Influenza, Covid-19 and RSV are all on a downward trend for the first time in months


A rough respiratory virus season in the US appears to be winding down as three major respiratory viruses that have ravaged the country in recent months are finally all on a downward trend at the same time.

A new dataset from the U.S. Centers for Disease Control and Prevention shows that emergency department visits for the three viruses combined — flu, Covid-19 and RSV — have fallen to their lowest level in three months. The decrease is visible in all age groups.

Measuring virus transmission levels can be challenging; Health officials agree that Covid-19 cases are vastly underestimated, and that surveillance systems used for flu and RSV provide a substantial but incomplete picture.

But experts say tracking emergency department visits could be a good indicator of how widespread — and severe — respiratory virus season is.

That’s the main complaint. When you come to the emergency room, you’re complaining about something,” said Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists. “Being able to look at the percentage of individuals seeking care in an emergency department for these respiratory disease issues is a really good measure of respiratory disease season.”

In the week after Thanksgiving, emergency department visits for respiratory viruses topped 235,000 — matching percentages from last January, according to CDC data.

While the increase in emergency room visits at the beginning of the year was almost entirely due to Omicron, the most recent spike was much more varied. In the week ending Dec. 3, about two-thirds of visits were for flu, about a quarter for Covid-19, and about 10% for RSV.

Grouping the impact of all respiratory viruses in this way offers an important perspective.

“There is a strong interest in thinking about respiratory diseases in a more holistic way,” Hamilton said. “Transmission is the same. And there are certain types of measures that provide good protection against all respiratory diseases. So that could really help people understand that when we’re in high circulation for respiratory disease, there are steps you can take — just in general.

Now Covid-19 once again accounts for most emergency room visits, but flu and RSV are still the reason for about a third of visits – and for the first time since the respiratory virus season picked up in September, they are going all backwards.

More new data from the CDC shows that overall respiratory virus activity continues to decline across the country. Only four states, along with New York City and Washington, DC, had “high” levels of flu-like illness. Nearly all states were in this category less than a month ago.

Whether that pattern will continue is still up in the air as vaccination rates for flu and Covid-19 lag and respiratory viruses can be quite fickle. While the level of respiratory virus activity is lower than before, it is still above baseline in most places and hospitals across the country are still about 80% full.

RSV activity started to pick up again in September and peaked in mid-November when 5 in 100,000 people – and 13 times as many children under five – were hospitalized in a single week.

RSV primarily affects children, and sales of over-the-counter pain and fever-reducing drugs for children were up 65% in November from a year earlier, according to the Consumer Healthcare Products Association. While “the worst may be over,” demand is still high, CHPA spokesman Logan Ramsey Tucker told CNN in an email — sales were up 30% year-over-year in December.

But this RSV season has been significantly more severe than years past, according to CDC data. The weekly RSV hospitalization rate is down to about a fifth of what it was two months ago, but it’s still higher than in previous seasons.

Flu activity increased earlier than usual, but seems to have already peaked. Flu hospitalizations — about 6,000 new admissions last week — are down to a quarter of what they were at their peak a month and a half ago, and CDC estimates for the total number of illnesses, hospitalizations and deaths from flu are down this season so far. kept within the limits of what can be expected. The US appears to have avoided the post-holiday spike that some experts warned about, but the flu is notoriously unpredictable and it’s not uncommon to see a second bump later in the season.

The Covid-19 spike was not as pronounced as flu, but hospital admissions did exceed summer levels. However, the surge in hospitalizations that began in November has begun to ease in recent weeks, and CDC data shows that the proportion of the population living in a county with a “high” covid-19 community level has fallen from 22 % to about 6 % over the past two weeks.

Still, the XBB.1.5 variant — which has key mutations that experts believe could make it more contagious — continues to gain ground in the US, causing about half of all infections last week. Vaccination rates are lagging, with only 15% of the eligible population receiving the updated booster and almost one in five people remaining completely unvaccinated.

Ensemble forecasts published by the CDC are hazy, predicting a “stable or uncertain trend” in Covid-19 hospitalizations and deaths in the coming month.

And three years after the first case of Covid-19 was confirmed in the US, the virus has not taken on a predictable pattern, according to Dr. Maria Van Kerkhove, the World Health Organization’s technical lead for the Covid-19 response.

“We didn’t need this level of death and devastation, but we’re dealing with it and we’re doing our best to minimize the impact going forward,” Van Kerkhove told the Conversations on Healthcare podcast this week.

Van Kerkhove says she believes 2023 could be the year Covid-19 is no longer considered a public health emergency in the US and around the world, but more work needs to be done to make that possible and transition to a longer period. -term management of respiratory disease of the outbreak will take more time.

“We just don’t use [vaccines] most effective around the world. I mean, 30% of the world still hasn’t gotten any vaccine,” she said. “In every country in the world, including the US, we are missing key demographics.”

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