the past two years. One possibility is a phenomenon known as “viral interference”, which involves the presence of a virus that reduces the risk of contracting another.
“COVID may be over, which is potentially good news,” Rubin says.