US faces onslaught of viral diseases heading into 2023

It’s not clear if this wave of COVID-19 infections will be as severe as the past two pandemic winters, but there are worrying signs that the epidemic will continue in the first few months of 2023. there is.

These threats include an ‘alphabet soup’, an early and severe onset of respiratory syncytial virus (RSV), and further co-infection with COVID-19, rather than a single coronavirus subspecies that must be confronted. including strong flu seasons that can cause

Adding to the concern, experts say Paxlovid, which is used to treat COVID-19 infection, is not being prescribed as widely as needed in older adults. Patients were free.

Additionally, the majority of people in the United States have not received the latest COVID-19 bivalent booster shots for the new variant that have been available for adults since September.

We also need to control seven respiratory viral pathogens rather than the widely reported three.

New drug approaches to COVID-19 treatment Under study by Dana-Farber Cancer Instituteamong other things, experts say the pressing issue is grappling with many complicating factors heading into 2023.

If the latest numbers of flu cases are any indication of what’s to come, millions of people will be in dire straits in the coming months.

As of Friday, the Centers for Disease Control and Prevention said Estimate At least 13 million people have been infected, 120,000 have been hospitalized and 7,300 have died since the flu season began in October.

This is well above the figures reported at the December 5 press conference. Rochelle Wallenskythe CDC director called the flu level the highest in a decade during this time.

in the meantime, COVID-19 cases, deaths and hospitalizations are rising Since October, the CDC said.

Nationwide, nearly 460,000 new cases of COVID-19 are reported each week. The death toll is increasing by nearly 3,000 each week. Around 38,000 people are hospitalized with the virus, with nearly 4,900 new hospitalizations each day.

This is a far cry from when the number of weekly COVID-19 cases in the United States peaked at over 5.5 million near the beginning of the year. And while the trend is upward, medical experts can’t say how big that number will be.

“COVID-19 continues to circulate and we are monitoring it closely into the winter,” CDC spokesman Scott Pauley told UPI in an email.

Polley said the coronavirus is “obviously not the devastating threat it once was,” with the tools now available to “prevent most COVID deaths.”

Still, while the number of deaths from COVID-19 “remained at relatively low levels in recent months” compared to the early days of the pandemic, “that doesn’t mean COVID is over,” he said. he said.

What’s next for coronavirus after this winter and in 2023 is a big unknown.

In a statement to UPI, the District of Columbia Health Department said, “COVID-19 may settle into a seasonal pattern and become more ‘flu-like,’ but only this time we will know.

“While there are indications that COVID-19 may be beginning to mutate in a flu-like, more predictable pattern of mutation, it is certainly possible that severe and unpredictable variants will continue to emerge. Yes,” said DC Health.

Vaccine expert Dr. Peter Hotez predicts a seasonal cycle for COVID-19, at least for the time being.

“It’s true that annual RSV flu peaks every winter. [since] It’s been that pattern for a long time,” Hotez, co-director of the Vaccine Development Center at Texas Children’s Hospital, told UPI in an email.

“It’s still unclear whether COVID-19 will become seasonal. I think that’s a likely scenario for at least the next few years.”

More quickly, Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, said: [COVID-19] Like 2021 and 2022, there will be waves in the winter, but I don’t know if they will be dramatic and big. [previous two] It was waves. “

He added: “It will depend a lot on whether we can improve. [COVID-19 vaccine] booster rate. “

According to the CDC, as of Friday, 13.5% of the nation’s population ages 5 and older had received the latest COVID-19 booster. A slight increase from a week ago.

December 8th, Food and Drug Administration Modification of Emergency Use Authorization Make Moderna and Pfizer-Biontech bivalent COVID-19 vaccine boosters available to children as young as 6 months of age.

Hotez refutes reports that the updated boosters are ineffective, saying that those boosted with a bivalent mRNA vaccine had a 15-fold reduced risk of dying from COVID-19 and a 3-fold reduced risk of getting infected. said to do.

“I think the message was poor,” he said. “There is real data that supports the benefits of boosters, but people misunderstand it.”

More broadly, the Federal Fund states: report Tuesday, two years of COVID-19 vaccines — during which the U.S. administered more than 655 million doses, with 80% of the population receiving at least one — added 18 million more hospitalizations and 3 million additional deaths were averted.

Hotez said there are seven respiratory disease pathogens active in the United States. BQ.1/1.1 Bacterial pathogens such as COVID-19, influenza, parainfluenza, RSV, rhinoviruses, metapneumoviruses, and pneumococci.

“We don’t have vaccines for everyone [seven respiratory viruses circulating now]but we have vaccines for COVID-19, influenza, and pneumonia.

Some good news is that flu vaccines appear to be more effective this season than they were last year.

On December 7, FDA announced First RSV vaccine candidate for priority review. It aims to be available for the elderly and pregnant women in 2023, as well as monoclonal antibody therapy to prevent severe RSV in high-risk infants.

In the meantime, Hotez said “avoiding droplet contact” by masking, washing hands, and using sanitizing wipes can help reduce transmission of respiratory viruses.

Given all the circulating pathogens, Hotez and other experts expect co-infections such as influenza and COVID-19 this winter.

Missouri reported a high prevalence of COVID-19/flu co-infection during the 2021-2022 flu season. study It was published in the journal Virology on November 2nd.

Co-infection peaked at 48% in October 2021 when the Delta variant predominated. University of Missouri School of Medicine found.

Professor Henry Wang, senior author of the study and director of the Next Generation Center for Influenza and Emerging Infectious Diseases at the University of Missouri, told UPI in an email.

“We are very concerned about the current situation,” said the Los Angeles Public Health Department. [COVID-19] It’s skyrocketed for a number of reasons,” publicist Hayley Devlin told UPI.

Notably, according to Devlin, the increase in COVID-19 cases and hospitalizations began earlier than last winter.

“Our average number [COVID-19] The number of reports per day is now more than double what it was this time last year, and the average number of hospitalizations per day is now nearly three times what it was this time last year,” she said in an email. I was. Both she’s increased by over 200%. in the past month.

Rising case rates, effluent concentrations of the coronavirus, and rates of emergency department visits for COVID-19 also point to widespread transmission, she said.

Also, her department is experiencing far more respiratory illnesses from influenza and respiratory syncytial virus than before, and “this is going to put more strain on hospitals,” Devlin said. “The current prevalence of influenza and RSV is higher than what we have seen so far in the last six years.”

And people are slow to get the updated bivalent booster vaccine, she said.

“Even among people over the age of 65 who are most at risk for severe COVID illness, only about 30% received the latest booster,” Devlin said.

Vaccines aside, Erin Fox, senior pharmacy director at the University of Utah Health, told UPI to predict how nationwide drug shortages will affect the respiratory virus load this winter and into the spring. Said it was difficult.

“Certainly, some strengths of a specific antibiotic, oseltamivir, are currently lacking. [an antiviral medication for influenza better known as Tamiflu] Liquid Tylenol and ibuprofen, which seem to be improving as production increases,” said Fox, who tracks drug shortages nationwide for the Health System Pharmacists Association.

Utah Health recently stopped administering Evusheld, the only COVID-19 pre-exposure prophylactic treatment with emergency use authorization. [a monclonal antibody therapy for COVID-19] with the rest of the country. ”

“The only ones left are paxlovid and remdesivir. Remdesivir is very difficult because it requires a three-day infusion. Our infusion area is already full.