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Tag: Flu

  • An Action Plan for Cold or Flu + COVID-19

    An Action Plan for Cold or Flu + COVID-19

    Photo Credit: diovp / Getty Images

    SOURCES:

    Arti Madhavan, MD, specialist-in-chief of family medicine, Detroit Medical Center.

    Luci Leykum, MD, chief clinical officer, Harbor Health, Austin, TX.

    Frontiers in Medicine: “COVID-19 and Influenza Co-infection: A Systematic Review and Meta-Analysis.”

    Cell Research: “Coinfection with influenza A virus enhances SARS-CoV-2 infectivity.”

    CDC: “COVID-19: What To Do If You Are Sick,” “Flu: What To Do If You Get Sick,” “COVID-19 Treatments and Medications,” “Factors That Affect Your Risk of Getting Very Sick from COVID-19,” “Pregnant and Recently Pregnant People,” “Changes in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic – United States, 2020-2021,” “People With Moderate to Severe Asthma,” “Stay Up to Date with COVID-19 Vaccines Including Boosters.”

    Morbidity and Mortality Weekly Report: “Decreased Influenza Activity During the COVID-19 Pandemic – United States, Australia, Chile, and South Africa, 2020,” “Changes in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic – United States, 2020-2021.”

    American Hospital Association: “Flurona and Its Impact on Flu Season.”

    National Institutes of Health: “Influenza and COVID-19.”

    Journal of Leukocyte Biology: “From virus to inflammation, how influenza promotes lung damage.”

    HHS.gov: “What are oral antivirals?”

    American Medical Association: “Questions your patients may have on COVID-19 and flu coinfection.” 

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  • COVID Vaccines Are Turning Into Flu Shots

    COVID Vaccines Are Turning Into Flu Shots

    For all the legwork that public-health experts have done over the past few years to quash comparisons between COVID-19 and the flu, there sure seems to be a lot of effort nowadays to equate the two. In an advisory meeting convened earlier today, the FDA signaled its intention to start doling out COVID vaccines just like flu shots: once a year in autumn, for just about everyone, ad infinitum. Whatever the brand, primary-series shots and boosters (which might no longer be called “boosters”) will guard against the same variants, making them interchangeable. Doses will no longer be counted numerically. “This will be a fundamental transition,” says Jason Schwartz, a vaccine policy expert at Yale—the biggest change to the COVID-vaccination regimen since it debuted.

    Hints of the annual approach have been dropping, not so subtly, for years. Even in the spring of 2021, Pfizer’s CEO was floating the idea of yearly shots; Peter Marks, the director of the FDA’s Center for Biologics Evaluation and Research, teased it throughout 2022. This past September, Joe Biden officially endorsed it as “a new phase in our COVID-19 response,” and Ashish Jha, the White House’s COVID czar, memorably highlighted the convenience of combining a flu shot and a COVID shot into a single appointment: “I really believe this is why God gave us two arms.”

    Still, in today’s meeting, FDA officials were pushier than ever in their advocacy for the flu-ification of COVID vaccines. “We think that simplification of the vaccination regimen would contribute to easier vaccine deployment, better communication, and improved vaccine coverage,” Jerry Weir, the FDA’s director of the division of viral products, said at the meeting. The timing is important: After renewing the U.S.’s pandemic-emergency declaration earlier this month, the Biden administration seems set to allow its expiration this coming April. That makes the present moment awfully convenient for repackaging a chaotic, crisis-caliber vaccination paradigm as a scheduled, seasonal, normal-seeming one. A once-a-year strategy, modeled on a routine recommendation, suggests that “we’re no longer in emergency mode,” says Maria Sundaram, a vaccine researcher at the Marshfield Clinic Research Institute. Or at least, that’s the message that the public is likely to hear.

    But federal regulators may be trying to fit a COVID-shaped peg into a flu-shaped hole. The experts I spoke with largely agreed: Eventually, someday, annual autumn shots for COVID “will probably be sufficient,” says Gregory Poland, a vaccinologist at Mayo Clinic. “Are we ready for that yet? I’m not sure that’s the case at all.”

    Even in the short term, COVID-vaccination tactics need a revamp. “It’s clear above all that the current approach isn’t working,” Schwartz told me. Despite abundant supply, demand for COVID boosters in the U.S. has been abysmal—and interest seems to be declining with each additional dose. Last fall’s bivalent shot has reached the arms of only 15 percent of Americans; even among adults over 65—a majority of whom sign up for flu shots each fall—the vaccination rate hasn’t yet reached 40 percent.

    For most of the time that COVID shots have been around, figuring out when to get them has been a hassle, with different guidelines and requirements that depend on age, sex, risk factors, vaccination history, and more. Pharmacies have had to stock an absurd number of vials and syringes to accommodate the various combinations of brands and dose sizes; record-keeping on flimsy paper cards has been a total joke. “I do this for a living, and I can barely keep track,” Schwartz said. Recommendations on the proper timing and number of doses have also changed so many times that many Americans have simply checked out. After the bivalent recipe debuted, polls found that an alarming proportion of people didn’t even know the shot was available to them.

    Streamlining COVID-vaccine recommendations will remove a lot of that headache, Sundaram told me. Most people would need to keep only one mantra in mind—one dose, each fall—and could top off their flu and COVID immunity at the same time. Burdens on pharmacies and clinics would be lower, and communication would be far easier—a change that could make an especially big difference for those with children, among whom COVID-vaccine uptake has been the lowest. “It’ll be more scheduled, more systematic,” says Charlotte Hobbs, a pediatric infectious-disease specialist at the University of Mississippi Medical Center. COVID shots could simply be offered at annual well-child visits, she told me. “It’s something we already know works well.”

    The advantages of a flu-ified COVID shot aren’t just about convenience. If we have to shoehorn COVID vaccines into an existing paradigm, Sundaram told me, influenza’s is the best candidate. SARS-CoV-2, like the flu, is excellent at altering itself to dodge our defenses; it spreads readily in winter; and our immunity to infection tends to fade rather quickly. All of that adds up to a need for regularly updated shots. Such a system has been in place for decades for the flu: At the end of each winter, a panel of experts convenes to select the strains that should be targeted by the next formulation; manufacturers spend the next several months whipping up big batches in time for an autumn-ish rollout. The pipeline depends on a global surveillance system for flu viruses, as well as regular surveys of antibody levels in the community to suss out which strains people are still protected against. The premise has been so well vetted by now that researchers can skip the chore of running large-scale clinical trials to determine the efficacy and safety of each new, updated recipe.

    But a seasonal strategy works best for a seasonal virus—and SARS-CoV-2 just isn’t there yet, says Hana El Sahly, an infectious-disease physician at Baylor College of Medicine. Though flu viruses tend to hop between the globe’s hemispheres, alternately troubling the north and the south during their respective cold months, this new coronavirus has yet to confine its spread to one part of the calendar. (Marks, of the FDA, tried to address this concern at today’s meeting, asserting that “we’re starting to see some seasonality” and that fall was indeed the very sensible for an annual rollout.) SARS-CoV-2 has also been spitting out concerning variants and subvariants at a faster rate than the flu (and flu shots already have a hard time keeping up with evolution). The FDA’s new proposal suggests picking SARS-CoV-2 variants in June to have a vaccine ready by September, a shorter timeline than is used for flu. That still might not be fast enough: “By the time we detect a variant, it will have ripped through the global population and, in a few more weeks, died down,” El Sahly told me. The world got a preview of this problem with last year’s bivalent shot, which overlapped with the dominance of its target subvariants for only a couple of months. A flu model for COVID would make more sense “if we had stable, predictable dynamics,” says Avnika Amin, a vaccine epidemiologist at Emory University. “I don’t think we’re at that point.”

    Murkiness around vaccine effectiveness makes this transition complicated too. Experts told me that it’s gotten much more difficult to tell how well our COVID vaccines are working, and for how long, fueling debates over how often they should be given and how often their composition should change. Many people have now been infected by the virus multiple times, which can muddy calculations of vaccine effectiveness; better treatments also alter risk profiles. And many researchers told me they’re concerned that the data shortcuts we use for flu—measures of antibodies as a proxy for immune protection—just won’t fly for COVID shots. “We need better clinical data,” El Sahly told me. In their absence, the hasty adoption of a flu framework could lead to our updating and distributing COVID shots too often, or not often enough.

    A flu-ish approach also wouldn’t fix all of the COVID vaccines’ problems. Today’s discussion suggested that, even if a new COVID-shot strategy change goes through, officials will still need to recommend several different dose sizes for several different age groups—a more complex regimen than flu’s—and may advise additional injections for those at highest risk. At the same time, COVID shots would continue to be more of a target for misinformation campaigns than many other vaccines and, at least in the case of mRNA-based injections, more likely to cause annoying side effects. These issues and others have driven down interest—and simply pivoting to the flu paradigm “is not going to solve the uptake problem,” says Angela Shen, a vaccine-policy expert at Children’s Hospital of Philadelphia.

    Perhaps the greatest risk of making COVID vaccines more like flu shots is that it could lead to more complacency. In making the influenza paradigm a model, we also threaten to make it a ceiling. Although flu shots are an essential, lifesaving public-health tool, they are by no means the best-performing vaccines in our roster. Their timeline is slow and inefficient; as a result, the formulations don’t always match circulating strains. Already, with COVID, the world has struggled to chase variants with vaccines that simply cannot keep up. If we move too quickly to the fine-but-flawed framework for flu, experts told me, it could disincentivize research into more durable, more variant-proof, less side-effect-causing COVID shots. Uptake of flu vaccines has never been stellar, either: Just half of Americans sign up for the shots each year—and despite years of valiant efforts, “we still haven’t figured out how to consistently improve that,” Amin told me.

    Whenever the COVID-emergency declaration expires, vaccination will almost certainly have to change. Access to shots may be imperiled for tens of millions of uninsured Americans; local public-health departments may end up with even fewer resources for vaccine outreach. A flu model might offer some improvements over the status quo. But if the downsides outweigh the pluses, Poland told me, that could add to the erosion of public trust. Either way, it might warp attitudes toward this coronavirus in ways that can’t be reversed. At multiple points during today’s meeting, FDA officials emphasized that COVID is not the flu. They’re right: COVID is not the flu and never will be. But vaccines can sometimes become a lens through which we view the dangers they fight. By equating our frontline responses to these viruses, the U.S. risks sending the wrong message—that they carry equal threat.

    Katherine J. Wu

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  • Is COVID Immunity Hung Up on Old Variants?

    Is COVID Immunity Hung Up on Old Variants?

    In the two-plus years that COVID vaccines have been available in America, the basic recipe has changed just once. The virus, meanwhile, has belched out five variants concerning enough to earn their own Greek-letter names, followed by a menagerie of weirdly monikered Omicron subvariants, each seeming to spread faster than the last. Vaccines, which take months to reformulate, just can’t keep up with a virus that seems to reinvent itself by the week.

    But SARS-CoV-2’s evolutionary sprint might not be the only reason that immunity can get bogged down in the past. The body seems to fixate on the first version of the virus that it encountered, either through injection or infection—a preoccupation with the past that researchers call “original antigenic sin,” and that may leave us with defenses that are poorly tailored to circulating variants. In recent months, some experts have begun to worry that this “sin” might now be undermining updated vaccines. At an extreme, the thinking goes, people may not get much protection from a COVID shot that is a perfect match for the viral variant du jour.

    Recent data hint at this possibility. Past brushes with the virus or the original vaccine seem to mold, or even muffle, people’s reactions to bivalent shots—“I have no doubt about that,” Jenna Guthmiller, an immunologist at the University of Colorado School of Medicine, told me. The immune system just doesn’t make Omicron-focused antibodies in the quantity or quality it probably would have had it seen the updated jabs first. But there’s also an upside to this stubbornness that we could not live without, says Katelyn Gostic, an immunologist and infectious-disease modeler who has studied the phenomenon with flu. Original antigenic sin is the reason repeat infections, on average, get milder over time, and the oomph that enables vaccines to work as well as they do. “It’s a fundamental part,” Gostic told me, “of being able to create immunological memory.”

    This is not just basic biology. The body’s powerful first impressions of this coronavirus can and should influence how, when, and how often we revaccinate against it, and with what. Better understanding of the degree to which these impressions linger could also help scientists figure out why people are (or are not) fighting off the latest variants—and how their defenses will fare against the virus as it continues to change.

    The worst thing about “original antigenic sin” is its name. The blame for that technically lies with Thomas Francis Jr., the immunologist who coined the phrase more than six decades ago after noticing that the initial flu infections people weathered in childhood could bias how they fared against subsequent strains. “Basically, the flu you get first in life is the one you respond to most avidly for the long term,” says Gabriel Victora, an immunologist at Rockefeller University. That can become somewhat of an issue when a very different-looking strain comes knocking.

    In scenarios like these, original antigenic sin may sound like the molecular equivalent of a lovesick teen pining over an ex, or a student who never graduates out of immunological grade school. But from the immune system’s point of view, never forgetting your first is logically sound. New encounters with a pathogen catch the body off guard—and tend to be the most severe. A deep-rooted defensive reaction, then, is practical: It ups the chances that the next time the same invader shows up, it will be swiftly identified and dispatched. “Having good memory and being able to boost it very quickly is sometimes a very good thing,” Victora told me. It’s the body’s way of ensuring that it won’t get fooled twice.

    Read: Annual COVID shots mean we can stop counting

    These old grudges come with clear advantages even when microbes morph into new forms, as flu viruses and coronaviruses often do. Pathogens don’t remake themselves all at once, so immune cells that home in on familiar snippets of a virus can still in many cases snuff out enough invaders to prevent an infection’s worst effects. That’s why even flu shots that aren’t perfectly matched to the season’s most prominent strains are usually still quite good at keeping people out of hospitals and morgues. “There’s a lot of leniency in how much the virus can change before we really lose protection,” Guthmiller told me. The wiggle room should be even bigger, she said, with SARS-CoV-2, whose subvariants tend to be far more similar to one another than, say, different flu strains are.

    With all the positives that immune memory can offer, many immunologists tend to roll their eyes at the negative and bizarrely moralizing implications of the phrase original antigenic sin. “I really, really hate that term,” says Deepta Bhattacharya, an immunologist at the University of Arizona. Instead, Bhattacharya and others prefer to use more neutral words such as imprinting, evocative of a duckling latching onto the first maternal figure it spots. “This is not some strange immunological phenomenon,” says Rafi Ahmed, an immunologist at Emory University. It’s more a textbook example of what an adaptable, high-functioning immune system does, and one that can have positive or negative effects, depending on context. Recent flu outbreaks have showcased a little bit of each: During the 2009 H1N1 pandemic, many elderly people, normally more susceptible to flu viruses, fared better than expected against the late-aughts strain, because they’d banked exposures to a similar-looking H1N1—a derivative of the culprit behind the 1918 pandemic—in their youth. But in some seasons that followed, H1N1 disproportionately sickened middle-aged adults whose early-life flu indoctrinations may have tilted them away from a protective response.

    Read: COVID science is moving backwards

    The backward-gazing immune systems of those adults may have done more than preferentially amplify defensive responses to a less relevant viral strain. They might have also actively suppressed the formation of a response to the new one. Part of that is sheer kinetics: Veteran immune cells, trained up on past variants and strains, tend to be quicker on the draw than fresh recruits, says Scott Hensley, an immunologist at the Perelman School of Medicine at the University of Pennsylvania. And the greater the number of experienced soldiers, the more likely they are to crowd out rookie fighters—depriving them of battlefield experience they might otherwise accrue. Should the newer viral strain eventually return for a repeat infection, those less experienced immune cells may not be adequately prepared—leaving people more vulnerable, perhaps, than they might otherwise have been.

    Some researchers think that form of imprinting might now be playing out with the bivalent COVID vaccines. Several studies have found that the BA.5-focused shots are, at best, moderately more effective at producing an Omicron-targeted antibody response than the original-recipe jab—not the knockout results that some might have hoped for. Recent work in mice from Victora’s lab backs up that idea: B cells, the manufacturers of antibodies, do seem to have trouble moving past the impressions of SARS-CoV-2’s spike protein that they got from first exposure. But the findings don’t really trouble Victora, who gladly received his own bivalent COVID shot. (He’ll take the next update, too, whenever it’s ready.) A blunted response to a new vaccine, he told me, is not a nonexistent one—and the more foreign a second shot recipe is compared with the first, the more novice fighters should be expected to participate in the fight. “You’re still adding new responses,” he said, that will rev back up when they become relevant. The coronavirus is a fast evolver. But the immune system also adapts. Which means that people who receive the bivalent shot can still expect to be better protected against Omicron variants than those who don’t.

    Historical flu data support this idea. Many of the middle-aged adults slammed by recent H1N1 infections may not have mounted perfect attacks on the unfamiliar virus, but as immune cells continued to tussle with the pathogen, the body “pretty quickly filled in the gaps,” Gostic told me. Although it’s tempting to view imprinting as a form of destiny, “that’s just not how the immune system works,” Guthmiller told me. Preferences can be overwritten; biases can be undone.

    Original antigenic sin might not be a crisis, but its existence does suggest ways to optimize our vaccination strategies with past biases in mind. Sometimes, those preferences might need to be avoided; in other instances, they should be actively embraced.

    For that to happen, though, immunologists would need to fill in some holes in their knowledge of imprinting: how often it occurs, the rules by which it operates, what can entrench or alleviate it. Even among flu viruses, where the pattern has been best-studied, plenty of murkiness remains. It’s not clear whether imprinting is stronger, for instance, when the first exposure comes via infection or vaccination. Scientists can’t yet say whether children, with their fiery yet impressionable immune systems, might be more or less prone to getting stuck on their very first flu strain. Researchers don’t even know for certain whether repetition of a first exposure—say, through multiple doses of the same vaccine, or reinfections with the same variant—will more deeply embed a particular imprint.

    It does seem intuitive that multiple doses of a vaccine could exacerbate an early bias, Ahmed told me. But if that’s the case, then the same principle might also work the other way: Maybe multiple exposures to a new version of the virus could help break an old habit, and nudge the immune system to move on. Recent evidence has hinted that people previously infected with an early Omicron subvariant responded more enthusiastically to a bivalent BA.1-focused vaccine—available in the United Kingdom—than those who’d never encountered the lineage before. Hensley, at the University of Pennsylvania, is now trying to figure out if the same is true for Americans who got the BA.5-based bivalent shot after getting sick with one of the many Omicron subvariants.

    Ahmed thinks that giving people two updated shots—a safer approach, he points out, than adding an infection to the mix—could untether the body from old imprints too. A few years ago, he and his colleagues showed that a second dose of a particular flu vaccine could help shift the ratio of people’s immune responses. A second dose of the fall’s bivalent vaccine might not be practical or palatable for most people, especially now that BA.5 is on its way out. But if next autumn’s recipe overlaps with BA.5 in ways that it doesn’t with the original variant—as it likely will to at least some degree, given the Omicron lineage’s continuing reign—a later, slightly different shot could still be a boon.

    Keeping vaccine doses relatively spaced out—on an annual basis, say, à la flu shots—will likely help too, Bhattacharya said. His recent studies, not yet published, hint that the body might “forget” old variants, as it were, if it’s simply given more time: As antibodies raised against prior infections and injections fall away, vaccine ingredients could linger in the body rather than be destroyed by prior immunity on sight. That slightly extended stay might offer the junior members of the immune system—lesser in number, and slower on the uptake—more of an opportunity to cook up an Omicron-specific response.

    In an ideal world, researchers might someday know enough about imprinting to account for its finickiness whenever they select and roll out new shots. Flu shots, for instance, could be personalized to account for which strains babies were first exposed to, based on birth year; combinations of COVID vaccine doses and infections could dictate the timing and composition of a next jab. But the world is not yet living that reality, Gostic told me. And after three years of an ever-changing coronavirus and a fluctuating approach to public health, it’s clear that there won’t be a single vaccine recipe that’s ideal for everyone at once.

    Even Thomas Francis Jr. did not consider original antigenic sin to be a total negative, Hensley told me. According to Francis, the true issue with the “sin” was that humans were missing out on the chance to imprint on multiple strains at once in childhood, when the immune system is still a blank slate—something that modern researchers could soon accomplish with the development of universal vaccines. Our reliance on first impressions can be a drawback. But the same phenomenon can be an opportunity to acquaint the body with diversity early on—to give it a richer narrative, and memories of many threats to come.

    Katherine J. Wu

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  • Flu Cases Fall, But Not Admissions and Deaths

    Flu Cases Fall, But Not Admissions and Deaths

    Editor’s note: See cold and flu activity in your location with the WebMD tracker.

    Jan. 9, 2023 – New cases of the flu in the United States continue to decline as flu-related outpatient visits to doctors offices and hospitals fell for the fifth straight week as 2022 ended, according to the latest CDC data. 

    While good news, the number of hospital admissions for flu and flu-like illnesses held steady. 

    Outpatient visits for flu-like illness made up 5.4% of all visits to health care providers during the week of Dec. 25-31, according to data from the CDC’s Outpatient Influenza-like Illness Surveillance Network. That is down from 6.0% the previous week and down from what seems like a seasonal peak of 7.5% in late November, based on the CDC Influenza Division’s latest FluView report.

    The CDC’s surveillance network defines influenza-like illness as fever plus cough or sore throat, not laboratory-confirmed flu, so the data includes other respiratory illnesses such as COVID-19 and respiratory syncytial virus (RSV). But the language in the FluView report makes it clear that the CDC puts the emphasis on the flu.

    State-level data confirms the national drop: Only 12 jurisdictions were at “very high” flu activity for the week of Dec. 25-31, compared with 24 the week before. (Jurisdictions include the 50 states, as well as territories, New York City, and the District of Columbia.) Another step down shows that the number of metro areas with very high activity fell from 59 to 37, the CDC said.

    Despite the declines in outpatient visits, hospital admissions remained right around 19,000 for a second straight week after a 2-week downturn, based on data from the U.S. Department of Health and Human Services Protect platform.Another measure not showing improvement was the proportion of deaths due to the flu, which was higher for Dec. 25-31 (1.63%) than either of the 2 previous weeks (1.53% and 1.6%), according to data from the National Center for Health Statistics that were included in the CDC report.

    Total deaths during the 2022-23 flu season number around 14,000 so far, with hospitalizations at 230,000 and illnesses around 22 million. Among the deaths reported during the latest week were 13 in children, and the total number for the season is now at 74, the CDC said.

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  • Flu Activity Falls for the Fourth Straight Week

    Flu Activity Falls for the Fourth Straight Week

    Editor’s note: See cold and flu activity in your location with the WebMD tracker.

    Jan. 3, 2023 – The 2022-23 influenza season got off to a fast and rather nasty start in October and November, but December brought a drop in infections instead of the usual surge, according to CDC data.

    “Seasonal influenza activity remains high but is declining in most areas,” the CDC’s Influenza Division said last week in its weekly FluView report.

    Nationally, 6.1% of outpatient visits for the week ending Dec. 24 were for influenza-like illness. Since that rate hit 7.5% in late November – the fastest start to a flu season since 2009 – activity has dropped for 4 consecutive weeks, the CDC said. 

    In 2009, the outpatient visit rate reached 7.7% in mid-October, but activity dropped quickly after that, falling to less than 3% by the end of November, CDC data show.

    As with the number of outpatient visits, hospital admissions are already on the decline as well. The weekly number of flu-related hospitalizations reached 26,000 in early December but has fallen for 3 straight weeks and was down to just under 19,000 for Dec. 18-24, according to data from nearly 4,900 hospitals to the Department of Health and Human Services.

    The CDC estimates the total number of flu hospitalizations to be 210,000 through the first 11 weeks of the 2022-23 season. There have been an estimated 20 million illnesses and 13,000 deaths from the flu so far in the United States, with 61 of those deaths in children. By comparison, there were 44 pediatric deaths from the flu during the entire 2021-22 season, only one in 2020-21, and 199 in 2019-20, the CDC said.

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  • A nutritionist shares the best snacks to bring on a plane to boost your immune system

    A nutritionist shares the best snacks to bring on a plane to boost your immune system

    Travelers have a host of pathogens to dodge this winter, including the “tripledemic” of infections caused by Covid-19, flu and RSV (respiratory syncytial virus).

    But there are steps people can take to reduce their chances of getting sick, say health specialists at Spain’s SHA Wellness Clinic.

    The key is to develop “a resilient immune system that can defend itself from attack by viruses and bacteria,” said Dr. Vicente Mera, SHA’s head of genomic medicine.

    What to eat

    “The most important thing is nutrition,” Mera said.

    But drastic dieting isn’t necessary, he added. Rather, travelers can simply eat whole, plant-based foods, which can help decrease inflammation, he said.

    Fiber in plant-based foods also helps the gut microbiome “fight pathogens that enter or are activated through the digestive tract,” he said.

    Dr. Vicente Mera, Melanie Waxman and Philippa Harvey of SHA Wellness Clinic in Alicante, Spain.

    Source: SHA Wellness Clinic

    Eating a nutrient-dense diet is the top recommendation from Melanie Waxman, an integrative nutrition specialist and eating coach at SHA Wellness Clinic.

    That means eating “lots of vegetables, whole grains, fresh herbs, beans, sea vegetables, fruits, nuts, seeds and fermented foods,” she said.

    What to pack on a plane

    Waxman said travelers should snack on alkaline foods to combat acidity that is commonly caused by air travel. She recommended these easy-to-pack foods:

    • Toasted nori snacks: “Great for travelling as they are light and easy to carry in small packs. Nori is alkaline and provides a good source of vitamin C, as well as omega-3 fatty acids, protein and minerals.”
    • Instant miso soup: “Contains all the essential amino acids … and restores beneficial probiotics to the intestines … great for flights and in hotel rooms as you only need to add boiling water to the sachet.”
    • Spirulina powder: “Packed with calcium and protein. It has a high chlorophyll content … is especially beneficial after spending hours in airplane cabins. The flavor can be strong so add it to a refreshing vegetable juice … [or take] as a capsule.”  
    • Plum balls: “A wonderful travel companion, as they are extremely alkaline, full of minerals that help increase energy, aid digestion, boost immunity and improve liver functions … the balls come in a container and are easy to pack in a cabin bag.”

    A fermented plum, called umeboshi in Japanese, can be added to a cup of tea on a flight. It is a “very sour plum that has been fermented for at least three years,” said SHA Wellness Clinic’s Melanie Waxman.

    Tomophotography | Moment | Getty Images

    Breakfast

    Waxman recommends drinking one tablespoon of apple cider vinegar mixed with a glass of water before breakfast. The vinegar is “a powerful immune booster … full of probiotics,” she said.

    For breakfast, a “wonderful” choice is oatmeal topped with berries, chia seeds and flax seeds, she said.

    “Oats actually help the body produce melatonin more naturally,” she said. “Oats contain amino acids, potassium, B vitamins, magnesium and complex carbs … berries pack a punch of vitamin C, and the seeds provide extra omega-3 and protein.”

    Jet lag

    To combat jet lag, Waxman recommends taking more vitamin C.

    She recommends eating sauerkraut, both before and after flying. “Fermenting cabbage causes the vitamin C and antioxidant levels to skyrocket,” she said.

    Fresh vegetable juice is also great for immunity and jet lag recovery, she said.

    Getting enough sleep

    Sleep and immunity are closely linked, Mera said.  

    “Restful sleep strengthens nature immunity,” he said, adding that poor quality, or quantity, of sleep increases the chances of falling sick.

    People who average less than six hours of sleep a night, or 40 hours per week, have “a serious risk of illness,” he said.

    Exercise — but don’t overdo it

    Moderate exercise strengthens the immune system, Mera said.

    But “30 minutes a day is more than enough,” he said. “Prolonged intense exercise can suppress the immune system.”

    To avoid suppressing the immune system, travelers shouldn’t exercise to the point of exhaustion, said Dr. Vicente Mera, head of genomic medicine at SHA Wellness Clinic.

    Westend61 | Westend61 | Getty Images

    Examples of beneficial exercise include running, walking, swimming and cycling, he said.

    Supplements, for some

    Studies indicate that certain supplements — such as vitamin C, vitamin D, zinc, garlic, echinacea and green tea — may strengthen the body’s immune response, Mera said.

    But, he said, they’re not necessary for everyone.

    “It only compensates for nutrient deficiencies, which usually occur when nutrition is inadequate, or the immune system is very depressed,” he said.

    Other recommendations

    To strengthen the immune system, Waxman also suggests Epsom salt baths (“magnesium is easily absorbed through the skin”), using essential oils (“especially lavender, eucalyptus or tree tree oil”), drinking plenty of water and cutting back on alcohol, caffeine and sugar.

    Mera added that relieving stress and anxiety is critical to immune health. He recommends meditation, yoga, tai chi and mindfulness to better manage emotions.

    Philippa Harvey, head of SHA’s traditional Chinese medicine department, said travelers should start taking steps to strengthen their immune systems about a week before traveling.

    “In TCM when someone is healthy and happy we say they have good qi, pronounced ‘chee’” she said.

    She recommends eating foods that are in season, especially garlic and ginger in the autumn and winter.

    She also recommends exercise and acupressure to stay healthy.

    “Before we travel, a nice brisk walk in fresh air is the simplest solution,” she said.

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  • Flu Hospitalizations Drop Amid Signs of an Early Peak

    Flu Hospitalizations Drop Amid Signs of an Early Peak

    Dec. 16, 2022 – It’s beginning to look less like an epidemic as seasonal flu activity “appears to be declining in some areas,” the CDC said this week.

    Declines in a few states and territories were enough to lower national activity, as measured by outpatient visits for influenza-like illness, for the second consecutive week. This reduced the weekly number of hospital admissions for the first time this season, according to the CDC Influenza Division’s weekly FluView report.

    Flu-related hospital admissions slipped to about 23,500 during the week of Dec. 4-10, after topping 26,000 the week before, based on data reported by 5,000 hospitals from all states and territories.

    The weekly hospitalization rate tumbled from 8 per 100,000 people to 4.5 per 100,000, which was still higher than any other December rate from all previous seasons going back to 2009-10, CDC data shows. 

    Visits for flu-like illness represented 6.9% of all outpatient visits reported to the CDC during the week of Dec. 4-10. The rate reached 7.5% during the last full week of November before dropping to 7.3%, the CDC said.

    There were 28 states or territories with “very high” activity for the latest reporting week, compared with 32 the previous week. Eight states – Colorado, Idaho, Kentucky, Nebraska, New Mexico, Oklahoma, Tennessee, and Washington – and New York City were at the very highest level on the CDC’s 1-13 scale of activity, compared with 14 areas the week before, the agency reported.

    So far this season, the CDC estimated there have been at least 15 million cases of the flu, 150,000 hospitalizations, and 9,300 deaths. Among those deaths have been 30 reported in children, compared with 44 for the entire 2021-22 season and just one for 2020-21. 

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  • U.S. Sees Most Flu Hospitalizations in a Decade

    U.S. Sees Most Flu Hospitalizations in a Decade

    Editor’s note: See cold and flu activity in your location with the WebMD tracker.

    Dec. 12, 2022 – The number of Americans hospitalized because of the flu has hit the highest levels the country has seen in at least a decade, the CDC said Friday. 

    But the number of deaths and outpatient visits for flu or flu-like illnesses was down slightly from the week before, the CDC said in its weekly FluView report.

    There were almost 26,000 new hospital admissions involving laboratory-confirmed influenza over those 7 days, up by over 31% from the previous week, based on data from 5,000 hospitals in the HHS Protect system, which tracks and shares COVID-19 data. 

    The cumulative hospitalization rate for the 2022-23 season is 26.0 per 100,000 people, the highest seen at this time of year since 2010-11, the CDC said, based on data from its Influenza Hospitalization Surveillance Network, which includes hospitals in select counties in 13 states.

    At this point in the 2019-20 season, just before the COVID-19 pandemic began, the cumulative rate was 3.1 per 100,000 people, the CDC’s data shows.

    On the positive side, the proportion of outpatient visits for influenza-like illness dropped slightly to 7.2%, from 7.5% the week before. But these cases from the CDC’s Outpatient Influenza-like Illness Surveillance Network are not laboratory-confirmed, so the data could include people with the flu, COVID-19, or respiratory syncytial virus (RSV). 

    The number of confirmed flu deaths for the week of Nov. 27 to Dec. 3 also fell slightly from the last full week of November, 246 vs. 255, but the number of pediatric deaths rose from two to seven, and total deaths in children are already up to 21 for 2022-23. That’s compared to 44 that were reported during all of the 2021-22 season, the CDC said.

    “So far this season, there have been at least 13 million illnesses, 120,000 hospitalizations, and 7,300 deaths from flu,” the agency estimated.

     

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  • Omicron subvariants are now dominant in the U.S. as COVID cases tick up and New York City becomes a hot spot

    Omicron subvariants are now dominant in the U.S. as COVID cases tick up and New York City becomes a hot spot

    Omicron subvariants continued to account for more new cases of COVID-19 in the U.S. in the latest week than did BA.5, according to the latest data from the Centers for Disease Control and Prevention.

    BQ.1 and BQ.1.1, which are sublineages of BA.5, accounted for 67.9% of cases in the week through Dec. 10, while BA.5 accounted for 11.5%, the data show.

    Last week, BQ.1.1 and BQ.1 accounted for 62.8% of all cases in the U.S., while BA.5 accounted for 13.8%.

    In the New York region, which includes New Jersey, Puerto Rico and the U.S. Virgin Islands, the numbers were even higher, with BQ.1 and BQ.1.1 accounting for 73.3% of new cases, compared with 10% for BA.5.

    In the previous week, BQ.1 and BQ.1.1 accounted for 72.4% of all cases, compared with 6.9% for BA.5.

    New York City is again emerging as a hot spot for COVID, according to a New York Times tracker, which shows cases up about 60% in recent weeks and hospitalizations at their highest level since February. 

    The test-positivity rate in New York City stood at 13% on Thursday, the tracker shows.

    Overall, known U.S. cases are up 53% from two weeks ago. The daily average for hospitalizations is up 30% at 37,066, while the daily average for deaths is up 35% to 460.

    For now, the numbers remain far below the peaks seen last winter, when omicron first hit, but with flu and other respiratory infections currently sweeping the country and affecting young children, experts are warning people to take precautions.

    Coronavirus Update: MarketWatch’s daily roundup has been curating and reporting all the latest developments every weekday since the coronavirus pandemic began

    Other COVID-19 news you should know about:

    • A rash of COVID-19 cases in schools and businesses was reported by social-media users Friday in areas across China. This comes after the ruling Communist Party loosened its antivirus rules as it tries to reverse a deepening economic slump, the Associated Press reported. Official data showed a fall in new cases, but after the government on Wednesday ended mandatory testing for many people, those data no longer cover large parts of the population. That was among the dramatic changes aimed at gradually emerging from the zero-COVID restrictions that have confined millions of people to their homes and sparked protests and demands for President Xi Jinping to resign.

    • U.S.-listed shares of China Jo-Jo Drugstores Inc.
    CJJD,
    +51.20%
    rallied on Friday as the stores filled with customers buying cold medicines after COVID restrictions were eased, MarketWatch’s Jaimy Lee reported. The stock was up 22%. The company, which is based in Hangzhou, China, operates drugstores and an online pharmacy in China. It is also a wholesale distributor of pharmacy products and grows and sells herbs used in traditional Chinese medicine. 

    Some movie theaters in China reopened and COVID-testing booths were dismantled ahead of an announcement by authorities on Wednesday that will scrap most testing and quarantine requirements. The changes come after nationwide protests against Beijing’s zero-COVID policy. Photo: Ng Han Guan/Associated Press

    • Pfizer
    PFE,
    -0.12%
    and German partner BioNTech
    BNTX,
    -0.88%
    have received fast-track designation from the U.S. Food and Drug Administration for a single-dose mRNA-based vaccine candidate targeting both COVID and flu. The companies have already announced that they are in early-stage trials to review the safety and immunogenicity of their combined vaccine in healthy adults. The vaccine will target the BA.4 and BA.5 omicron sublineages, which have become dominant globally, as well as four different flu strains recommended for use in the Northern Hemisphere by the World Health Organization. If approved, the vaccine would be the first to target both COVID and flu.

    • A bill to rescind the COVID vaccine mandate for members of the U.S. military and to provide nearly $858 billion for national defense was passed by the House on Thursday as lawmakers scratch one of the final items off their yearly to-do list, the AP reported. The bill provides about $45 billion more for defense programs than President Joe Biden requested, the second consecutive year Congress has significantly exceeded his request, as lawmakers seek to boost the nation’s military competitiveness with China and Russia. The bill is expected to easily pass the Senate and then be signed into law by Biden.

    Here’s what the numbers say:

    The global tally of confirmed cases of COVID-19 topped 648 million on Friday, while the death toll rose above 6.65 million, according to data aggregated by Johns Hopkins University.

    The U.S. leads the world with 99.4 million cases and 1,084,236 fatalities.

    The Centers for Disease Control and Prevention’s tracker shows that 228.6 million people living in the U.S., equal to 68.9% of the total population, are fully vaccinated, meaning they have had their primary shots.

    So far, just 42 million Americans have had the updated COVID booster that targets the original virus and the omicron variants, equal to 13.5% of the overall population.

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  • COVID, flu, RSV: The benefits of advocating for boosters in the workplace–and how to go about it

    COVID, flu, RSV: The benefits of advocating for boosters in the workplace–and how to go about it

    With a triple pandemic of COVID, flu, and Respiratory syncytial virus (RSV) hitting the U.S. hard this winter and resulting in an explosion of cases, business executives need to take the lead on promoting the newly updated, Omicron-specific boosters. Doing so will help reduce the number of sick days taken by their workers, minimize COVID outbreaks and superspreader events in their companies, reduce employee fears about returning to the office, and position executives as trustworthy participants in stakeholder capitalism.

    Research shows that the new boosters from Pfizer and Moderna, which are bivalent (they target both Omicron and the original COVID strain) are very safe, like current vaccines. They are also more effective than previous vaccines against the Omicron variants, which are prevalent in the U.S. and around the globe.

    The boosters are widely available and price is not an issue: the federal government purchased plenty of doses to give away for free to anyone approved to get one. They’re authorized for Americans aged 12 or older. The Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky stated “there is no bad time to get your COVID-19 booster and I strongly encourage you to receive it.”

    Unfortunately, these recommendations are largely falling on deaf ears. Only 7.6 million Americans received the new booster in September, the first month it became widely available.

    Missing booster shots could have dire consequences

    The reason for low uptake stems from vaccine hesitancy and a lack of awareness. According to a Kaiser Family Foundation survey, less than a third of the targeted population intend to get the new boosters.

    This low number is not surprising, given an Ipsos poll showing that 65% believe there is a small or no risk in returning to their normal, pre-COVID life. That belief would not be a problem if we didn’t have hundreds of COVID-related deaths per day right now, and many additional deaths from flu and RSV as part of the triple pandemic. Moreover, the University of Washington’s Institute for Health Metrics and Evaluation projects a new wave of COVID in the winter that could more than quadruple the current infection rate, which aligns with projections of a major winter wave by the FDA.

    The consequences for executives and their teams can be dire. We knew since early 2022 that, according to a CDC study, the original vaccine’s effectiveness against Omicron fades quickly. Those who received two doses of Moderna or Pfizer have 71% less likelihood of being hospitalized with COVID compared to non-vaccinated people within the first month of getting the shots. However, that effectiveness fades relatively quickly to 58% after four months and continues falling off after that. Someone who received the original two doses and then a booster gets a protection of 91% against hospitalization immediately. Effectiveness falls to 78% after four months.

    By now, it’s been many months since most Americans received the original vaccine series and the booster shots. That makes us seriously vulnerable to COVID, especially the most experienced, senior staff at companies, whose age puts them in a high-risk category.

    The immediate danger of staff members being out for several weeks in a hospital, or even dying, is just part of the problem. We can’t forget about the threat of long COVID, meaning long-term symptoms of COVID infection. These symptoms can range from fatigue and brain fog to sudden heart failure and strokes in otherwise healthy young and middle-aged people.

    A CDC survey from June 2022 shows that 7.5% of Americans report having long COVID symptoms, defined as symptoms lasting three or more months after first contracting the virus. A study by the University of Southern California finds that 23% of those who get sick with COVID are likely to get long COVID symptoms.

    Per a study published in The Lancet, 22% of those who had long COVID symptoms were unable to work, and another 45% needed reduced hours. The Brookings Institution evaluated these numbers to find that long COVID is keeping anywhere from 2 to 4 million Americans out of the labor force. No wonder we’re experiencing such labor shortages!

    Nobody wants their staff–or themselves–to become part of these statistics. Yet what are executives doing about it? Not much. That’s despite serious recent outbreaks at major companies that mandated office returns, such as Google or CalPERS, the $441.9 billion California Public Employees’ Retirement System.

    By failing to take action, business leaders are falling into the omission bias. This term refers to a dangerous judgment error–a cognitive bias that downplays the costs of inaction in our minds.

    In fact, some companies are taking steps in the opposite direction in their desperation to drive staff to the office. For example, Goldman Sachs lifted vaccination requirements everywhere except in areas that have government vaccine mandates for being in the office.

    What should managers do?

    What executives should be thinking about is the long-term consequences of failing to encourage new booster shots. Given the data, we can confidently state that the more employees get shots, the fewer sick days they will take. It will also lower the chance of staff having to permanently reduce their hours or even withdraw from the labor force.

    Similarly, advocating for boosters will minimize COVID outbreaks in a company. Doing so avoids the bad PR from such outbreaks, as well as the decreased morale afflicting staff at a time when companies are trying to have their staff return to the office, as Google, CalPERS, and others have discovered.

    On a related note, to reduce employee fears about returning to the office, encouraging everyone to get the new booster is an excellent strategy. Whether a company pursues a flexible, team-led model in returning to the office as I encourage my clients to do, or a more rigid, top-down approach, many employees have fears about COVID. An internal survey my company just completed for a Fortune 500 SaaS company showed that 64% of respondents felt somewhat concerned about COVID in the office. That aligns with broader surveys, such as one by Ipsos in September showing that 57% of those surveyed feel somewhat concerned about COVID.

    Last, but far from least, comes the crucial role of executives to serve as trustworthy exemplars of what the Business Roundtable calls the new purpose of companies: stakeholder capitalism. A critical aspect of stakeholder capitalism involves “supporting the communities in which we work.”

    There’s little doubt that reducing COVID among company employees supports broader community health and well-being. According to Edelman’s trust barometer, business leaders are trusted more than the government, nonprofits, and the media. Some 86% of respondents to the trust barometer expect CEOs to speak out on issues such as pandemic impact. This makes it only more urgent for executives who wish to be on the front line of stakeholder capitalism to speak out in favor of the new boosters.

    Mandates are certainly not the right way to go about promoting new boosters, given that we are transitioning from the emergency of the pandemic into a more endemic stage of learning to live with the virus. A much better approach is creating appropriate norms and nudging employees to engage in win-win behaviors by using behavioral science-based approaches.

    To create appropriate norms, executives need to both publicly advocate for the new boosters and get the shot themselves. The CEO at one of my client organizations wrote up a blog post for an internal company newsletter about the benefit of getting the bivalent booster, accompanied by a photo of himself getting the jab. She also strongly encouraged her C-suite and mid-level managers to get the booster and discuss doing so with their team members. The company also brought in a well-respected epidemiologist to talk about the benefits of getting a bivalent vaccine booster, who answered questions and addressed concerns among staff.

    To nudge employees, this company offered paid time off for getting the shot, along with sick leave for any side effects. It also created a competition between different teams within the organization. Team members could submit anonymized proof of their shots, and the first three teams to have all their members get shots got treated to an all-expense-paid weekend getaway. The company offered the same prize through a lottery for five employees across the organization who got the booster within the first three months it became available.

    Other companies I work with have adopted similar techniques to developing norms and nudging employees, customized to their own needs. These approaches help create a context that encourages employees to protect everyone’s health without forcing them to get the shot. Doing so benefits the bottom line by reducing sick days, addressing worker resistance to coming to the office, minimizing PR fiascos, and helping executives be at the forefront of stakeholder capitalism.

    Gleb Tsipursky, Ph.D., is the CEO of the boutique future-of-work consultancy Disaster Avoidance Experts. He is the best-selling author of seven books, including Never Go With Your Gut: How Pioneering Leaders Make the Best Decisions and Avoid Business Disasters and Leading Hybrid and Remote Teams: A Manual on Benchmarking to Best Practices for Competitive Advantage. His expertise comes from over 20 years of consulting for Fortune 500 companies from Aflac to Xerox and over 15 years in academia as a behavioral scientist at UNC-Chapel Hill and Ohio State.

    The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.

    More must-read commentary published by Fortune:

    Gleb Tsipursky

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  • Flu Season Raged Over Thanksgiving

    Flu Season Raged Over Thanksgiving

    Editor’s note: See cold and flu activity in your location with the WebMD tracker. 

    Dec. 2, 2022 – The flu virus made the most of the Thanksgiving holiday by reaching the highest level of national activity seen since the 2017-18 influenza season, according to the CDC. 

    The biggest 1-week increase in what is becoming an unprecedented flu season had flu-like activity at 7.5% for the week of Nov. 20-26, as measured by the proportion of outpatient visits reported to the CDC that involved respiratory illness, which may also include respiratory syncytial virus (RSV) and COVID-19.

    That 7.5% is the highest level of flu-like activity recorded in the United States since early February 2018, at the peak of the 2017-18 flu season, and the highest rate recorded in November since the CDC began tracking such data in 1997. Flu-like activity reached 7.7% in October of 2009 but then dropped below 7% by the first week of November and did not rise again for the rest of that season, the CDC’s data shows.

    There are more signs of a worse flu or flu-like season this year.. The total hospitalization rate for confirmed cases of flu, 16.6 per 100,000 people, is higher than the rate seen at this point in the season during any season since 2010-2011, the CDC said.

    The high rate of hospitalizations from Nov. 20-26 is nearly double the the previous week’s numbers, the CDC noted in its weekly Fluview report.

    So far this season, the CDC estimates, “there have been at least 8.7 million illnesses, 78,000 hospitalizations, and 4,500 deaths from flu.” In 2018-19, the last full influenza season before COVID, there were 148 deaths through the first 8 weeks, based on CDC data.

    Flu-like activity at the state and territory levels, which the CDC categorizes on a scale range from 1-13 – from minimal (1-3) to very high (11-13) – puts 31 states at very high for the week, compared with 19 the week before. Only New Hampshire and the Northern Mariana Islands are in the minimal range, according to the CDC.

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  • U.S. Flu Activity Already at Mid-Season Levels

    U.S. Flu Activity Already at Mid-Season Levels

    Nov. 29, 2022 – Reports of respiratory illness continued to rise as the 2022-23 flu season maintained its early surge through mid-November, according to the CDC. 

    Nationally, 6% of all outpatient visits were because of flu or flu-like illness for the week of Nov. 13-19, up from 5.8% the previous week, the CDC’s Influenza Division said in its weekly FluView report.

    Those figures are the highest recorded in November since 2009, but the peak of the 2009-10 flu season occurred even earlier – the week of Oct. 18-24 – and the rate of flu-like illness had already dropped to just over 4.0% by Nov. 15-21 that year and continued to drop thereafter.

    Although COVID-19 and respiratory syncytial virus (RSV) are included in the data from the CDC’s Outpatient Influenza-like Illness Surveillance Network, the agency did note that “seasonal influenza activity is elevated across the country” and estimated that “there have been at least 6.2 million illnesses, 53,000 hospitalizations, and 2,900 deaths from flu” during the 2022-23 season.

    Total flu deaths include 11 reported in children as of Nov. 19, and children ages 0-4 had a higher proportion of visits for flu like-illness than other age groups.

    The agency also said the cumulative hospitalization rate of 11.3 per 100,000 population “is higher than the rate observed in [the corresponding week of] every previous season since 2010-2011.” Adults 65 years and older have the highest cumulative rate, 25.9 per 100,000, for this year, compared with 20.7 for children 0-4; 11.1 for adults 50-64; 10.3 for children 5-17; and 5.6 for adults 18-49 years old, the CDC said.

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  • Bird flu prompts slaughter of 1.8M chickens in Nebraska

    Bird flu prompts slaughter of 1.8M chickens in Nebraska

    OMAHA, Neb. — Nebraska agriculture officials say another 1.8 million chickens must be killed after bird flu was found on a farm in the latest sign that the outbreak that has already prompted the slaughter of more than 50 million birds nationwide continues to spread.

    The Nebraska Department of Agriculture said Saturday that the state’s 13th case of bird flu was found on an egg-laying farm in northeast Nebraska’s Dixon County, about 120 miles (193 kilometers) north of Omaha, Nebraska..

    Just like on other farms where bird flu has been found this year, all the chickens on the Nebraska farm will be killed to limit the spread of the disease. The U.S. Department of Agriculture says more than 52.3 million birds in 46 states — mostly chickens and turkeys on commercial farms — have been slaughtered as part of this year’s outbreak.

    Nebraska is second only to Iowa’s 15.5 million birds killed with 6.8 million birds now affected at 13 farms.

    In most past bird flu outbreaks the virus largely died off during the summer, but this year’s version found a way to linger and started to make a resurgence this fall with more than 6 million birds killed in September.

    The virus is primarily spread by wild birds as they migrate across the country. Wild birds can often carry the disease without showing symptoms. The virus spreads through droppings or the nasal discharge of an infected bird, which can contaminate dust and soil.

    Commercial farms have taken a number of steps to prevent the virus from infecting their flocks, including requiring workers to change clothes before entering barns and sanitizing trucks as they enter the farm, but the disease can be difficult to control. Zoos have also taken precautions and closed some exhibits to protect their birds.

    Officials say there is little risk to human health from the virus because human cases are extremely rare and the infected birds aren’t allowed to enter the nation’s food supply. Plus, any viruses will be killed by properly cooking poultry to 165 degrees Fahrenheit.

    But the bird flu outbreak has contributed to the rising prices of chicken and turkey along with the soaring cost of feed and fuel.

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  • Bird flu prompts slaughter of 1.8M chickens in Nebraska

    Bird flu prompts slaughter of 1.8M chickens in Nebraska

    OMAHA, Neb. — Nebraska agriculture officials say another 1.8 million chickens must be killed after bird flu was found on a farm in the latest sign that the outbreak that has already prompted the slaughter of more than 50 million birds nationwide continues to spread.

    The Nebraska Department of Agriculture said Saturday that the state’s 13th case of bird flu was found on an egg-laying farm in northeast Nebraska’s Dixon County, about 120 miles (193 kilometers) north of Omaha, Nebraska..

    Just like on other farms where bird flu has been found this year, all the chickens on the Nebraska farm will be killed to limit the spread of the disease. The U.S. Department of Agriculture says more than 52.3 million birds in 46 states — mostly chickens and turkeys on commercial farms — have been slaughtered as part of this year’s outbreak.

    Nebraska is second only to Iowa’s 15.5 million birds killed with 6.8 million birds now affected at 13 farms.

    In most past bird flu outbreaks the virus largely died off during the summer, but this year’s version found a way to linger and started to make a resurgence this fall with more than 6 million birds killed in September.

    The virus is primarily spread by wild birds as they migrate across the country. Wild birds can often carry the disease without showing symptoms. The virus spreads through droppings or the nasal discharge of an infected bird, which can contaminate dust and soil.

    Commercial farms have taken a number of steps to prevent the virus from infecting their flocks, including requiring workers to change clothes before entering barns and sanitizing trucks as they enter the farm, but the disease can be difficult to control. Zoos have also taken precautions and closed some exhibits to protect their birds.

    Officials say there is little risk to human health from the virus because human cases are extremely rare and the infected birds aren’t allowed to enter the nation’s food supply. Plus, any viruses will be killed by properly cooking poultry to 165 degrees Fahrenheit.

    But the bird flu outbreak has contributed to the rising prices of chicken and turkey along with the soaring cost of feed and fuel.

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  • Will Flu and RSV Always Be This Bad?

    Will Flu and RSV Always Be This Bad?

    In the Northern Hemisphere, this year’s winter hasn’t yet begun. But Melissa J. Sacco, a pediatric-intensive-care specialist at UVA Health, is already dreading the arrival of the one that could follow.

    For months, the ICU where Sacco works has been overflowing with children amid an early-arriving surge of respiratory infections. Across the country, viruses such as RSV and flu, once brought to near-record lows by pandemic mitigations, have now returned in force, all while COVID-19 continues to churn and the health-care workforce remains threadbare. Most nights since September, Sacco told me, her ICU has been so packed that she’s had to turn kids away “or come up with creative ways to manage patients in emergency rooms or emergency departments,” where her colleagues are already overwhelmed and children more easily slip through the cracks. The team has no choice: There’s nowhere else for critically ill kids to go.

    Similar stories have been pouring in from around the nation for weeks. I recently spoke with a physician in Connecticut who called this “by far the worst spike in illness I’ve seen in 20 years”; another in Maryland told me, “There have been days when there is not an ICU bed to be found anywhere in the mid-Atlantic.” About three-quarters of the country’s pediatric hospital beds are full; to accommodate overflow, some hospitals have set up tents outside their emergency department or contemplated calling in the National Guard. Last week, the Children’s Hospital Association and the American Academy of Pediatrics asked the Biden administration to declare a national emergency. And experts say there’s no end to the crisis in sight. When Sacco imagines a similar wave slamming her team again next fall, “I get that burning tear feeling in the back of my eyes,” she told me. “This is not sustainable.”

    Read: The worst pediatric-care crisis in decades

    The experts I spoke with are mostly optimistic that these cataclysmic infection rates won’t become an autumn norm. But they also don’t yet fully understand the factors that have been driving this year’s surge, making it tough to know with certainty whether we’re due for an encore.

    One way or another, COVID has certainly thrown the typical end-of-year schedule out of whack. Respiratory viruses typically pick up speed in late fall, peak in mid-to-late winter, and then bow out by the spring; they often run in relay, with one microbe surging a bit before another. This year, though, nearly every pathogen arrived early, cresting in overlapping waves. “Everything is happening at once,” says Kathryn Edwards, a pediatrician and vaccinologist at Vanderbilt University. November isn’t yet through, and RSV has already sent infant hospitalizations soaring past pre-pandemic norms. Flu-hospitalization rates are also at their worst in more than a decade; about 30 states, plus D.C. and Puerto Rico, are reporting high or very high levels of the virus weeks before it usually begins its countrywide climb. And the country’s late-summer surge in rhinovirus and enterovirus has yet to fully abate. “We just haven’t had a break,” says Asuncion Mejias, a pediatrician at Nationwide Children’s Hospital.

    Previous pandemics have had similar knock-on effects. The H1N1-flu pandemic of 2009, for example, seems to have pushed back the start of the two RSV seasons that followed; seasonal flu also took a couple of years to settle back into its usual rhythms, Mejias told me. But that wonky timetable wasn’t permanent. If the viral calendar is even a little more regular next year, Mejias said, “that will make our lives easier.”

    This year, flu and RSV have also exploited Americans’ higher-than-average vulnerability. Initial encounters with RSV in particular can be rough, especially in infants, whose airways are still tiny; the sickness tempers with age as the body develops and immunity builds, leaving most children well protected by toddlerhood. But this fall, the pool of undefended kids is larger than usual. Children born just before the pandemic, or during the phases of the crisis when mitigations aplenty were still in place, may be meeting influenza or RSV for the first time. And many of them were born to mothers who had themselves experienced fewer infections and thus passed fewer antibodies to their baby while pregnant or breastfeeding. Some of the consequences may already have unfurled elsewhere in the world: Australia’s most recent flu season hit kids hard and early, and Nicaragua’s wave at the start of 2022 infected children at rates “higher than what we saw during the 2009 pandemic,” says Aubree Gordon, an epidemiologist at the University of Michigan.

    Read: What a ‘tripledemic’ means for your body

    In the U.S., many hospitals are now admitting far more toddlers and older children for respiratory illnesses than they normally do, says Mari Nakamura, a pediatric-infectious-disease specialist at Boston Children’s Hospital. The problem is worsened by the fact that many adults and school-age kids avoided their usual brushes with flu and RSV while those viruses were in exile, making it easier for the pathogens to spread once crowds flocked back together. “I wouldn’t be surprised,” Gordon told me, “if we see 50 to 60 percent of kids get infected with flu this year”—double the estimated typical rate of 20 to 30 percent. Caregivers too are falling sick; when I called Edwards, I could hear her husband and grandson coughing in the background.

    By next year, more people’s bodies should be clued back in to the season’s circulating strains, says Helen Chu, a physician and an epidemiologist at the University of Washington. Experts are also hopeful that the toolkit for fighting RSV will soon be much improved. Right now, there are no vaccines for the virus, and only one preventive drug is available in the U.S.: a tough-to-administer monoclonal antibody that’s available only to high-risk kids. But at least one RSV vaccine and another, less cumbersome antibody therapy (already being used in Europe) are expected to have the FDA’s green light by next fall.

    Even with the addition of better tech, though, falls and winters may be grueling for many years to come. SARS-CoV-2 is here to stay, and it will likely compound the respiratory burden by infecting people on its own or raising the risk of co-infections that can worsen and prolong disease. Even nonoverlapping illnesses might cause issues if they manifest in rapid sequence: Very serious bouts of COVID, for instance, can batter the respiratory tract, making it easier for other microbes to colonize.

    A few experts have begun to wonder if even milder tussles with SARS-CoV-2 might leave people more susceptible to other infections in the short or long term. Given the coronavirus’s widespread effects on the body, “we can’t be cavalier” about that possibility, says Flor Muñoz Rivas, a pediatrician at Baylor College of Medicine. Mejias and Octavio Ramilo, also at Nationwide, recently found that among a small group of infants, those with recent SARS-CoV-2 infections seemed to have a rougher go with a subsequent bout of RSV. The trend needs more study, though; it’s not clear which kids might be at higher risk, and Mejias doubts that the effect would last more than a few months.

    Gordon points out that some people may actually benefit from the opposite scenario: A recent brush with SARS-CoV-2 could bolster the body’s immune defenses against a second respiratory invader for a few days or weeks. This phenomenon, called viral interference, wouldn’t halt an outbreak by itself, but it’s thought to be part of the reason waves of respiratory disease don’t usually spike simultaneously: The presence of one microbe can sometimes crowd others out. Some experts think last year’s record-breaking Omicron spike helped punt a would-be winter flu epidemic to the spring.

    Even if all of these variables were better understood, the vagaries of viral evolution could introduce a plot twist. A new variant of SARS-CoV-2 may yet emerge; a novel strain of flu could cause a pandemic of its own. RSV, for its part, is not thought to be as quick to shape-shift, but the virus’s genetics are not well studied. Mejias and Ramilo’s data suggest that the arrival of a gnarly RSV strain in 2019 may have pushed local hospitalizations past their usual highs.

    Read: Will we get Omicron’d again?

    Behavioral and infrastructural factors could cloud the forecast as well. Health-care workers vacated their posts in droves during the pandemic, and many hospitals’ pediatric-bed capacity has shrunk, leaving supply grossly inadequate to address current demand. COVID-vaccination rates in little kids also remain abysmal, and many pediatricians are worried that anti-vaccine sentiment could stymie the delivery of other routine immunizations, including those against flu. Even temporary delays in vaccination can have an effect: Muñoz Rivas points out that the flu’s early arrival this year, ahead of when many people signed up for their shot, may now be aiding the virus’s spread. The new treatments and vaccines for RSV “could really, really help,” Nakamura told me, but “only if we use them.”

    Next fall comes with few guarantees: The seasonal schedule may not rectify itself; viruses may not give us an evolutionary pass. Our immune system will likely be better-prepared to fend off flu, RSV, rhinovirus, enterovirus, and more—but that may not be enough on its own. What we can control, though, is how we choose to arm ourselves. The past few years proved that the world does know how to drive down rates of respiratory disease. “We had so little contagion during the time we were trying to keep COVID at bay,” Edwards told me. “Is there something to be learned?”

    Katherine J. Wu

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  • Is It a Surge? Flu Season Gains Strength Before Holidays

    Is It a Surge? Flu Season Gains Strength Before Holidays

    Editor’s note: See cold and flu activity in your location with the WebMD tracker. 

    Nov. 21, 2022 — The 2022-2023 flu season continues its early start as respiratory illness activity climbed to levels typically seen in January or February, according to a new report from the CDC. 

    One important measure of the season’s severity, the proportion of outpatient visits involving influenza-like illness (ILI), rose to 5.8% for the week of Nov. 6-12. The last flu season to have such high activity so early was 2009-10, when visits for flu-like illness hit 7.7% in mid-October, the CDC’s data shows. That same season, visit levels quickly dropped and were back to normal by the beginning of January.

    As with so many other things, however, the emergence of COVID-19 has brought about changes in how flu activity is measured. 

    About a year ago, the CDC changed the definition of flu-like illness to exclude specific mention of flu itself, which has brought COVID-19 and RSV (respiratory syncytial virus) into play, since with both patients often have fever plus cough or sore throat. All three viruses are being monitored by the CDC’s Outpatient Influenza-like Illness Surveillance Network, which monitors outpatient visits for respiratory illness.

    As the CDC monitors flu-like illness, a potential wild card is emerging research showing these viruses don’t play well together. 

    Researchers in Canada reported in February that the flu virus interferes with the coronavirus that causes COVID-19 and helps prevent the coronavirus from replicating itself. The opposite is true, as well, where the coronavirus can interfere with the flu virus, the researchers reported in a study published in the journal Viruses.

    Likewise, there is evidence that rhinoviruses, which cause the common cold, may interfere with the coronavirus. 

    What this means, some experts believe, is that it’s unlikely all three viruses would peak at the same time, overwhelming the health care system. 

    Despite the change in the CDC’s tracking definitions, activity during the 2021-22 flu season was below average: The national flu-like illness rate never reached 5% and fell below the current national baseline (an average of the last three non-COVID flu seasons plus 2021-22 and selected weeks of 2019-20) by the end of January.

    That does not seem to be the case in 2022-23. 

    “So far this season, there have been at least 4.4 million illnesses, 38,000 hospitalizations, and 2,100 deaths from flu,” the CDC said in the weekly report from its Influenza Division, while also noting that the rate of hospital admissions “is higher than the rate observed [at the same point] during every previous season since 2010-2011.”

    Among those 2,100 influenza-associated deaths this season are seven children. That is more than occurred through 6 weeks of the 2021-22 season, when the first of 44 total deaths didn’t occur until week 8, and through the entire 2020-21 season, when there was only one. In the three flu seasons before that, there were 199 (2019-20), 144 (2018-19), and 188 (2017-18) children who died from the flu, the CDC said.

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  • Symptoms as Clues: Is It RSV, COVID, the Flu or the Common Cold?

    Symptoms as Clues: Is It RSV, COVID, the Flu or the Common Cold?

    Editor’s note: See cold and flu activity in your location with the WebMD tracker. 

    Nov. 17, 2022 – The overlapping symptoms of respiratory viruses with household names – COVID-19, the flu, the common cold, and RSV (respiratory syncytial virus) – can make it challenging to tell them apart. 

    But how quickly the symptoms come on, how long they last, and even which symptom(s) you have can be important clues. Some treatments are available, and they’re most effective when taken early, so it’s worth figuring out which infection is hitting you, a friend, or a loved one. 

    The American Academy of Pediatrics came up with a helpful chart of which symptoms are most likely with which respiratory illnesses. “I think that’s a really good chart. And I do think that It is mostly the same for children and adults,” says Patricia (Patsy) A. Stinchfield, a registered nurse and president of the National Foundation for Infectious Diseases (NFID).

    One exception she offered is that children with COVID-19 report less loss of taste and smell, compared to adults. 

    “It is extremely, extremely difficult to differentiate our symptoms between influenza, RSV, and COVID-19 … for parents and physicians for that matter,” says Mobeen Rathore, MD, a member of the American Academy of Pediatrics’ Committee on Infectious Diseases.

    Stinchfield agrees that these viruses cause many of the same symptoms, such as congestion, coughing, and the potential for fever. But that does not mean it’s impossible to tell them apart. 

    The Fast and the Furious

    “After 44 years as an infectious disease nurse practitioner, one of the things I would ask people trying to figure out how sick they are is about the onset.” For both children and adults, the flu often comes on very quickly. “It’s like one minute a child is playing or an adult is working – and the next minute … it’s that feeling like you got hit by a Mack truck.”

    In contrast, the other viral illnesses tend to come on more slowly, she says. “People will say they feel like they’re coming down with something, they have chills, a sore throat, or feel ‘blah.’” 

    GI symptoms can be another clue. Vomiting and diarrhea are more common with COVID-19, and to some extent the flu, compared to RSV. This happens in part because the COVID-19 virus attaches to ACE2 receptors found in both the lungs and the gut, so it can affect both parts of the body.

    In addition, it is well accepted that loss of taste and smell is a unique sign of COVID-19 infection. So that can help you tell COVID-19 from other viral illnesses.

    Symptoms That Point to RSV

    More sneezing, “copious amounts” of nasal mucus – snot – coming from a runny nose, and wheezing are some hallmark symptoms of RSV. Wheezing is when a child or adult makes a whistling sound while breathing. Stinchfield says, “You don’t see wheezing as much in COVID or influenza as you do with RSV.”

    “With RSV, it’s more of the upper respiratory type of infection, and people tend to have more of what we call bronchiolitis,” Rathore says. Bronchiolitis is inflammation and congestion in the small airways of the lungs, which in turn can cause the wheezing sound.

    In addition, some people with RSV have so much trouble breathing normally that they recruit other muscles to help, including muscles right above and below the breastbone. 

    The Common Cold Is Still Around

    “People are talking a lot about RSV right now – and rightly so – but at least what we are seeing is quite different,” Rathore says. The latest internal figures from the American Academy of Pediatrics’ Committee on Infectious Diseases suggest that the common cold is predominant virus at the moment, followed by influenza, RSV, and COVID-19. 

    Rathore estimates that about 35% of patients coming in with a viral illness test positive for the rhino enterovirus causing the common cold. 

    “So it is probably much more common than any of the other infections we are talking about,” he says. And yes, the cold is more common, “but it’s also relatively less likely to cause more severe illness.”

    Testing Remains Essential

    Stinchfield shared two main messages. Testing is the only reliable way to diagnose a viral illness. “So if someone says: ‘This is definitely RSV’ and your child hasn’t been tested, you really don’t know.”

    Testing very young children is important because they cannot describe their aches and pains, says Rathore, who is also chief of the Division of Pediatric Infectious Diseases and Immunology at the University of Florida in Jacksonville. 

    Testing can also confirm flu or COVID. “The nice thing is that there are some combination rapid tests that we use in clinics that can look at COVID-19, the flu, and RSV all in one,” Stinchfield says. She hopes that similar combination home tests will be available in the future.

    Another reason to test is “there’s treatment for COVID-19 and there’s treatment for influenza, so it is important to know what is it that you have so that you could potentially benefit from early treatment.”

    Stinchfield also says there are effective vaccines for COVID-19 and influenza, and a vaccine to protect against RSV is in development. 

    Don’t Hesitate to Get Help

    Trust your instinct if you feel a viral illness is getting worse, Stinchfield says. “Just listen to your gut. If you are afraid, if you’re like, ‘This is not right,’ ‘my husband doesn’t look good,’ ‘my baby doesn’t look good,’” get medical help.

    “That’s what we’re here for,” she says. 

    Stinchfield acknowledges there can be longer than usual waits to see a pediatrician or infectious disease doctor because of the RSV outbreak. Also, consider a virtual appointment if you are concerned about exposure to other people in a medical setting, she says. 

    Are We in for a Worrisome Winter?

    With multiple noteworthy viruses in circulation, some experts are warning about a “twindemic” or “tripledemic” this coming winter. Rathore took it a step further. “I’m actually calling a possibility of a quaternary-demic.” In addition to COVID-19, RSV, and the flu, the common cold virus is widespread as well. 

    In fact, in his area of northeast Florida, RSV rates seem to be going down, flu is going up, and with COVID-19, “there is a concern that it may come back as it did in previous seasons.” At the same time, rates for the common cold are holding steady. 

    “There is nothing you can say for sure” about which viruses will dominate over the coming winter,” Rathore says. But the flu season in the Southern Hemisphere was relatively severe, and that often predicts what happens in the United States and other parts of the Northern Hemisphere, he says. 

    On a positive note, the flu vaccine this past season was a good match for protecting against the flu strain that circulated in Australia and elsewhere, which could be reassuring here. “So that is one more reason that all those eligible for the influenza vaccine should get it.”

     

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  • Smaller food cos. get set for a high-priced holiday season

    Smaller food cos. get set for a high-priced holiday season

    NEW YORK — Holiday celebrants in Hilo, Hawaii, might notice something different about the traditional Yule Log cake from the Short ’N Sweet bakery this year.

    Maria Short typically makes her popular $35 bûche de Noël with two logs combined to look like a branch. This year, thanks to soaring prices for eggs and butter and other items, she’s downsizing to one straight Yule log.

    “It’s the same price, but smaller,” she said. “That cuts down on size and labor.”

    Higher prices are hitting everyone this holiday, but food vendors are seeing some of the biggest increases. Small businesses that count on food-centric holidays like Thanksgiving and Christmas are bracing for a difficult season.

    At the wholesale level, egg prices are more than triple what they were a year ago, milk prices are up 34% and butter is up 70%, according to data from the U.S. Department of Agriculture. Businesses are also paying more for everything from packages to labor.

    Many owners are raising prices to offset the higher costs. But raising prices too much risks driving away the crucial holiday shopper. So, businesses are adapting: adjusting the way they make products, changing gift basket components and adding free gifts instead of giving discounts, among other steps.

    Maria Short says that even for Hawaii, where the cost of living is among the highest of any U.S. state, the price increases are “drastic.”

    For example, she says, the Short N Sweet Bakery is paying $123 for a case of eggs that cost $42 in October last year. A case of butter that was $91 in October ago; it’s $138 this year.

    Among the ways Short is cutting costs, she’ll use a generic box decorated with stickers instead of using a customized box for her desserts. And she ordered a cookie printer rather than having bakers hand-pipe frosting, to save on labor costs.

    Sarah Pounders, who co-owns Nashville-based Made in TN, a retailer of locally made food and gifts, says the local vendors who make the items she sells are facing higher prices. The cost of butter needed to make cookies is five times the price from a year ago and cardboard packaging is double.

    Made in TN has raised some prices and is selling other items for less profit. Customers are already paying more for things like gas, clothing and cars, as well as services like eating out and travel, so they’re not as quick to spend as they might have been in prior years. They’re noticing the price increases, she said.

    “If bread is up 50 cents you will still buy bread,” Pounders said. “But if it’s an impulse buy or luxury specialty item — if chocolate-covered cookies are up $1 — you might think twice.”

    Price increases aren’t an option for her popular gift basket business. Corporations often have a $50 cap and events at hotels like weddings can have a $20 sweet spot. So, Pounders has made adjustments. In some cases, she has replaced a $20 bag of coffee, which is up $3, with less expensive hot chocolate. Or she puts one less chocolate bar in the basket.

    She’s also buying more items that could sell throughout the year and less seasonal inventory like peppermint bark and hot chocolate on a stick.

    “Every year is a guess, and the economy makes it even more volatile,” she said.

    Eric Ludy, co-founder of Cheese Brothers, an online purveyor of Wisconsin cheese and gift baskets, faces a tricky task this holiday season as he tries to offset higher costs for packaging, labor — and cheese. Half of his business comes in the weeks between Black Friday and Christmas.

    Cheese Brothers has nominally raised prices for their cheese – a block of cheddar will cost customers $7.50 instead of $7, for example. Ludy says he’ll also rely less on discounts this year and more on gifts and other giveaways.

    A bit of a gamble that Ludy is taking is upping the spending limit for free shipping to $70 from $59.

    “People buy enough to get free shipping, it’s a huge motivator,” he said. He hopes raising the shipping price could push the average order up to $70. But it could also stop people from clicking the “Buy” button.

    “We might start to see people push back and not buy as much,” he said. “It’s a delicate balance.”

    Americans eat an estimated 40 million turkeys during the holidays, according to industry group The National Turkey Federation. But turkey purveyors are facing a double whammy this Thanksgiving: higher prices plus an avian flu epidemic that is shaping up to be one of the worst in history.

    Kevin Smith, owner of Beast and Cleaver, a butcher shop in Seattle, Washington, gets his turkeys from small, local farms. He says he’s paying $6 a pound for turkey this year, up from $3.80 to $4.20 last year. In addition, he only plans to sell 150 turkeys this year, down from 250 last year, due to shortages caused by the avian flu.

    Still, Smith doesn’t plan to charge more for turkey than he did last year: $9 a pound. He says he has a “solid base of customers” willing to pay for more local, sustainable turkeys, but there’s a limit.

    “We don’t want people to have to pay $12 a pound for turkey,” he said.

    He’s raising the price of other items, like ground sausage and pates, to offset the higher costs of poultry. And while the rush of panic-buying during the pandemic has subsided, he’s still expecting a good holiday season.

    “We’re still very busy,” he said. “It’s just a more stable busy.”

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  • Respiratory illness forces KCK school to close for the rest of the week

    Respiratory illness forces KCK school to close for the rest of the week

    A surge in an upper respiratory illness has shut down a Kansas City, Kansas, school and is filling pediatric wards around the metro area.Micah Nelson turned 9 months old on Wednesday. He’s being treated at the University of Kansas Health System for RSV and has been in and out of the pediatric ward of the hospital for about a week.”He was grunting and making a lot of noises when he was breathing. So, we knew he was having some trouble,” said Melody Nelson, Micah’s mother.”The shifts have been long. There have been a lot of admissions and bed shuffling to make sure we take care of the ill children,” said Dr. Shawn Sood, pediatric critical care physician at the University of Kansas Health System.Respiratory illnesses have shut down Christ the King School in Kansas City, Kansas, for the rest of the week. A custodial crew spent Wednesday spraying disinfectant and wiping down surfaces at the school.According to principal Cathy Fithian, 50 to 60 of the 250 students were out sick and seven of her 21 teachers have flu, RSV or COVID-19.”It was a tough decision because the protocol is not so much how many students are out when the school might close, it is how many faculty and staff. If you can’t staff your building and have teachers in the classrooms, you just can’t have school,” she said.Overland Park Regional Medical Center is reporting a 100% increase in patient volume with up to 60 children treated daily in the pediatric ER over the past few weeks with viral infections, mostly RSV.The Kansas City, Missouri Health Department reported from Oct. 23 to Oct. 30, there was an average of 90 ER visits per day for children under 18 to the emergency room for problems with flu-like symptoms, including RSV.That same week has far outpaced any other previous year since at least 2017.The Kansas City Health Department reports that children under 18 are 10 times more likely to be seen in emergency rooms for those respiratory infections than adults.Centers for Disease Control Data for the Midwest Region, which includes Kansas and Missouri, shows a significant spike in RSV cases since Oct. 1.According to the Unified Government Public Health Department, in addition to increased hospitalizations for RSV and flu, COVID-19 is still circulating in our area and is likely to increase this winter.The health department also encourages people to get flu and COVID-19 vaccines if they haven’t already done it.RSV is especially troublesome for children and infants under 2 years old.”The main treatment is supportive care, oxygen therapy and IV fluids if they need it,” Sood said.If children that young are having trouble breathing, Sood recommended seeking medical attention for them as quickly as possible. He also recommended hand washing and disinfecting surfaces to prevent the spread of respiratory illnesses like RSV.

    KANSAS CITY, Kan. —

    A surge in an upper respiratory illness has shut down a Kansas City, Kansas, school and is filling pediatric wards around the metro area.

    Micah Nelson turned 9 months old on Wednesday. He’s being treated at the University of Kansas Health System for RSV and has been in and out of the pediatric ward of the hospital for about a week.

    “He was grunting and making a lot of noises when he was breathing. So, we knew he was having some trouble,” said Melody Nelson, Micah’s mother.

    “The shifts have been long. There have been a lot of admissions and bed shuffling to make sure we take care of the ill children,” said Dr. Shawn Sood, pediatric critical care physician at the University of Kansas Health System.

    Respiratory illnesses have shut down Christ the King School in Kansas City, Kansas, for the rest of the week. A custodial crew spent Wednesday spraying disinfectant and wiping down surfaces at the school.

    According to principal Cathy Fithian, 50 to 60 of the 250 students were out sick and seven of her 21 teachers have flu, RSV or COVID-19.

    “It was a tough decision because the protocol is not so much how many students are out when the school might close, it is how many faculty and staff. If you can’t staff your building and have teachers in the classrooms, you just can’t have school,” she said.

    Overland Park Regional Medical Center is reporting a 100% increase in patient volume with up to 60 children treated daily in the pediatric ER over the past few weeks with viral infections, mostly RSV.

    The Kansas City, Missouri Health Department reported from Oct. 23 to Oct. 30, there was an average of 90 ER visits per day for children under 18 to the emergency room for problems with flu-like symptoms, including RSV.

    That same week has far outpaced any other previous year since at least 2017.

    The Kansas City Health Department reports that children under 18 are 10 times more likely to be seen in emergency rooms for those respiratory infections than adults.

    Centers for Disease Control Data for the Midwest Region, which includes Kansas and Missouri, shows a significant spike in RSV cases since Oct. 1.

    According to the Unified Government Public Health Department, in addition to increased hospitalizations for RSV and flu, COVID-19 is still circulating in our area and is likely to increase this winter.

    The health department also encourages people to get flu and COVID-19 vaccines if they haven’t already done it.

    RSV is especially troublesome for children and infants under 2 years old.

    “The main treatment is supportive care, oxygen therapy and IV fluids if they need it,” Sood said.

    If children that young are having trouble breathing, Sood recommended seeking medical attention for them as quickly as possible. He also recommended hand washing and disinfecting surfaces to prevent the spread of respiratory illnesses like RSV.

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  • Seinfeld’s Jason Alexander Wants Everyone to Get Their Shot

    Seinfeld’s Jason Alexander Wants Everyone to Get Their Shot

    Nov. 2, 2022 — When Jason Alexander performed in the musical Jerome Robbins’ Broadway in 1989, he got the flu. 

    Turns out, not getting the flu vaccine that year almost cost him a Tony award.

    “I missed six performances because my flu turned into bronchitis,” says Alexander, who has asthma and is best known for his role as George Costanza in Seinfeld. “I’ll never forget how the producers said ‘I don’t care how sick you are, get back on stage.’ I spent a solid week trying to do a very physically taxing show with bronchitis.”

    Though Alexander did go on to win the Tony, he never missed his annual flu shot again. That experience is just one reason he’s participating in a new flu campaign, a partnership between the American Nurses Association and flu vaccine maker Sanofi.

    Entitled “Not Today, Flu,” the campaign features Alexander encouraging people to get vaccinated and urge their loved ones to get a flu shot, too.

    This is all the more pressing as flu season is in full swing and experts are now warning of a “tridemic” this winter as COVID-19 restrictions have been eased. The CDC reports that this year’s flu season is coming on strong and early. Between Oct. 1 and Oct. 22, 443 flu-related hospitalizations were reported in the agency’s surveillance network, the highest number of hospitalizations reported at this time of the season in 10 years.

    “With so much talk about vaccinations over the past 2 years, I understand why people are either avoiding or are hesitant about vaccinations,” Alexander says.  “But there’s concern in the medical community that this could be a devastating flu season if people don’t inoculate.”

    The goal of getting vaccinated: To keep people out of the hospital and avoid respiratory complications.

    Turns out, Alexander knows a thing or two about hospital life. His mom was a nurse and he was often around sick people who were struggling to regain their health.

    “I grew up in and around the hospital where she worked,” he says. “I worked as a dishwasher and in the laundry room there. My mother would have been very happy if I gravitated toward the medical field, but I’m a functional idiot, so I went into this instead.”

    Ultimately, Alexander has just one message: Got get your shot as quickly as possible, especially with the holiday season right around the corner.

    “Because we’ve been in a pandemic and everybody has been staying away from each other, we’ve lost some of our natural immunity to the flu,” Alexander says. “This might be the first holiday season since the pandemic began that people are getting together with loved ones. Why derail that because you’re laid up with the flu!”

    And rest assured: The flu shot is safe.

    “There are no horror stories about the flu shot,” he says. “It’s been around your whole life, it’s been well tested, and it definitely won’t make keys stick to your forehead.”

    To find a flu shot near you, visit NotTodayFlu.

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