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State of Affairs: Oct 31
Happy Halloween! Is this respiratory season getting spooky? (I couldn’t resist.) Here is your State of Affairs.
The climate of respiratory health in the United States (coined “influenza-like illnesses by CDC) continues to creep up but still remains below the “epidemic” level threshold. So far, this year seems to have landed somewhere between pre-pandemic years and last year.
Two demographics are specifically seeing increased activity:
The South, with “moderate levels” of respiratory virus activity peppering the landscape.
Kids under 4 years old, with emergency department visits beginning exponential growth for respiratory illness.
Here is a deeper dive into the “big three” viruses.
After a healthy decline, all Covid-19 metrics have plateaued. This follows the previous year’s patterns, as shown in wastewater below.
Covid-19 continues to dominate respiratory hospitalizations and deaths, regardless of plateauing, though.
SARS-CoV-2 continues to mutate. A recent study found that it mutates faster than other viruses, including 2.5 times more rapidly than flu. Two specific subvariants are making the news:
HV.1. This is an Omicron sub-variant taking over. This is a relative of XBB (if you remember, this is the Covid-19 fall vaccine formula) and its mutations represent a small incremental, ladder-like evolution (as we would expect and hope for).
JN.1. The highly mutated variant we discovered a few weeks ago (BA.2.86) has started to mutate and has been given the name JN.1. The estimated percentage of cases is very small—about 0.1%.— but catching the eye of scientists because of how quickly it’s growing in France and the U.K. (between 116-132% growth advantage; as a comparison the original Omicron was 500%). If we assume it can spread as fast in the U.S., JN.1 will reach dominance between November 22 and January 3. This is not great timing, as holidays will help fuel the fire, resulting in a wave. We do not think this will cause a tsunami.
Flu: Low and stable
Not much to report here. Influenza remains at low levels. Hospitalizations, as shown below, are not yet making movement. There have been no influenza-associated pediatric deaths yet.
RSV: Exponentially increasing
RSV, though, is well on its way. Yet again, this is very early in the season compared to pre-pandemic times. CDC predicts this wave won’t get as high as last season, thanks to last year’s immunity wall. (RSV immunity wanes less quickly than, for example, Covid-19). Time will tell.
Three RSV notes:
RSV antibody medication (i.e., monocolonal antibodies) for babies is extremely strained. The CDC alerted physicians that they should ration for the highest-risk kids. Not having an adequate supply is incredibly frustrating, as the potential of this drug was huge, given that this is the leading cause of hospitalizations for those under 5.
RSV vaccine for older adults: Remember V-Safe? The text messages you received for the Covid-19 shot from CDC? Well, CDC adapted it for RSV vaccines. If you’re over 60 and had/getting your RSV vaccine, please sign up! This will help immensely with vaccine safety surveillance.
Questions about how to protect yourself against RSV? Check out this YLE Q&A from last year.
And, some good news
I got the Novavax last week. mRNA vaccines have consistently given me 48 hours of terrible side effects. So, I was crossing all my fingers and toes that it wouldn’t be the case with Novavax. And guess what?! NOT ONE SIDE EFFECT. Heck yes. If you’re in the same boat as me, try Novavax. You may have the same luck.
Respiratory season is heating up. But guess what? We can do things to protect ourselves, like getting vaccinated. If you’re not up-to-date, the time is right now.
Have a wonderful Halloween holiday! I look forward to stealing my girls’ Kit Kats.
“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH Ph.D.—an epidemiologist, wife, and mom of two little girls. During the day, she is a senior scientific consultant to several organizations. At night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health world so that people will be well-equipped to make evidence-based decisions. This newsletter is free, thanks to the generous support of fellow YLE community members. To support this effort, subscribe below: