Hot Topics: 2022 Holiday Season Begins: RSV Running Rampant, COVID-19 Spiking

Saskia v Popescu, PhD, MPH, MA, CIC

The holidays are fast approaching and for much of the United States, that means gatherings. Friends, family, coworkers, etc. Tis the time for breakroom potlucks, right? Well, let’s keep in mind a few things….

First, we’re facing a dire situation across the country in terms of pediatric hospitalizations, deaths, and overwhelmed hospitals due to respiratory syncytial virus infection (RSV)

And, of course, influenza, and COVID-19. Many hospitals have had to initiate emergency efforts, such as diversion and resource to crisis capacity. Bed and staffing shortages are rampant, and some individuals are having to postpone elective surgeries. Now more than ever, using visitor restrictions and respiratory precautions will be critical.

In the US, COVID-19 cases are continuing to rise. Across the country, there’s a 7% increase in the last two weeks. Test positivity is also up, now at 8.6%, which is a 4% change in the last 14 days. Several states are seeing significant upticks in cases. In terms of 14-day changes, Arizona is up 110%, Nebraska 60%, California 56%, Oregon 34%, Washington is now up 279%, and Alaska is up 63%. Very few states are seeing a drop in cases, and Maine is the winner of the biggest drop in cases over the last two weeks with a 45% decrease in cases. Right now in the United States, there are 111.4 million people fully vaccinated. If we look at the total U.S. population, 34% are boosted, and only 68% are fully vaccinated.

Looking back around this time last year, keeping in mind we saw the novel variant–Omicron–come into the picture, it was right around early December when cases started to rise. Not surprising if you consider the Thanksgiving gatherings and travel, but will we see the same trend this year? Hopefully not and definitely hoping to avoid another new highly transmissible variant. What is worrisome though, is the perfect storm brewing that could lead to a significant surge. First, it’s important to remember that viruses mutate where they can spread…so we want to avoid transmission in general. No brainer, right?

The piece so many experts are so concerned about is this perfect storm–the waning interest in boosters and vaccines, but also the waning immunity that is creeping up on us. Those low hospitalization and death rates are are a result of effective vaccines and, thankfully, a variant that appears to cause less significant disease. The other component is a total relaxation of pretty much all public health interventions. Gone are the days of mask mandates, focused eating outside, and quality ventilation, and employer-mandated quarantine or isolation. Did I mention access to quality tests? Yes, antigen tests from your local stores are a wonderfully accessible tool, but too often we see people testing negative in the first few days of illness and not retesting, despite knowing everything from low viral levels to poor sample collection could be an issue…not to mention that antigen tests aren’t that precise. All these things are worrisome and require us to try and infuse some COVID-19 infection prevention efforts into this holiday season.

PS.

Need some reading on non-COVID-19 topics this week? Check out these articles on infectious disease. A new article in The Lancet discusses global mortality associated with 33 bacterial pathogens (hint, Staphylococcus aureus is a major one). There’s also this one on a fungal endophthalmitis outbreak following cataract surgery in South Korea.