With the new year just beginning, the respiratory virus season is kicking in strong.
Emergency room visits for flu and RSV (respiratory syncytial virus) are considered “very high” and climbing, while COVID-19 emergency department admissions are low but also on the rise.
“Most of the current surge is being driven by high influenza activity as well as RSV,” says Peter Chin-Hong, MD, an infectious disease specialist and a professor of medicine at the University of California San Francisco School of Medicine. “RSV came first in November, followed by influenza in December. RSV is possibly at its peak now and being overtaken by influenza as the respiratory virus driving emergency department visits and hospitalizations nationally.”
Test Positivity and Wastewater Indicators Are Climbing
Wastewater (sewage) testing, however, suggests that COVID cases may soon shoot up. Because traces of infectious disease circulating in a community can be detected in wastewater, testing can provide an early warning if infections are on the upswing. Currently, the level of COVID activity in wastewater is at “high,” while measures for flu and RSV are both “moderate.”
“You’re likely to see upticks [of viral activity] in wastewater measurements sometimes several weeks before you actually observe an increase in clinical cases,” says Dean Winslow, MD, an infectious-disease specialist and a professor of medicine at Stanford University in California. “COVID-19 hit a low point in November, but as wastewater shows it may pick up again.”
It’s the Most Virus-Filled Time of the Year
“I don’t see a common thread as to why these states in particular are seeing the highest levels of activity,” says Erica Prochaska, MD, a pediatric infectious diseases specialist with Johns Hopkins Children’s Center in Baltimore. “Unfortunately, I suspect that the states that have lower numbers now are probably going to have higher numbers over the next few weeks because that’s typically what happens.”
“In addition, low humidity this time of year may make viral particles lighter and more easily spread,” says Dr. Chin-Hong.
It Can Be Challenging to Know if You Have Flu, RSV, or COVID-19
Common symptoms include cough, headaches, sneezing, runny nose, and congestion. NFID says that aches, fatigue, and fever occur often with flu; difficult breathing, fatigue, and sore throat occur often with COVID-19; and wheezing is a frequent and distinguishing symptom with RSV.
Preventing Spread Can Protect the Most Vulnerable
- Cover your cough or sneeze, preferably with a tissue.
- Keep your distance from people who are sick.
- Stay home when sick.
- Clean and disinfect surfaces when someone is sick at home.
- Consider wearing a mask to protect against circulating viruses.
- Wash hands regularly.
“Frequent hand-washing is probably one of the best protections,” says Dr. Winslow, who warns that we all have to touch doorknobs, railings, and the like, which can be contaminated with viruses.
It’s Not Too Late to Get Vaccinated
“There is still time to get vaccinated,” he says. “Influenza in particular has a long tail of infection that can extend into April. COVID is famously unpredictable so it may still emerge later in the season — I would vaccinate now if unvaccinated this year, especially for those who are older than 65 and/or immunocompromised.”
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