Respiratory Virus Season: Colds and COVID-19 Update

The COVID-19 pandemic has disrupted our lives here in the United States and around the world for nearly two years. COVID-19 simultaneously overturned all other normal respiratory viruses that circulate at different intensities at different times and climates throughout the year.

SARS-CoV-2 has proven to be a formidable enemy of all other respiratory viruses. It has dominated Earth for over a year, and will probably continue to do so for some time.

Background

After the emergence of the SARS-CoV-2 virus and the resulting pandemic of COVID-19, the world directly witnessed the sudden elimination of all other respiratory viruses. Many factors contributed to these trends. The high infectivity and mortality of this new virus has eliminated the colonization of other benign seasonal respiratory viruses in the community. SARS-CoV-2 achieved this by becoming an active front runner, shortening the lifespan of its host, reducing the number of infected hosts, and thereby reducing the transmission of other respiratory virus infections.

With the heavy burden on the healthcare system and the global pandemic morbidity and mortality of COVID-19, there is growing concern that the influenza season may intensify in parallel in the Northern Hemisphere. increase. However, due to the high compatibility of the SARS-CoV-2 virus, influenza activity remained very low during the peak season of normal influenza.¹ It presented a compelling example of preventing infection both inside and outside the healthcare system, along with good mitigation measures.

Driven by fears that the twin epidemic could completely disrupt the struggling health system and workforce, health workers and health professionals have urged people to be vaccinated against seasonal flu. rice field. Influenza vaccination serves as a means of protecting all individuals, including immunocompromised adults and children with worse consequences, while at the same time promoting a strong and sustainable workforce during an ongoing pandemic. ..

With a surge in COVID-19 cases in the winter of 2020 and record hospitalizations and deaths nationwide, there was virtually no seasonal influenza activity. This tendency was fortunate and was also evident in other respiratory viruses, including respiratory syncytial virus (RSV), parainfluenza, metapneumovirus, and adenovirus.²

Influenza vaccination and appropriate mitigation measures, along with the more competitive enemies of SARS-CoV-2, have prevented many coinfections and the consequent twin infections. Due to the lack of immunity and the lack of COVID-19 vaccine, there were an average of about 300,000 cases per day nationwide.³ The third surge the country experienced was one of the toughest. This was facilitated by the more contagious Alpha variant, combined with mitigation strategies, vacation trips, and pandemic fatigue mitigation.

Traditional seasonal respiratory viruses have remained at low levels due to a combination of virtual education, continued domination by SARS-CoV-2, and other infection prevention strategies.

Vaccination and respiratory virus trends

Due to the nationwide spread of vaccination, the number of cases of COVID-19 decreased from spring to early summer 2021. The light at the end of the tunnel was finally visible, and many Americans were willing to claim a victory over the pandemic. ..

Relaxing mitigation strategies, such as masks, increased the activity levels of other respiratory viruses that are usually prominent during the fall and winter seasons of the Northern Hemisphere. We have seen an increase in cases of RSV, parainfluenza, and human metapneumovirus during the summer months as socialization resumes across age groups.²

Other respiratory viruses, such as rhinovirus, have re-emerged internationally and domestically, despite the mask, due to the unique properties of the virus. Rhinovirus lacks an outer lipid layer, is more resistant to disinfectants, has the potential to survive in the vector for longer periods of time, and is more contagious in schools.^Four Rhinovirus surge cases may correlate with school reopening.

Decreased cases, possible low-level virus

After community infections have peaked, COVID-19 infection rates have declined in the United States, averaging about 75,000 new cases per day, with peaks exceeding 300,000 per day. increase.^Five Although significant improvements have been seen, the incidence remains high compared to the lowest level of approximately 11,000 daily cases reported in June.⁶

With more than 190 million individuals fully vaccinated and industrially vaccinated, vaccination can continue to provide relief from high levels of circulating viruses in our community. I can do it.⁷ As we head for yet another pandemic winter, this time we have a vaccine on our side, but in the hope of better protection and less outbreaks, hospitalizations, and deaths, we will enter the next stage of the pandemic. ..⁸

Cases of a surge in other respiratory viruses

As the number of cases decreases, there is a false sense of victory over COVID-19, which leads to a decrease in overall mitigation measures. Resurrection of other respiratory viruses occurs in addition to potential coinfection with SARS-CoV-2 and other respiratory viruses in areas with low vaccination rates, as masking is not obligatory in most countries. There is likely to be. Areas that are largely unvaccinated and lack innate immunity from previous infections are most affected, as evidenced by the surge in summer.

Concerns about coinfection are even more worrisome as patient outcomes can be exacerbated, hospitalizations increase, and health care workers and hospitals are burdened. From all our previous experience during the COVID-19 pandemic, it is clear that a tense healthcare system leads to worse consequences for both patients and workers.⁹

The decline in the proportion of routine immunizations in the pediatric population, coupled with previous non-existent influenza activity, can lead to the worst and troublesome influenza season this year. Due to current infodemic misinformation and disinformation campaigns, resistance to the COVID-19 vaccine has spillover effects on many other routine immunities, including influenza, with significant health implications. There is a possibility.^Ten

The answer remains unknown

Schools are fully open, with a pediatric population aged 5-11, accounting for 28 million in the U.S. population, and the majority are unvaccinated as vaccines are readily available. ..^{11 11} Vaccination of the pediatric population has begun, but it is not yet known how fast and how much vaccination will occur in this population. The risk of coinfection with SARS-Cov-2 and seasonal respiratory infections is high. According to the findings, children, whether symptomatic or asymptomatic, can carry significant amounts of the virus and can continue to infect the community.¹²

Pediatric cases of COVID-19 were high during the summer surge and during the week of October 7, accounting for 24.8% of the reported COVID-19.⁷ Vaccination of children aged 12 to 17 accounted for 5% (8,599,514) of the U.S. population aged 12 to 15 and 2.5% (4,799,654) of the U.S. population aged 16 to 17 (age-based data available). It was possible) 91% of those who were completely vaccinated).¹³

Concerns about vaccination of pediatric populations exist and can hinder the development of a pandemic. A recent study by the COVID-19 Vaccine Education and Fairness Project and the National Association of School Nurses found that two-thirds of parents with school-aged children (ages 5-11) plan to vaccinate their children. Shown.¹⁴

Little is known about what will happen next in a pandemic. According to the Institute for Health Metrics, the number of predicted cases of COVID-19 will increase from December / January. However, the impact of this depends on behavioral patterns and vaccination rates. Global travel will continue to dominate emerging variants. As we experienced directly during this pandemic, what lies ahead is quite unpredictable.

Uzma Syed, DO, FIDSA are board-certified infectious disease specialists. She is a South Shore Infectious Disease Partner, Chair of the COVID-19 Task Force at the Good Samaritan Hospital Medical Center, and Director of the Antimicrobial Stewardship Center of Excellence at the Good Samaritan Hospital Medical Center. Syed is a Fellow of the Infectious Diseases Society of America and a member of Inclusion, Diversity, Access & Equity Task Force. As Principal Investigator, Syed has led clinical trials of several COVID-19 treatments.

reference:

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11. Hernandez J. USA is ready to deploy the COVID vaccine once it is approved for children aged 5-11 years. NPR.. October 20, 2021. Accessed on November 9, 2021. https://www.npr.org/sections/coronavirus-live-updates/2021/10/20/1047587933/covid-19-children-kids-vaccine-coronavirus?utm_campaign=politics&utm_source=twitter.com&utm_medium=social&utm_term=nprnews
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14. New study: Two out of every three parents of children aged 5 to 11 will be vaccinated against COVID-19. COVID-19 Vaccine Education and Equity Project. October 14, 2021. Accessed on November 9, 2021. https://covidvaccineproject.org/news/parentpoll/