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COVID, flu and RSV this U.S. winter: Why experts are worried

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COVID, flu and RSV this U.S. winter: Why experts are worried​

By Nancy Lapid
October 26, 20226:45 PM GMT+8

Oct 26 (Reuters) - U.S. doctors are warning that a surge in cases of respiratory syncytial virus (RSV) is coinciding with an increase in COVID transmission and an earlier-than-normal flu season, raising the specter of a "tripledemic" of respiratory illness this winter.

In particular, RSV infections among young children are reportedly filling some U.S. hospitals to capacity.

"We are already seeing patients testing positive for more than one virus," said pediatrician Dr. Ira Wardono of Providence Cedars-Sinai Tarzana Medical Center in Tarzana, California, in a statement.

Infants are most at risk from RSV because they often cannot cough up the secretions caused by the virus and may need airway suctioning or intravenous fluids. Some may need extra oxygen. Older children and most adults typically experience mild, cold-like symptoms.

On average, RSV leads to 58,000 hospitalizations among children under age 5 and 177,000 hospitalizations among adults age 65 and older each year, according to the U.S. Centers for Disease Control and Prevention.

RSV deaths are rare in U.S. children, but 14,000 adults die annually from the virus, with older or immunocompromised individuals at greatest risk, the CDC said.

Infection with RSV can be prevented in the same way one would ward off any virus: staying away from people who are sick, ensuring the best possible ventilation when you are indoors, wearing a high quality mask, and keeping your hands as clean as possible, said Dr. Jay Varma, Chief Medical Adviser at Kroll.com and Director of the Weill Cornell Center for Pandemic Prevention and Response.

High-risk infants can receive preventive treatment with monthly doses of Synagis (palivizumab) from Swedish drugmaker Orphan Biovitrum. AstraZeneca Plc and Sanofi SA are hoping for U.S. and European approval of Beyfortus (nirsevimab) for preventing RSV infections in newborns and infants.

There is no vaccine against RSV, although Pfizer Inc is developing RSVpreF for adults. In the meantime, it is important "for everyone to get up to date on their COVID and flu vaccines," Varma said.

WHAT IS CAUSING THIS SURGE?

Part of the increase in RSV cases is due to the relaxation of COVID-precautions, such as masking and social distancing, which reduced rates of both RSV and flu during the pandemic, Varma said.

RSV rates were unusually low in the fall/winter of 2020-2021 but increased dramatically starting in Spring 2021 and have spiked since late August.

The CDC says it cannot yet predict when the previous seasonal patterns will return.


 
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NY hospitalization rate exceeds Delta.
Zero covid BAD !


New York’s struggle with the new Omicron variant BQ is trying to tell us something​

BYERIN PRATER
October 22, 2022 at 6:30 PM GMT+8

What happens in New York doesn’t stay in New York—not during a pandemic, anyway.


As scientists speculate what an autumn COVID wave might look like in the U.S., all eyes are on the Empire State. That’s because it’s considered a “bellwether” when it comes to viral conditions, and what happens there often provides a preview for the rest of the country..........................

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The state’s current hospitalization wave is “pretty close, if not higher than the Delta peak,” he said, referring to the deadly COVID wave that rocked the U.S. late last year, right before Omicron hit. ..........................
 
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US still suffers 400-500 deaths from covid every single day now, they can ignore it but it doesn't mean it's no longer there.
 
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Some US hospitals report beds are full among increase in respiratory infections in children​

Cases of flu and RSV are rising earlier than usual.
ByMary Kekatos

Some hospitals across the United States say their beds are full as cases of respiratory viruses continue to increase among children.

According to the Centers for Disease Control and Prevention, infections due to respiratory syncytial virus, or RSV, have spiked by 69% over the last four weeks from 4,667 to 7,917 and are appearing earlier than usual.

At the same time, doctors are preparing for what could be the most severe flu season seen in years after little-to-no flu activity during the pandemic and the potential threat of COVID-19, which has traditionally increased during Thanksgiving over the last two years.

Dr. Anita Patel, attending in pediatric critical care medicine at Children's National Medical Center in Washington, D.C., said she and her colleagues are seeing a rapidly diminishing number of available pediatric beds.

PHOTO: A mother holds her child's hand while she is hospitalized, in a stock image.

A mother holds her child's hand while she is hospitalized, in a stock image.
iStockphoto via Getty Images

"We have been operating at essentially near capacity for the past several weeks," she told ABC News.

Patel said the high number of patients is mainly due to a mix of RSV cases and flu cases, the latter of which are 10 times higher this year compared to last year at her hospital.

"What I can tell you about the flu, which is pretty dramatic compared to last year, is we've seen already 80 patients that are positive for the flu across our health system, which is compared to only eight from last year. So, we really are seeing this early flu surge," she said.

Because of the surge in patients, this has led to between 10 and 20 children at any given point at Children's National emergency room waiting for a pediatric intensive care unit (PICU) bed, although Patel says PICU-level care has been provided to kids who are waiting to be transferred.

Additionally, staff at University of California, San Francisco Benioff Children's Hospital, in Oakland, say they are currently operating at capacity.

"We are earlier than usual in having a situation where our beds are full," Dr. April Zaat, a pediatric hospitalist at Benioff Children's, told local affiliate KGO-TV ABC 7. "I came in this morning and I'm on one of the in-patient teams. My team is full, our respiratory unit is full, and there were five to seven kids in the emergency room waiting for beds.

Zaat continued, "A lot of them have respiratory illnesses, like rhinovirus, enteroviruses. Sort of a potpourri if you will of respiratory viruses that are causing virus in kids. RSV is the main player."

Doctors are urging parents to get their children vaccinated, particularly against COVID-19 and the flu, to protect themselves and to help prevent an already strained health care system from becoming overburdened.

"One of the best ways to keep kids and adults out of the hospital is to make sure they're up to date on their vaccinations," Patel said. "I'm not just a PICU doctor, I'm also a mom. I made sure that my two-and-a-half-year-old is up to date on not only her COVID vaccination, but she's also received her flu shot -- and that is one of the best ways to prevent severe disease and hospitalization in our children."

PHOTO: A child sits on bed while hospitalized, in a stock image.

A child sits on bed while hospitalized, in a stock image.
Hraun/Getty Images

In addition, Patel recommended that parents make sure their children are practicing good hand hygiene and staying home if they are sick. She also suggested families that have high-risk members consider wearing masks when indoors.

"Despite the constant debate about whether they work, the truth is that when masks are mandated viral transmission was very low," she said. "So, particularly in families where there are high-risk individuals at home, I would not hesitate to ask your children to wear masks if they're amenable to that."

 
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Omicron subvariants resistant to key antibody treatments are increasing every week in the U.S.​

PUBLISHED FRI, OCT 28 20224:29 PM EDT

KEY POINTS
  • The subvariants BQ.1 and BQ.1.1 now represent 27% of infections in the U.S., a significant jump from the week prior when they made up about 16% of new cases.
  • They are likely resistant to Evusheld and bebtelovimab, key antibody treatments that protect people with compromised immune systems.
  • President Joe Biden this week cautioned people with compromised immune system that they in particular are at risk this winter
Two omicron subvariants that are resistant to key antibody treatments are on the rise in the U.S., according to data from the Centers for Disease Control and Prevention.

The subvariants BQ.1 and BQ.1.1 now represent 27% of infections in the U.S., a significant jump from the week prior when they made up about 16% of new cases, according to CDC data published Friday.

Omicron BA.5, though still the dominant variant, is diminishing every week. It now represents about 50% of infections in the U.S., down from 60% the week prior, according to the data.

President Joe Biden this week warned people with compromised immune systems that they were particularly at risk this winter because antibody treatments are not effective against emerging subvariants.

BQ.1 and BQ.1.1 are likely resistant to Evusheld and bebtelovimab, according to the National Institutes of Health.

Evusheld is an antibody cocktail administered as two injections that people ages 12 and older with moderately or severely compromised immune systems take to prevent Covid-19. Bebtelovimab is a monoclonal antibody taken to treat Covid after an infection.

Biden urged people with weak immune systems to consult their physicians on what precautions to take. Dr. Ashish Jha, head of the White House Covid task force, said the U.S. is running out of options to treat the vulnerable because Congress failed to pass more money for the nation’s Covid response.

“We had hoped that over time as the pandemic went along, as our fight against this virus went along, we would be expanding our medicine cabinet,” Jha told reporters this week. “Because of lack of congressional funding that medicine cabinet has actually shrunk and that does put vulnerable people at risk.”

It’s unclear how well the new boosters will protect against variants such as BQ.1 and BQ.1.1. Jha has said the boosters should offer better protection than the old shots because these subvariants are descended from BA.5, which is contained in the updated vaccines.

Two independent studies from Columbia and Harvard this week found that the omicron boosters did not perform much better than the old shots against BA.5. The Food and Drug Administration said the studies were too small to draw any definitive conclusions.

The CDC, the FDA and the White House Covid taskforce believe the new shots will prove more effective because they are better matched to the circulating variants than the first generation vaccines.

“It is reasonable to expect based on what we know about immunology and the science of this virus that these new vaccines will provide better protection against infection, better protection against transmission and ongoing and better protection against serious illness,” Jha told reporters in September.

Jha called for all eligible Americans to get the omicron booster and their flu shot by Halloween so that they are protected when families start gathering for the holidays.

 
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