Something strange is going on.
And not just the pandemic.
All manner of viruses have been surprising us lately — and epidemiologists are scrambling to explain the connections.
Take the flu.
And while you’re at it — take the RSV virus, which can cause dangerous lung problems — especially in children.
Public health officials say that both the flu and RSV all but skipped a season last winter, popped up again this summer — and could have something of a rebound season this winter. As a result, they’re urging people to get flu shots — and hoping for the early release of an RSV vaccine.
Unfortunately, vaccine rates for most diseases have actually declined during the pandemic — perhaps because people have proven more reluctant to go to the doctor or perhaps because the partisan bickering about the COVID-19 vaccine has fueled the already worrisome resistance to other vaccines.
The federal Centers for Disease Control has warned of a “significant” drop in US vaccination rates, including well-established, life-savings shots like measles, mumps, rubella, diphtheria, tetanus, pertussis and others. Some studies have documented a 50% decline, with the biggest impact on minority and low-income communities. People without health insurance are especially likely to have skipped their shots — with the number of uninsured once more on the rise.
Not counting COVID, about 50,000 Americans die each year of vaccine-preventable diseases, according to the CDC.
Gila County Health officials have noted the pattern here.
Normally, the county health department has almost now flu or RSV cases before November. But in 2019-20, the county reported 57 cases in August. The next year (2020-21 season) that number dropped to two cases. But this August, it bounced back up to 34.
Statewide, a running average for the last five years shows that almost all RSV cases occur between mid November and mid April. But this year, the season started in June, peaked by about August 25, followed by a steep decline in cases.
On the other hand, flu remains strangely absent across the state, with last winter’s normal peak entirely absent.
Like COVID-19, flu and RSV are respiratory viruses — spread mostly from person to person on microscopic droplets released every time you cough, sneeze, sing, talk or sigh at the baffling complexity of the world.
Both the flu and RSV normally peak in the winter months and often rely on clusters of infection among children — who crowd together in school and daycare and laugh and shout happily in one another’s faces.
The reliable peak of flu and RSV in the winter prompted epidemiologists to predict that COVID would follow a similar pattern.
Instead, a couple of weird things happened.
For starters, COVID has peaked and receded, peaked and receded — without a strong connection to winter temperatures, when the cold drives people indoors across much of the country where they share air and airborne viruses.
Even more baffling — the RSV viruses all but vanished last winter, but then produced a weird, off-season peak this summer. Cases have started to climb again, suggesting a return to a more normal pattern. The RSV virus accounts for about 5% of deaths of children younger than five worldwide.
The same thing seems to have happened to the coronavirus, a cause of the common cold and a close relative of the SARS virus that causes COVID-19. The coronavirus remained at a very low level last winter, hit a strange peak this summer and now seems poised for a winter comeback.
Public health officials have lots of competing ideas on what’s going on — but so far no firm consensus.
Clearly, the flip-flopping policies designed to deal with COVID have affected the spread of other respiratory viruses. That includes the months-long shift to virtual learning in schools, the cancellation of a whole season of concerts and crowded entertainment venues, the widespread wearing of masks, the dramatic slowdown in air travel and a host of other pandemic measures.
Moreover, epidemiologists suspect that the viruses and our immune systems are also all interacting — creating a microscopic ecosystem in which an infection by one virus can affect how the immune system responds to a different virus.
Epidemiologists admit they’re baffled — but worried about a resurgence for both flu and RSV this winter — as the nation abandons most of its COVID-19 protective measures.
The flu typically kills 300,000 to 650,000 people worldwide annually. Normally, the flu kills 30,000 to 50,000 Americans annually — but last year claimed just 646, according to the federal Centers for Disease Control. That’s a fraction of the 4 million who have fallen to COVID-19, including more than 700,000 Americans — but it’s still a serious toll. Children and the elderly run the greatest risk. But with the delta strain of COVID still widespread, a second respiratory disease could do a lot more damage.
On the other hand, rhinoviruses — another cause of the common cold — continued to spread during the pandemic. In some countries, infections peaked above normal. Perhaps that’s because they weren’t as much affected by the measures taken to slow down COVID-19. Perhaps it’s because they faced less competition from other viruses that did fade away. Some evidence suggests that such mild viruses might actually protect people from infection by more serious respiratory viruses.
The billions spent on researching COVID-19 may spill over into a better understanding of these other respiratory viruses. For instance, researchers are currently testing a new mRNA flu virus similar to the one that has proven so successful against COVID. The flu virus evolves rapidly. Every year, doctors must develop a new vaccine, based on the strains that dominate in the southern hemisphere winter. The vaccines are typically only 40% to 60% effective in preventing infection — although they can also reduce the severity of illness. Researchers hope the new vaccine technology will produce a vaccine that not only works better but doesn’t require a new recipe every season.
Drug companies are also currently enrolling patients to test the protection offered by a new RSV vaccine.
In the meantime, doctors hope people this winter will not only get a vaccine against COVID-19 — but make sure to get a flu shot as well.