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Tag: rsv

  • How FDA’s top vaccines official is timing his COVID booster and flu shot for fall 2023

    How FDA’s top vaccines official is timing his COVID booster and flu shot for fall 2023

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    A top-ranking Food and Drug Administration official, responsible for overseeing the approvals of the new vaccines now rolling out for this fall and winter’s three respiratory virus threats, said this month he is personally planning to space out his vaccinations over the coming weeks. 

    “Some people are saying, ‘Well, could I get RSV, COVID and the flu vaccine on the same day?’ Yes, indeed, you could. But honestly, I might not,” said Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research. 

    Instead, he said he intended to get the COVID shot right away and the flu shot in early October.

    Marks, who was speaking during a recent call with FDA stakeholders, stressed that he did not disagree with guidance from the Centers for Disease Control and Prevention which allows giving multiple different routine shots during the same visit. Doctors refer to this as “coadministration” or “simultaneous administration” of vaccines.

    However, he acknowledged that getting up to three of the different vaccines at the same time could lead to more side effects — like stronger fatigue or a small fever — in the days after getting the shots. 

    Spacing out the shots by around two weeks could “minimize the chance of interactions, and minimize confusing side effects from one with another,” he said. They might be a good option for people who did not mind multiple trips to the pharmacy or their doctor’s office.

    “I might just want to space them out a little bit. But if you had to drive a lot of miles to get the vaccines, then it might not be unreasonable to get all three of them at once,” said Marks.

    Getting an updated COVID-19 vaccine now

    Of the currently available options, Marks said that his plan was to get a dose of the updated COVID-19 vaccine first.

    Health authorities have been fortunate to have a vaccine that appears likely to work well for protecting against the currently circulating strains of the virus, he said.

    “It’s like having a bird in the hand. I have a bird in the hand, good match, a lot of COVID around, great time to go get vaccinated,” said Marks. 

    The FDA had selected the strain to target in the current batch of shots back in June, clearing the way for vaccine makers to ramp up their production ahead of a fall rollout. 

    Marks cited recent data suggesting that these updated vaccines, which have been revised from previous designs to now target the XBB.1.5 strain of the virus, would also work to boost protection against its closely-related descendants now dominant nationwide.

    Early results shared by the vaccine makers with a CDC panel earlier this month also suggests that these updated shots will also work against the highly mutated BA.2.86 variant, which has been reported in a growing number of states. 

    Several leading COVID trends, like emergency department visits, have started to slow in recent weeks following a summer wave that began to accelerate last month. Another “moderate” wave is predicted to begin over the coming colder months, the CDC’s disease forecasters say, with that surge’s peak expected to arrive potentially earlier than it did last season.

    Marks said it was possible that health authorities might allow for another dose to be offered to some vulnerable groups later in the fall and winter. 

    “I think if we saw that it appeared that people might benefit in a few months from an additional dose, we would probably work with our CDC colleagues to issue a recommendation at that time. But right now we are just talking about a single recommendation, a single dose,” he said.

    Scheduling a flu shot for early October

    By early next month, Marks said he plans to have received his flu shot. 

    “I usually get my influenza vaccine around October 1st,” Marks said. 

    This is later than some other health officials within the Biden administration. CDC Director Dr. Mandy Cohen posted on social media on Sept. 6 to say she had gotten vaccinated for the flu.

    Similar to previous seasons, CDC’s official recommendations for this year are that “[flu] vaccination should ideally be offered during September or October.” 

    Marks said that the boost in protection offered by flu vaccines can wane, underscoring why the shots should not be given too early in the season, before the threat of infections ramps up. Flu season in the U.S. typically peaks between December and February, but can stretch into the spring.

    The protection from a flu shot “has a little bit of a shorter life than we might like, in some ways it’s a little like the COVID vaccines,” Marks said.

    Right now, weekly CDC data suggests flu activity remains at low levels in most parts of the country. 

    New options for RSV

    Some Americans also have new options to be immunized for RSV, or respiratory syncytial virus, for the first time this year. 

    Older adults, ages 60 and older, can get a dose of the new vaccines developed by Pfizer or GSK. The CDC recommends that shots be offered “as early as vaccine supply becomes available” this year.

    CDC data suggests RSV infections have begun to accelerate in some parts of the country, with the steepest rises in the Southeast. 

    A panel of CDC advisers on Friday recommended that Pfizer’s new RSV vaccine should be given during pregnancy as well, in hopes of passing on protection to newborns during their most vulnerable early months of life. The panel recommended that pregnant people take one dose of the vaccine between weeks 32 and 36 of pregnancy. 

    A new antibody injection from Sanofi and AstraZeneca is also available for babies this year, which is recommended to be given to infants born ahead of this coming RSV season.

    Alexander Tin

    CBS News reporter covering public health and the pandemic.

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  • CDC recommends first-ever RSV vaccine during pregnancy

    CDC recommends first-ever RSV vaccine during pregnancy

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    CDC recommends first-ever RSV vaccine during pregnancy – CBS News


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    The U.S. Centers for Disease Control and Prevention have recommended the first-ever vaccine designed to protect infants from respiratory syncytial virus. The CDC said the Pfizer vaccine should be taken during weeks 32 and 36 of pregnancy.

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  • We Can Finally Do Something About the Third ‘Tripledemic’ Virus

    We Can Finally Do Something About the Third ‘Tripledemic’ Virus

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    Every fall, when the air turns chilly and the leaves red, pediatric ICUs begin preparing for the onslaught of the virus known as RSV. Not flu, not COVID, but RSV, or respiratory syncytial virus, is the No. 1 reason babies are hospitalized, year after year. Their tiny airways can become inflamed, and the sickest ones struggle to breathe. RSV is deadly on the other end of the age spectrum too, killing 6,000 to 10,000 elderly Americans every year.

    For decades though, there was no way to stop the virus’s seasonal tide. The quest for a vaccine always came up short. And then suddenly, the vaccines started working.

    This year, doctors have not just one but multiple new shots to prevent RSV. Three gained FDA approval in rapid succession in recent months: an antibody shot for infants called nirsevimab, a form of passive immunization for babies too young to get proper vaccines; a vaccine from Pfizer for both adults over 60 and pregnant mothers, who can pass the immunity on to their babies; and finally, a vaccine from GlaxoSmithKline also aimed at adults older than 60. Together, these herald a new era for RSV.

    That these three new RSV shots are coming out at once is no coincidence. They succeed where others failed because they all target a specific weak spot in the virus, first identified in 2013. This strategy of finding a virus’s most vulnerable points applies to other pathogens too, and experts say it can revolutionize the design of vaccines for other diseases. In fact, it was quietly used to make the COVID vaccines from Pfizer and Moderna. Scientists had originally perfected the idea with RSV, only to repurpose it for the COVID vaccine, which raced ahead, given the urgency of the pandemic. This year, though, the shots are coming for RSV.

    “We’re in a really good position, finally, after more than 65 years,” says Asunción Mejías, an infectious-diseases doctor at St. Jude Children’s Research Hospital.

    The first attempts to make an RSV vaccine began not long after the virus’s discovery, in 1956, but an early trial ended so catastrophically that it had a chilling effect for decades.

    It had started off with promise. The early vaccine was modeled after a successful one for polio, in which the virus is inactivated with a chemical called formalin. But when infants given the early RSV vaccine later caught the virus, a whopping 80 percent had to be hospitalized—compared with only 5 percent in the control group. Two of the babies died, their lungs ravaged. The vaccine did worse than offer no protection; it made the disease more severe. “It was such a disaster,” says Ann Falsey, an infectious-diseases doctor at the University of Rochester. Scientists spent years piecing together why—the vaccine riled up the wrong part of the immune system in very young babies—but they got no closer to making a vaccine that worked. The field was stuck.

    Then, in 2008, a serendipitous meeting led to an eventual breakthrough. A young, freshly minted Ph.D. named Jason McLellan, who studies the structure of proteins, began a new job at the National Institutes of Health to work on HIV vaccines. The lab he had joined, on the fourth floor, had run out of room, though, so he got put in another, on the second. There, he ran into Barney Graham, a virologist who had been trying to solve the puzzle of RSV since the 1980s. He convinced McLellan that this virus was worth a look too.

    By then, scientists had at least homed in on a plausible vaccine target. Much as COVID uses spike protein to infect cells, RSV uses a protein—called F for “fusion”—to physically fuse the virus particle to a human cell. F comes in two forms, though: an extremely unstable prefusion state and a far more stable postfusion state. And once it switches to the postfusion state—which can also happen spontaneously— “it can’t come back,” McLellan told me.

    When RSV vaccines are manufactured, all the F protein eventually switches to the postfusion state. But the antibodies against postfusion F weren’t very effective. McLellan soon figured out why. He found that extremely potent neutralizing antibodies bind to a specific site—the very tip of the prefusion F—that is lost when the protein rearranges into its postfusion form. With that, Graham told me, “you lose ten- to 1,000-fold potency.” An effective RSV vaccine would need to target the prefusion F.

    The team knew what to do, but had a practical dilemma: How to stabilize F in its prefusion form, so the team could put it in a vaccine? McLellan rejiggered the protein slightly, adding molecular “staples” and filling a hole in the protein structure. These changes froze F in its prefusion shape. When the team tested this version of the vaccine in mice, the results could not have been clearer. The vaccine induced the highest levels of neutralizing antibodies Graham had ever seen in his three decades of studying RSV. “This is it,” McLellan remembers thinking.

    Soon, pharmaceutical companies came calling, and the race was on. (The experts in this article—like nearly everyone who works on RSV vaccines—have all received research grants, consulted for, or worked in some other way with one or more of the companies developing shots for RSV.) Today, Pfizer’s and GlaxoSmithKline’s newly approved RSV vaccines target the prefusion F protein, as does nirsevimab, the antibody shot for infants from AstraZeneca and Sanofi. Both the vaccines and the antibody shot trigger immunity against RSV: Vaccines stimulate the immune system to make its own antibodies, and nirsevimab is a direct infusion of antibodies.

    Trials for all three shots were already under way when the coronavirus pandemic hit. But because RSV nearly disappeared during social distancing, the trials got delayed. Meanwhile, McLellan and Graham devised a similar molecular trick to stabilize COVID’s spike protein, which Pfizer and Moderna later used in their vaccines. (The stabilization wasn’t make-or-break for COVID, as it was for RSV, though—AstraZeneca’s COVID vaccine was effective despite not having this modification.) But unstable fusion proteins are found in many different classes of viruses beyond RSV. McLellan, now at the University of Texas at Austin, is working on shots against the prefusion structure of other stubborn viruses such as cytomegalovirus and Crimean-Congo hemorrhagic fever. (Graham is now a professor at Morehouse School of Medicine.) This approach—called structure-based vaccine design—could unlock new ways of targeting once-elusive viruses.

    For RSV, this fall and winter will be a test of how well the shots fare in the real world. As the adage goes, vaccines don’t save lives; vaccinations do. Falsey, the University of Rochester doctor, specializes in studying RSV in the elderly, and she worries that too few Americans over 60 will get the new vaccines this year. A CDC advisory panel decided that elderly Americans can get the vaccines through “shared clinical decision-making” with their doctors but did not go as far as to fully recommend vaccination, which would have triggered private insurers to cover the shots under the Affordable Care Act. Out of pocket, they can cost more than $300. The vaccine for pregnant women, meanwhile, has FDA approval, but the same CDC panel is voting today on whether to recommend it. The panel will likely scrutinize a possible link to premature births, which has shown up before with RSV vaccines.

    Nirsevimab, the antibody shot for infants, has gotten a full-throated endorsement, though, and it’s poised to have the biggest impact this season. It replaces an existing RSV-antibody shot called palivizumab, which is not widely used. Palivizumab targets a less potent site that is on both the pre- and postfusion F, and it needs to be administered up to five times a season (compared with once for nirsevimab), at a cost of some $1,500 a dose. For these reasons, it’s been reserved for the highest-risk babies, such as preemies with underdeveloped lungs. But most babies who end up hospitalized were healthy to begin with, says St. Jude’s Mejías, so the older shot didn’t put much of a dent in overall hospitalizations.

    Nirsevimab is meant to be more widely used: The shot is approved for all infants in their first RSV season. “It’s going to change the way we manage and treat RSV,” Mejías told me. It should be available for babies starting in October. And if all goes according to plan, pediatric ICUs could be a little quieter this winter.

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    Sarah Zhang

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  • 3 vaccines recommended to prevent

    3 vaccines recommended to prevent

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    3 vaccines recommended to prevent “tripledemic” – CBS News


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    To prevent a repeat of last winter’s “tripledemic” of respiratory illnesses, the Centers for Disease Control and Prevention are recommending three vaccines: one for COVID, one for the flu and a new one for RSV. Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center, joined CBS News to talk about the vaccines.

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  • Moderna is developing a Lyme disease vaccine in a first for the company

    Moderna is developing a Lyme disease vaccine in a first for the company

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    Moderna Inc. said Tuesday it’s working to develop its first bacterial vaccine to protect against Lyme disease, the tick-borne illness that causes a range of painful symptoms, including fever, headaches, fatigue, joint pain and rash.

    The biotech
    MRNA,
    -2.75%    ,
    whose first product to be approved by the U.S. Food and Drug Administration was its mRNA-based COVID vaccine, said it has two candidates in development to address Lyme disease, named mRNA-1982 and mRNA-1975.

    It announced the news at its fourth Vaccine Day, where it offered a full update on its clinical pipeline, which includes vaccines to protect against flu and respiratory syncytial virus, or RSV, as well as HIV, Epstein-Barr virus and herpes simplex virus, among others.

    There are about 120,000 cases of Lyme disease in the U.S. and Europe every year, creating a “significant quality of life burden,” the company said in a statement. Rising temperatures are helping the disease spread more easily, and it is difficult to diagnose, because the symptoms are similar to those of many other diseases. It most seriously affects children below the age of 15 and older adults.

    “Older adults appear to have higher odds of unfavorable treatment response as compared with younger patients, and neurologic manifestations are more common at presentation for this older adult population,” said the statement.

    Tick and Lyme disease season is here, and scientists warn this year could be worse than ever. Dr. Goudarz Molaei joins Lunch Break’s Tanya Rivero to explain what triggered the rapid spread of the disease and how people can avoid being affected. Photo: Kent Wood/Science Source

    The mRNA-1982 candidate is designed to create antibodies for Borrelia burgdorferi, the pathogen that causes almost all Lyme disease in the U.S., while mRNA-1975 is designed to elicit antibodies specific to the four major Borrelia species that cause the disease in the U.S. and Europe.

    Other new candidates in Moderna’s pipeline include mRNA-1405 and mRNA-1403, which aim to address the enteric virus norovirus. Norovirus is highly contagious and is the leading cause of diarrheal disease globally, Moderna said. It’s associated with about 18% of all such illnesses worldwide and causes about 200,000 deaths every year.

    Overall, Moderna is expecting to launch six major vaccine products in the next few years, all of them with large addressable markets.

    The company expects the annual global endemic market for COVID boosters alone to be worth about $15 billion.

    It has dosed the first participant in a late-stage trial of its next-generation, refrigerator-stable COVID-19 vaccine candidate, mRNA-1283. The vaccine “has demonstrated encouraging results in multiple clinical studies,” the company said.

    See now: Moderna CEO defends price increase for COVID vaccine to Congress

    A separate trial of a flu vaccine called mRNA-1010 fared less well, however.

    That trial “did not accrue sufficient cases at the interim efficacy analysis to declare early success in the Phase 3 Northern Hemisphere efficacy trial and the independent DSMB recommended continuation of efficacy follow-up,” the company said.

    The company expects the market for respiratory-product sales to range from $8 billion to $15 billion by 2027 and for operating profit that year to range from $4 billion to $9 billion.

    The stock was down 4% Tuesday and has fallen 15% in the year to date, while the S&P 500
    SPX,
    +0.17%
    has gained 7%.

    See also: Moderna’s stock slides as earnings fall short of estimates amid steep decline in COVID-vaccine sales

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  • Kids’ COVID More Dangerous When Co-Infected With RSV, Colds

    Kids’ COVID More Dangerous When Co-Infected With RSV, Colds

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    By Amy Norton 

    HealthDay Reporter

    WEDNESDAY, Jan. 18, 2023 (HealthDay News) — As colds, flu and COVID continue to circulate this winter, a new U.S. government study finds that young children infected with COVID plus a second virus tend to become sicker.

    While severe COVID is rare among children, kids can and do fall ill enough to end up in the hospital.

    During the pandemic’s first two years, young U.S. children who were hospitalized with COVID tended to be more severely ill if they also tested positive for a second respiratory virus, according to the new study, by the U.S. Centers for Disease Control and Prevention.

    Usually, those coinfections were with one of the many viruses that cause the common cold — including rhinoviruses, enteroviruses and respiratory syncytial virus (RSV).

    RSV, which can cause more serious lung infections in babies, practically vanished early in the pandemic due to social distancing, mask-wearing and other COVID-controlling measures. The virus then came roaring back in the spring and summer of 2021 — well outside of its normal peak in wintertime — as COVID restrictions eased.

    The CDC study found that when children younger than 5 were hospitalized with COVID, they were twice as likely to become severely ill if they also tested positive for one of those other respiratory viruses.

    “Severe” meant they were admitted to the intensive care unit or required machines to help them breathe.

    Experts in pediatric infectious disease said the findings align with their experience during the first two years of the pandemic.

    But things are somewhat different now, they said. For one, the flu has staged a comeback this season — after all but disappearing at the pandemic’s outset, and then laying low in 2021 as well.

    So while COVID/flu coinfections were rare during the study period, that’s no longer the case.

    “It has definitely been an evolving picture,” said Dr. Vandana Madhavan, clinical director of pediatric infectious diseases at Massachusetts General Hospital in Boston.

    She said the hospital is still seeing kids with RSV, sometimes in combination with COVID, but the flu and other viruses — as well as bacterial infections — are taking center stage, too.

    In general, it’s breathing problems that prompt parents to rush their child to the ER, according to Madhavan, who is also a spokeswoman for the Infectious Diseases Society of America.

    As far as testing for the culprit, she said, “we start with the heavy hitters — COVID, the flu and RSV.”

    If a child is sick enough to be admitted to the hospital, more extensive testing may be done, Madhavan said. That’s, in part, for infection control — to keep children with, say, the flu away from other kids without it.

    There may be cases where having a second infection along with COVID affects a child’s treatment. Madhavan said. But often, it does not change things — as symptom control and keeping kids hydrated and breathing well are the priorities.

    The CDC study — published Jan. 18 in Pediatrics — is based on data from hospitals in 14 U.S. states. From March 2020 through February 2022, 4,372 children were hospitalized with COVID. More than 60% were also tested for other respiratory viruses, with 21% testing positive.

    Kids with coinfections were more likely to need a CPAP or BiPAP machine to help them breathe (10% did, versus 6% of other children), and more often needed to be admitted to the ICU (38%, versus 27%).

    When the researchers looked at the data by age, they found that multiple infections raised the risk of severe illness only among children younger than 5.

    When youngsters have more than one infection, it’s hard to know what’s “driving” their symptoms, said Dr. William Muller, an infectious disease specialist at Lurie Children’s Hospital of Chicago. He also noted that severely ill kids are probably more often tested for multiple bugs.

    But to Muller, the bottom line is straightforward: “We need to vaccinate more,” he said.

    That means both COVID vaccination and the yearly flu shot, Muller said. Both can be given to children age 6 months or older, and both slash the risk of severe illness.

    Both doctors stressed that the point is not to alarm parents: The vast majority of children with COVID or the flu do not land in the hospital. At the same time, there are ways to lower those odds.

    And even in mid-January, both doctors said, it’s not too late for children to get the flu shot. Flu season can extend into April or even May, and often peaks in February.

    Some simple measures can also limit the spread of respiratory bugs, Madhavan noted — like delaying that play date if your child has a runny nose or cough.

    More information

    The American Academy of Pediatrics has more on COVID in children.

     

    SOURCES: Vandana Madhavan, MD, MPH, clinical director, pediatric infectious diseases, Massachusetts General Hospital, Boston, and spokeswoman, Infectious Diseases Society of America, Arlington, Va.; William Muller, MD, PhD, attending physician, infectious diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, and professor, pediatrics, Northwestern University Feinberg School of Medicine, Chicago; Pediatrics, Jan. 18, 2023, online

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  • Flu Cases Fall, But Not Admissions and Deaths

    Flu Cases Fall, But Not Admissions and Deaths

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    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

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    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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  • “Tripledemic” severely strains children’s hospitals

    “Tripledemic” severely strains children’s hospitals

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    “Tripledemic” severely strains children’s hospitals – CBS News


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    Pediatric hospitals are in crisis mode due to a wave of respiratory illness. The U.S. Centers for Disease Control and Prevention said 45 states are reporting “high” or “very high” levels of influenza. Janet Shamlian is at a children’s hospital in Tennessee with the details.

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  • China predicts COVID ‘normalcy’ within months, but experts forecast more than 1 million deaths

    China predicts COVID ‘normalcy’ within months, but experts forecast more than 1 million deaths

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    China’s closely watched reopening is now causing concern as the number of new COVID-19 cases grows and the country reports the first deaths in several weeks. 

    Much of the news out of China this week is in stark contrast to zero COVID, the strict policy that was in place up until a month ago. In response to widespread protests, authorities have lifted many of the restrictions that limited how people in China were able to move, work and treat their illnesses.

    Now some local governments are encouraging people with mild COVID to continue to work. Beijing reported five COVID deaths on Tuesday and two on Monday — the first COVID fatalities to be reported in the country in weeks. Cities like Guangzhou are expanding “fever clinics” that can handle up to 110,000 patients a day, up from 40,000. And basic cold medicines are in short supply.

    Chinese authorities have reportedly told state media that the surge is part of an “exit wave” of cases, according to the Financial Times. A headline from Monday’s China Daily, an English-language news outlet in China, reads: “Virus experts expect normalcy by spring.”

    Experts have predicted that millions of people in China will get sick, and up to 1.6 million people could die in 2023.

    COVID news to know: 

    • In the U.S., it’s still hard to find children’s cold medications. CVS Health
    CVS,
    -0.31%
    and Walgreens Boots Alliance
    WBA,
    +0.95%
    this week put limits on purchases of children’s cold and flu medicines in response to high demand amid a surge in cases of pediatric COVID, influenza and respiratory syncytial virus, or RSV, according to the Wall Street Journal. This includes medications like acetaminophen and ibuprofen. 

    • Testing positive a second or third time may worsen long-COVID symptoms, according to a study published in Nature in November. However, it can be hard to predict how each new infection will affect an individual patient. “It makes sense that repeat infections would not be beneficial to a person’s health,” one doctor told WebMD. “But I think it’s really hard to know what the additional risk of each subsequent infection would be because there are all sorts of other things in the mix.” 

    • COVID hospitalizations are rising in the U.S. There are about 40,000 people hospitalized with COVID right now, a figure that is 11% higher than it was two weeks ago, according to the most recent update of a New York Times tracker. The numbers of new infections and COVID-related deaths are also rising this month. The seven-day daily average of new cases is about 66,000, while about 413 people are dying each day.

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  • Flu Hospitalizations Drop Amid Signs of an Early Peak

    Flu Hospitalizations Drop Amid Signs of an Early Peak

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    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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  • With COVID cases rising fast, critics question why there’s no push for face masks in indoor settings

    With COVID cases rising fast, critics question why there’s no push for face masks in indoor settings

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    A growing chorus of voices is questioning why there is no concerted effort to persuade Americans to wear face masks in public settings again as COVID cases, hospitalizations, fatalities and test-positivity rates rise across the nation.

    The Centers for Disease Control and Prevention continues to encourage people to keep up with vaccines and boosters and to urge others to do so too. But for now, there is no push for face masks or social distancing, the public safety measures that helped contain the spread of the virus at the peak of the pandemic.

    The daily average for new cases stood at 65,528 on Monday, according to a New York Times tracker, up 56% from two weeks ago. Cases are climbing in 47 states, led by Mississippi, where they are up 356% from two weeks ago.

    The average for hospitalizations is up 24% to 38,331. Hospitalizations are climbing in 44 states, led by Vermont, where they are up 83% from two weeks ago.

    The number of COVID deaths is up 48% to a daily average of 468, a disappointing reversal of the declining trend seen over the past several months. The test-positivity rate has climbed 25% to 12%.

    New York City and New York state have emerged as hot spots, with an average of 6,405 new cases a day in the state in the last week, the tracker shows. Cases are up 74% from two weeks ago.

    The omicron strains called BQ.1 and BQ.1.1 have become dominant in the Empire State, replacing BA.5. Both are sublineages of BA.5 but are more infectious than the original variant, meaning they can spread faster and more easily.

    Meanwhile, other respiratory illnesses including flu, RSV and strep throat are also circulating, adding to the burden on healthcare systems.

    Children are having an especially rough winter so far amid shortages of medicines to treat common childhood illnesses such as flu, ear infections and sore throats, CNN reported.

    “Right now, we are having severe shortages of medications. There’s no Tamiflu for children. There’s barely any Tamiflu for adults. And this is brand-name and generic,” Renae Kraft, a relief pharmacist in Oklahoma City, told the network. Additionally, she said, “as far as antibiotics go, there’s not a whole lot.”

    Physicians are reporting high numbers of respiratory illnesses like RSV and the flu earlier than the typical winter peak. WSJ’s Brianna Abbott explains what the early surge means for the winter months. Photo illustration: Kaitlyn Wang

    Families have taken to social media to highlight their hunt for oseltamivir, the generic for Tamiflu, as well as for the antibiotics amoxicillin and augmentin, said CNN. And there is also a shortage of the inhaler albuterol, which helps open airways in the lungs, according to the American Society of Health-System Pharmacists.

    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:

    • Some two years after they were first introduced, COVID vaccines have prevented more than 3 million additional deaths and about 18 million additional hospitalizations in the U.S., according to a new study from the Commonwealth Fund. More than 655 million doses of vaccine have been administered in the U.S., and 80% of the overall population has had at least one dose. “The swift development of the vaccine, emergency authorization to distribute widely, and rapid rollout have been instrumental in curbing hospitalization and death, while mitigating socioeconomic repercussions of the pandemic,” the authors wrote.

    • Chinese universities say they will allow students to finish the semester from home in hopes of reducing the potential for a large COVID-19 outbreak during the January Lunar New Year travel period, the AP reported. It wasn’t clear how many schools were participating, but universities in Shanghai and nearby cities said students would be given the option of returning home early or staying on campus and undergoing testing every 48 hours. The Lunar New Year, which falls on Jan. 22, is traditionally China’s busiest travel season.

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

    • The Nasdaq-listed 111 Inc.
    YI,
    +4.80%
    has started retail sales of Pfizer’s
    PFE,
    +1.74%
    oral COVID-19 treatment pill in China, according to the healthcare platform’s website, Dow Jones Newswires reported. The sales page for the Chinese platform on Tuesday showed it is now offering ​Paxlovid, the COVID medication that Beijing approved in February, for customers with positive results from polymerase chain reaction or antigen tests. Paxlovid has been used by medical practitioners to treat patients in China since March, when Shanghai was hit by a COVID outbreak, according to local media reports.

    Here’s what the numbers say:

    The global tally of confirmed cases of COVID-19 topped 650.1 million on Monday, while the death toll rose above 6.65 million, according to data aggregated by Johns Hopkins University.

    The U.S. leads the world with 99.5 million cases and 1,084,766 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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  • U.S. Sees Most Flu Hospitalizations in a Decade

    U.S. Sees Most Flu Hospitalizations in a Decade

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    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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  • Surge in respiratory virus cases push hospitals to the limit

    Surge in respiratory virus cases push hospitals to the limit

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    Surge in respiratory virus cases push hospitals to the limit – CBS News


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    Hospitals across the U.S. are seeing an influx of patients due to a “tripledemic” of flu, Respiratory Syncytial Virus (RSV) and COVID-19 cases. Danya Bacchus has the details.

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  • CDC urges masking in NYC and Los Angeles as COVID-19 cases surge

    CDC urges masking in NYC and Los Angeles as COVID-19 cases surge

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    CDC urges masking in NYC and Los Angeles as COVID-19 cases surge – CBS News


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    The Centers for Disease Control and Prevention is urging people in New York City, Los Angeles and other communities to mask up as COVID-19 cases surge amid a spike in other respiratory viruses. Elise Preston has more.

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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

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    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:

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  • Hospital financial decisions play a role in the critical shortage of pediatric beds for RSV patients:

    Hospital financial decisions play a role in the critical shortage of pediatric beds for RSV patients:

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    The dire shortage of pediatric hospital beds plaguing the nation this fall is a byproduct of financial decisions made by hospitals over the past decade, as they shuttered children’s wards, which often operate in the red, and expanded the number of beds available for more profitable endeavors like joint replacements and cancer care.

    To cope with the flood of young patients sickened by a sweeping convergence of nasty bugs — especially respiratory syncytial virus, influenza, and coronavirus — medical centers nationwide have deployed triage tents, delayed elective surgeries, and transferred critically ill children out of state.

    A major factor in the bed shortage is a years-long trend among hospitals of eliminating pediatric units, which tend to be less profitable than adult units, said Mark Wietecha, CEO of the Children’s Hospital Association. Hospitals optimize revenue by striving to keep their beds 100% full — and filled with patients whose conditions command generous insurance reimbursements.

    “It really has to do with dollars,” said Dr. Scott Krugman, vice chair of pediatrics at the Herman and Walter Samuelson Children’s Hospital at Sinai in Baltimore. “Hospitals rely on high-volume, high-reimbursement procedures from good payers to make money. There’s no incentive for hospitals to provide money-losing services.”

    The number of pediatric inpatient units in hospitals fell 19% from 2008 to 2018, according to a study published in 2021 in the journal Pediatrics. Just this year, hospitals have closed pediatric units in Boston and Springfield, Massachusetts; Richmond, Virginia; and Tulsa, Oklahoma.

    The current surge in dangerous respiratory illnesses among children is yet another example of how covid-19 has upended the health care system. The lockdowns and isolation that marked the first years of the pandemic left kids largely unexposed — and still vulnerable — to viruses other than covid for two winters, and doctors are now essentially treating multiple years’ worth of respiratory ailments.

    The pandemic also accelerated changes in the health care industry that have left many communities with fewer hospital beds available for children who are acutely ill, along with fewer doctors and nurses to care for them.

    When intensive care units were flooded with older covid patients in 2020, some hospitals began using children’s beds to treat adults. Many of those pediatric beds haven’t been restored, said Dr. Daniel Rauch, chair of the American Academy of Pediatrics’ committee on hospital care.

    In addition, the relentless pace of the pandemic has spurred more than 230,000 health care providers — including doctors, nurses, and physician assistants — to quit. Before the pandemic, about 10% of nurses left their jobs every year; the rate has risen to about 20%, Wietecha said. He estimates that pediatric hospitals are unable to maintain as many as 10% of their beds because of staffing shortages.

    “There is just not enough space for all the kids who need beds,” said Dr. Megan Ranney, who works in several emergency departments in Providence, Rhode Island, including Hasbro Children’s Hospital. The number of children seeking emergency care in recent weeks was 25% higher than the hospital’s previous record.

    “We have doctors who are cleaning beds so we can get children into them faster,” said Ranney, a deputy dean at Brown University’s School of Public Health.


    Respiratory “tripledemic” worries nation’s doctors

    02:52

    There’s not great money in treating kids. About 40% of U.S. children are covered by Medicaid, a joint federal-state program for low-income patients and people with disabilities. Base Medicaid rates are typically more than 20% below those paid by Medicare, the government insurance program for older adults, and are even lower when compared with private insurance. While specialty care for a range of common adult procedures, from knee and hip replacements to heart surgeries and cancer treatments, generates major profits for medical centers, hospitals complain they typically lose money on inpatient pediatric care.

    When Tufts Children’s Hospital closed 41 pediatric beds this summer, hospital officials assured residents that young patients could receive care at nearby Boston Children’s Hospital. Now, Boston Children’s is delaying some elective surgeries to make room for kids who are acutely ill.

    Rauch noted that children’s hospitals, which specialize in treating rare and serious conditions such as pediatric cancer, cystic fibrosis, and heart defects, simply aren’t designed to handle this season’s crush of kids acutely ill with respiratory bugs.

    Even before the autumn’s viral trifecta, pediatric units were straining to absorb rising numbers of young people in acute mental distress. Stories abound of children in mental crises being marooned for weeks in emergency departments while awaiting transfer to a pediatric psychiatric unit. On a good day, Ranney said, 20% of pediatric emergency room beds at Hasbro Children’s Hospital are occupied by children experiencing mental health issues.

    In hopes of adding pediatric capacity, the American Academy of Pediatrics joined the Children’s Hospital Association last month in calling on the White House to declare a national emergency due to child respiratory infections and provide additional resources to help cover the costs of care. The Biden administration has said that the flexibility hospital systems and providers have been given during the pandemic to sidestep certain staffing requirements also applies to RSV and flu.

    Doernbecher Children’s Hospital at Oregon Health & Science University has shifted to “crisis standards of care,” enabling intensive care nurses to treat more patients than they’re usually assigned. Hospitals in Atlanta, Pittsburgh, and Aurora, Colorado, meanwhile, have resorted to treating young patients in overflow tents in parking lots.

    Dr. Alex Kon, a pediatric critical care physician at Community Medical Center in Missoula, Montana, said providers there have made plans to care for older kids in the adult intensive care unit, and to divert ambulances to other facilities when necessary. With only three pediatric ICUs in the state, that means young patients may be flown as far as Seattle or Spokane, Washington, or Idaho.

    A young child is treated in a hospital bed
    A young child with RSV is treated at the Community Medical Center in Missoula, Montana. 

    Community Medical Center


    Hollis Lillard took her 1-year-old son, Calder, to an Army hospital in Northern Virginia last month after he experienced several days of fever, coughing, and labored breathing. They spent seven anguished hours in the emergency room before the hospital found an open bed and transferred them by ambulance to Walter Reed National Military Medical Center in Maryland.

    With proper therapy and instructions for home care, Calder’s virus was readily treatable: He recovered after he was given oxygen and treated with steroids, which fight inflammation, and albuterol, which counteracts bronchospasms. He was discharged the next day.

    Although hospitalizations for RSV are falling, rates remain well above the norm for this time of year. And hospitals may not get much relief.

    People can be infected with RSV more than once a year, and Krugman worries about a resurgence in the months to come. Because of the coronavirus, which competes with other viruses, “the usual seasonal pattern of viruses has gone out the window,” he said.

    Like RSV, influenza arrived early this season. Both viruses usually peak around January. Three strains of flu are circulating and have caused an estimated 8.7 million illnesses, 78,000 hospitalizations, and 4,500 deaths, according to the Centers for Disease Control and Prevention.

    Krugman doubts the health care industry will learn any quick lessons from the current crisis. “Unless there is a radical change in how we pay for pediatric hospital care,” Krugman said, “the bed shortage is only going to get worse.”

    KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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  • Hospitals face

    Hospitals face

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    Hospitals face “tripledemic” as cases of flu, COVID-19 and RSV rise – CBS News


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    Hospitals in the U.S. are seeing a rising number of cases of the flu, RSV and COVID-19 as Americans let their guard down. Carter Evans has more.

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  • Beyond Babies, RSV Infections Put Older People at Risk, Too

    Beyond Babies, RSV Infections Put Older People at Risk, Too

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    Dec. 5, 2022 – The respiratory syncytial virus (RSV) “season” this year is notable for a number of reasons, including the relatively early and large spike in cases that is challenging the capacity of children’s hospitals nationwide. 

    But the spotlight on pediatric cases is overshadowing how this virus also raises risk for people 65 and older. RSV in older Americans “remains under-recognized by both physicians and especially the public,” says Ann R. Falsey, MD, a professor at the University of Rochester School of Medicine in New York. 

    Even the family of the president of the National Foundation for Infectious Diseases has not been spared. 

    “Our family had what’s a pretty typical experience of RSV — where the little ones got it first,” says foundation president Patricia (Patsy) A. Stinchfield, a certified pediatric nurse practitioner. Her immediate family includes her and her husband, both in their 60s; their daughter and her husband, in their 30s; and two grandchildren, who are 3 years and 16 months old. 

    Stinchfield and her husband help with child care much of the week, “so we’re with the kids a lot,” she says. 

    It started when the 3-year-old went to preschool and came home with what seemed like a mild cold at first. Then a note came home that three kids in her classroom tested positive for RSV, “so it was very likely that is what she had, although she was never tested,” Stinchfield says. “The way the disease progressed was very much like RSV.” 

    The 3-year-old then passed the infection to the 16-month-old. They both had low-grade fevers, runny noses, and coughing, but not too much wheezing.

    Stinchfield, her daughter, and her husband each had mild symptoms for less than a week. “My whole career has been in pediatrics with kids coughing directly in my face, so I think I have some pretty good RSV antibodies,” she says.

    Her husband was not as fortunate. “My husband, who is the oldest at 66 years old, is just now, 4 weeks later, getting his cough settled down.”

    Illustrating how RSV can be more serious in older adults, “he had a lot of wheezy coughing, bad body aches, and he actually was in bed for the first few days. He really just had a hard time catching his breath,” she says.

    “That’s typical for RSV. After you’re done with the infectious period and you’re starting to feel a little bit better, you can have a lingering cough for 3 to 4 weeks,” Stinchfield says.

    Similar Symptoms

    Diagnosis in both the young and old can be challenging because RSV symptoms often overlap those of the flu, COVID-19, the common cold, and other illnesses. Clues that point to RSV include wheezing – a high-pitched breathing sound – and using stomach and other muscles to help with breathing. 

    The symptoms of RSV in younger and older people are often similar. “Many things are the same, especially the prominence of severe cough and airway disease,” says Richard G. Wunderink, MD, a professor of medicine at Northwestern University Feinberg School of Medicine in Chicago.

    But because children have smaller airways than adults, the inflammation caused by RSV can cause more trouble in younger patients, Wunderink says. Clearing increased mucus can be more difficult, for example. 

    That much mucus can plug the child’s airway and even cause a lung to collapse. This condition, known as atelectasis, “is a major reason for admission to pediatric ICUs,” Wunderink says

    In contrast, he says, “Adults have bigger airways, so we don’t see as much mucus plugging and atelectasis.” 

    RSV Risks in Older People

    More older people are getting RSV from exposure to grandchildren who have the virus, Wunderink says. 

    The risks in people 65 and older differ primarily because of weaker immune systems connected to aging and other health conditions. Wunderink pointed out in a 2017 study that said “as the number of elderly adults and those with chronic medical conditions increases, the burden of viral respiratory infections will increase.”

    People with heart and lung problems are at highest risk, Falsey says. An infection can worsen chronic obstructive pulmonary disease, emphysema, heart failure, or asthma, for example.

    Falsey co-authored a June 2022 review and analysis of 14 studies that found, depending on the health condition, people older than 65 who sought medical attention for RSV were up to 28 times more likely to be hospitalized, compared to someone the same age without a chronic medical condition. 

    Tracking the Symptoms

    It’s important to keep a close eye on someone with RSV of any age to make sure the symptoms don’t worsen, Falsey says. For example, if an older person with RSV is “very frail, elderly, or has serious underlying health issues, follow-up in a day or two is needed to make sure they don’t get into trouble and need medical care.”

    The weekly RSV rate by age group reported by the CDC shows RSV hospitalizations are more than 10 times more likely for children under 5 years, compared to adults 65 years and older. The rate for the week ending Nov. 19 was 36 hospitalizations per 100,000 people in the younger group, compared to 3 per 100,000 in the older group. 

    But even though it’s less common, RSV can be serious in some older people. The CDC also estimates 60,000 to 120,000 older Americans get hospitalized with RSV infections each year, and about 6,000 to 10,000 die from the infection. 

    “What we worry about with older people is that sometimes, that can turn into a secondary bacterial infection that settles in one part of your lung, causes you to have pneumonia, and that brings you to the hospital,” Stinchfield says. “That’s where we get some of these startling numbers” regarding hospitalizations and deaths in people 65 and older. 

    Stinchfield also shared a practical tip. “RSV is a virus that is very durable on surfaces, especially smooth surfaces like kitchen countertops, tables, and remotes – those high-touch surfaces.” If someone in your household has RSV, frequently cleaning with antiviral wipes could help reduce the spread, she says.

    Potential RSV Vaccines

    With no specific antiviral approved to treat RSV infection, many people will be prescribed supportive care. This means treating the symptoms and not the illness directly.

    “Until we [had] specific treatments or preventions, differentiating between the various types of viral respiratory tract infections wasn’t important,” Wunderink says. “Treatments for influenza and SARS-CoV-2 have changed that.”

    Multiple vaccines to prevent RSV infection are in development and are expected to be approved first for adults. 

    On a positive note, RSV is getting diagnosed more frequently, Falsey says, because the  tests doctors use to diagnose the flu and COVID-19 often detect RSV as well. 

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  • Flu Season Raged Over Thanksgiving

    Flu Season Raged Over Thanksgiving

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    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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