Several media outlets predict that 2022 will be the worst flu season since before the pandemic. Covid cases are slowly up ticking in many cities. RSV cases in children are also on the rise. Are we headed into a winter ‘tridemic?’
The Main Concern: Healthcare Staffing Shortages
Hospital and healthcare systems are still trying to recover from the pandemic and COVID surges. Many hospitals around the country are experiencing a nursing shortage. Physician’s covering emergency rooms are also in short supply. A pending ‘tridemic’ poses a great threat to the already ailing healthcare system.
What’s New About the Flu?
The CDC states that while the overall flue activity remains low, early increases in cases are being reported all over the country. The southwestern and southcentral areas of the United States report significantly high levels of activity.
Flue trends in California are particularly rising compared to five years ago. According to Cal Matters, 6.6% of flu tests came back positive. Even Harry Styles had to postpone his California tour due to being sick in bed with the Flu.
The CDC recommends a flu vaccine for all people over the age of six months. Flu vaccines for the 2022-2023 season are quadrivalent and will protect against four types of flu viruses, including two types of influenza A and two types of influenza B.
For people between the ages of 65 years and older, the CDC recommends Fluzone, High Dose Quadrivalent, and Fluad quadrivalent vaccines.
The effectiveness of the flu vaccine can vary from season to season. Pregnant women, infants, and the elderly are particularly at high risk for flu illnesses during the winter months.
Do Onions Help Prevent the Flu?
If you’re on Tiktok, you’ve probably heard about ‘Poshmamma’s’ onion recommendations against the Flu that have won her over 2.3 billion views. But do onions combat the Flu and other viruses?
Believe it or not, people have used onions to combat viruses for centuries.
Perhaps this tale stems from a story from 1919 about a farming family who placed onions around their home to combat the Spanish Flu. The legend states that none of the members of the family became ill. Although to date, there is no scientific evidence to support onions combating the flue or any other viruses. It is considered a ‘wives’ tale’ that is passed on from generation to generation and tends to go viral every winter.
RSV: The Most Common Virus to Infect Children Worldwide
If you work in Pediatrics, you know about RSV. Typically, RSV season begins in mid-September and lasts till mid-November. Respiratory Syncytial Virus (RSV) is the most common virus affecting children and some older adults worldwide.
RSV presents in children as an upper respiratory infection. Common symptoms include cough, runny nose, sneezing, fever, or wheezing. Most children recover without worsening symptoms. If symptoms do worsen, inflammation can cause bronchiolitis and pneumonia, which may result in hospitalization.
The Origins of RSV
In 1956, RSV was first discovered in a group of chimpanzees suffering from colds and upper reparatory infections resembling hay fever. Once the virus was isolated it was called the chimpanzee coryza agent. RSV was later detected in children who had bronchopulmonary pneumonia.
Who’s at Risk?
The CDC reports that each year RSV leads to 58,000 to 80,000 hospitalizations in children younger than five years old. Elderly adults are also at risk for contracting RSV. Infants who are immunocompromised, born premature, or have cardiac issues are at the most significant risk of contracting RSV. Infants and young children under the age of 2 years old cannot clear their mucus secretions which makes them susceptible to upper airway obstruction causing difficulty with respirations.
Treatment of RSV
Supportive care includes lubricating and suctioning of the nasal airway to relieve nasal congestion, along with fever relief and adequate hydration. If a child is experiencing increased respirations and low oxygenation, they need oxygen and ventilatory support. Doctors might recommend hospitalization.
RSV Prophylaxis and Vaccines
The American Academy of Pediatrics recommends palivizumab be given as an immune prophylaxis to premature infants less than or equal to 29 weeks gestational age, born with chronic lung disease, congenital heart disease, or neuromuscular disorders.
Pfizer has just released data from their phase 3 trial for their RSV vaccine that was tested on pregnant women. The vaccine is 82% effective. Pfizer plans to submit their data to the Food and Drug Administration towards the end of the year.
COVID cases and hospital admissions are rising for the first time in several months. In the past two weeks, Nevada, Utah, and New Mexico have reported a 50% increase in COVID cases. Various hospitals around the United States report a 20% increase in COVID admissions.
The latest COVID-19 variants BQ.1, BQ.1.1, XBB, and XBB.1which, are all derived from Omicron and are highly transmissible. However, they also evade vaccine-derived immunity and infection-derived immunity. According to the National Institutes of Health treatment guidelines, only one monoclonal antibody treatment exists, and BQ.1 and BQ.1.1 are most likely resistant to Bebtelovimab. The drug is only recommended if people cannot take Paxlovid or Remdesivir. Although the virus can evade these treatments, they remain the first defense against severe SARS-CoV-2.
Tips to Survive a Tridemic
Practice good hand washing
Boost your immune system
Get adequate sleep
Exercise in moderation
Stay home from work or school if you are sick
Wear a mask in heavily populated places
Practice social distancing
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