You can expect more runny noses, coughs, and fevers ahead as levels of flu, COVID-19, and RSV continue to be elevated across the country.
The latest weekly update from the Centers for Disease Control and Prevention (CDC) on January 26 shows that the number of people seeking healthcare for fever plus cough or sore throat is elevated but decreasing in most areas. In some locales, such as Toledo, Ohio, and Milwaukee, news outlets are reporting that respiratory illness is going strong, with indicators climbing in the past week.
Although respiratory illnesses may be persisting, their spread overall appears to be waning. This week, 22 jurisdictions experienced high or very high activity, compared with 37 jurisdictions two weeks ago.
Although public health officials have been on the alert for a second period of increasing influenza activity that often occurs after the winter holidays, the federal flu surveillance report for January 26 shows positive tests holding steady but hospitalizations and deaths dipping downward. That said, an additional 10 pediatric deaths related to flu were recorded this past week, bringing that total to 57 for the season.
Nationwide, COVID-19 and RSV test positivity decreased compared with the previous week, and a downward trend in virus activity levels in wastewater is being seen this week in all parts of the country. The highest regional levels are in the South, notes the CDC.
While elevated, emergency room visits for all the viruses have inched downward in many areas, and hospital bed occupancy for all patients, including within intensive care units, remains stable nationally.
Rohan S. Mankikar, MD, a clinical instructor of medicine at NYU Grossman School of Medicine and a pulmonologist at NYU Langone Health in New York City, has been noticing a definite downward trend in the number of patients coming in for COVID, flu, and RSV.
“From Christmas through New Year’s, we started seeing a peak that lasted about two weeks after that,” he says. “But I definitely see a decline this week.”
Why Are Some People Still Getting Severely Sick?
Despite some promising signs, many people are still dying of respiratory illnesses every week. The percentage of viral respiratory deaths for the week ending January 13 increased from 5.2 to 5.4 percent. The percentage of COVID-19 deaths climbed from 3.8 to 4.1 percent, although the portion of influenza deaths dipped slightly from 1.3 to 1.2 percent, and the rate of RSV deaths remained stable at 0.1 percent.
The National Center for Health Statistics found that at least 2,670 individuals in the United States died of pneumonia, influenza, or COVID-19 during the week ending January 20.
Dr. Mankikar notes that he’s seen several cases of post-flu pneumonia. “Patients have flu for about a week. The symptoms present, they get better, and then a week or two later, they start having a fever again and end up having bacterial pneumonia,” he says. “Although they’ve recovered from flu, they’re still immunocompromised and a bacterial infection sets in.”
Nationally, the total number of deaths due to COVID-19, influenza, or RSV is highest among those age 65 and older, according to the CDC. Infants and young children are also among those most vulnerable to severe illness. People with obesity, diabetes, asthma or chronic lung disease, sickle cell disease, or who are immunocompromised can also be at increased risk, as well as pregnant people and smokers.
Vaccinations Make a Difference
A major factor that raises the likelihood of severe illness is being unvaccinated.
“I’m definitely seeing more severe symptoms in patients who are not vaccinated,” says Mankikar.
He adds that those who have not been vaccinated may also have symptoms that linger on longer, especially when it comes to the flu.
“Most patients who get the virus will recover in a week,” says Mankikar. “But there are a lot of patients — even without underlying lung conditions — who take a longer time to recover, especially if they’re not vaccinated. In some cases, it can take four to six weeks.”
National vaccination rates for COVID-19, influenza, and RSV, however, have been low. Mankikar stresses that it’s not too late to get vaccinated, and there are still many weeks of respiratory virus season ahead.
Additional Tips for Protection Against Seasonal Viruses
In addition to vaccination, Robert H. Hopkins Jr., MD, the medical director of the National Foundation for Infectious Diseases (NFID), offers these tips to stop the spread of respiratory viruses and avoid catching one yourself.
- Stay home if you are sick, and contact a healthcare professional for additional recommendations. If you have trouble breathing or cannot keep fluids down, seek emergency care.
- Wear a mask if you are going to be in a crowded indoor setting.
- Wash your hands or use hand sanitizer frequently.
- If you have to cough or sneeze, do it into your sleeve or a tissue (not your hands), then wash your hands.
- Think about whether your planned activity is worth the risk of getting sick before you go, and if you decide to go, use the other approaches outlined here.
- Improve indoor air quality by using air filters or open doors and windows to bring outdoor air inside.