CNN
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A difficult respiratory virus season in the United States appears to be easing as three major respiratory viruses that have hit the country in recent months are finally all trending down at the same time.
A new dataset from the US Centers for Disease Control and Prevention shows that the number of emergency room visits for all three viruses combined – influenza, Covid-19 and RSV – has fallen to a three-month low. The decline is visible in all age groups.
Measuring virus transmission levels can be difficult; health officials agree that Covid-19 cases are vastly undercounted, and the surveillance systems used for influenza and RSV capture a substantial, but incomplete, picture.
But experts say tracking emergency room visits can be a good indicator of the extent – and severity – of the respiratory virus season.
“That is 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 proportion of people who go to an emergency department for these respiratory disease issues is a really good measure of respiratory disease season.”
In the week after Thanksgiving, emergency room visits for respiratory viruses topped 235,000 — rates matching those of last January, CDC data shows.
While the increase in ER visits at the start of the year was almost entirely due to Omicron, the most recent spike was much more varied. In the week ending December 3, around two-thirds of visits were for influenza, around a quarter for Covid-19 and around 10% for RSV.
Grouping the impact of all respiratory viruses in this way provides important insight.
“There’s a strong interest in thinking about respiratory disease in a more holistic way,” Hamilton said. “The transmission is the same. And there are certain types of measures that are good protection against all respiratory diseases. So that could really help people understand that when we’re in high traffic for respiratory disease, there are steps you can take – just in general.
Now Covid-19 accounts for most ER visits again, but flu and RSV are still the reason for around a third of visits – and they’re all trending down for the first time since virus season breathing began to resume in September.
Other new data from the CDC shows that overall respiratory virus activity continues to decline across the country. Only four states, along with New York and Washington, DC, had “high” levels of flu-like illness. Almost all states were in this category less than a month ago.
Whether this pattern will hold is still up in the air, as flu and Covid-19 vaccination rates lag and respiratory viruses can be quite fickle. Additionally, although the level of respiratory virus activity is lower than it was, it is still above baseline in most places and hospitals across the country are still around 80% full.
RSV activity began to pick up in September, peaking in mid-November when 5 in 100,000 people – and 13 times as many children under five – were hospitalized in a single week.
RSV particularly affects children, and sales of over-the-counter pain and fever medications for children rose 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 spokesperson Logan Ramsey Tucker told CNN in an email — sales are up 30% from a year on year in December.
But this RSV season has been significantly more severe than in recent years, according to CDC data. The weekly hospitalization rate for RSV has dropped to about a fifth of what it was two months ago, but is still higher than in previous seasons.
Influenza activity increased earlier than usual, but appears to have already peaked. Flu hospitalizations — about 6,000 new admissions last week — have fallen 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, Influenza hospitalizations and deaths so far this season have remained within expected ranges. It appears the United States has avoided the post-holiday spike that some experts have warned of, but the flu is notoriously unpredictable and it’s not uncommon to see a second bump later in the season.
The peak of Covid-19 was not as pronounced as the flu, but hospitalizations exceeded summer levels. However, the rise in hospitalizations that began in November has begun to slow in recent weeks and CDC data shows the share of the population living in a county with a “high” community level of Covid-19 has risen from 22 % to about 6% over the past two weeks.
Yet the XBB.1.5 variant – which has key mutations that experts say could help it be more contagious – continues to gain traction in the United States, causing around half of all infections last week. Vaccination rates continue to lag, with only 15% of the eligible population receiving their updated booster and nearly one in five people remain completely unvaccinated.
The ensemble forecast released by the CDC is hazy, predicting a “stable or uncertain trend” in Covid-19 hospitalizations and deaths over the next month.
And three years after the first case of Covid-19 was confirmed in the United States, the virus has not settled into 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 to have 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 thinks 2023 could be the year in which Covid-19 is no longer considered a public health emergency in the United States and around the world, but there is still work to be done so that this to happen and move on to longer. -long-term management of outbreak respiratory disease will take longer.
“We just don’t use [vaccines] more efficiently around the world. I mean 30% of the world still hasn’t had a single vaccine,” she said. “In every country in the world, including the United States, we are missing key demographics.”
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