It鈥檚 winter, that cozy season that brings crackling fireplaces, indoor gatherings 鈥 and a wave of respiratory illness. Nearly four years since the pandemic emerged, people are growing weary of dealing with it, but the virus is not done with us.
Nationally, a sharp uptick in emergency room visits and hospitalizations for covid-19, influenza, and respiratory syncytial virus, or RSV, began in mid-December and appears to be gaining momentum.
Here are a few things to know this time around:
What鈥檚 Circulating Now?
The covid virus is continually changing, and a recent version is rapidly climbing the charts. Even though it appeared only in September, the variant known as JN.1, a descendant of omicron, is rapidly spreading, representing between 39% to half of the cases, according to pre-holiday stats from the .
Lab data indicates that the updated vaccines, as well as existing covid rapid tests and medical treatments, are effective with this latest iteration. More good news is that it 鈥 to public health beyond that of other recent variants,鈥 according to the CDC. Even so, new covid hospitalizations 鈥 34,798 for the week that ended Dec. 30 鈥 are trending upward, although rates are still substantially lower than last December鈥檚 tally. It鈥檚 early in the season, though. Levels of 鈥 one indicator of how infections are spreading 鈥 are 鈥渧ery high,鈥 exceeding the levels seen this time last year.
And don鈥檛 forget, other nasty bugs are going around. More than 20,000 people were hospitalized Dec. 30, and the CDC reports that RSV remains elevated in many areas.
鈥淭he numbers so far are definitely going in the not-so-good direction,鈥 said , the chief of the research and development service at the Veterans Affairs St. Louis Healthcare System and a clinical epidemiologist at Washington University in St. Louis. 鈥淲e鈥檙e likely to see a big uptick in January now that everyone is back home from the holidays.鈥
But No Big Deal, Right?
Certainly, compared with the first covid winter, things are better now. Far fewer people are dying or becoming seriously ill, with vaccines and prior infections providing some immunity and reducing severity of illness. Even compared with last winter, when omicron was surging, the situation is better. New hospitalizations, for example, are about one-third of what they were around the 2022 holidays. dropped slightly the last week of December to 839 and are also substantially below levels from a year ago.
鈥淭he ratio of mild disease to serious clearly has changed,鈥 said , a professor of medicine in the division of infectious diseases at Vanderbilt University School of Medicine in Nashville, Tennessee.
Even so, the 鈥 is broad, basically referring to anything short of being sick enough to be hospitalized.
While some patients may have no more than the sniffles, others experiencing 鈥渕ild鈥 covid can be 鈥渕iserable for three to five days,鈥 Schaffner said.
How Will This Affect My Day-to-Day Life?
鈥淎m I going to be really sick? Do I have to mask up again?鈥 It is important to know the basics.
For starters, symptoms of the covid variants currently circulating will likely be familiar 鈥 such as a runny nose, sore throat, cough, fatigue, fever, and muscle aches.
So if you feel ill, stay home, said Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. 鈥淚t can make a big difference.鈥
Dust off those at-home covid test kits, check the extended expiration dates on , and throw away the ones that have aged out. Tests can be bought at most pharmacies and, if you haven鈥檛 ordered yours yet, are still available through a federal program at covid.gov.
Test , especially if your symptoms are mild. The at-home rapid tests may not detect covid infection in the first couple of days, according to the FDA, which recommends using 鈥渕ultiple tests over a certain time period, such as two to three days.鈥
With all three viruses, those most at risk include the very young, older adults, pregnant people, and those with compromised immune systems or underlying diseases, including cancer or heart problems. But those without high-risk factors can also be adversely affected.
While mask-wearing has dropped in most places, you may start to see more people wearing them in public spaces, including stores, public transit, or entertainment venues.
Although a federal mask mandate is unlikely, 鈥 California, Illinois, Massachusetts, and New York 鈥 have again told staff and patients to don masks. Such requirements were loosened last year when the public health emergency officially ended.
Such policies are advanced through county-level directives. The CDC data indicates that, nationally, about are seeing moderate to high hospital admission rates of covid.
鈥淲e are not going to see widespread mask mandates as our population will not find that acceptable,鈥 Schaffner noted. 鈥淭hat said, on an individual basis, mask-wearing is a very intelligent and reasonable thing to do as an additional layer of protection.鈥
The N95, KN95, and KF94 masks are the most protective. Cloth and paper are not as effective.
And, finally, if you haven鈥檛 yet been vaccinated with an updated covid vaccine or gotten a flu shot, it鈥檚 not too late. There are also new vaccines and monoclonal antibodies recommended for certain populations, which include older adults, pregnant people, and young children.
Generally, flu peaks in midwinter and runs into spring. Covid, while not technically seasonal, has higher rates in winter as people crowd together indoors.
鈥淚f you haven鈥檛 received vaccines,鈥 Schaffner said, 鈥渨e urge you to get them and don鈥檛 linger.鈥
Aren鈥檛 We All Going to Get It? What About Repeat Infections?
People who have are in the minority.
At the same time, repeat infections are common. Fifteen percent of respondents to a recent said they鈥檇 had covid two or three times. released in December found 1 in 5 residents said they had gotten covid more than once as of last June.
Aside from the drag of being sick and missing work or school for days, debate continues over whether repeat infections pose smaller or larger risks of serious health effects. There are no definitive answers, although experts continue to study the issue.
Two research efforts suggest repeat infections may increase a person鈥檚 chances of developing serious illness or even long covid 鈥 which is defined various ways but generally means having one or more effects lingering for a month or more following infection. The precise percentage of cases 鈥 鈥 of long covid and why people get it are among the many unanswered questions about the condition. However, there is among researchers that vaccination is protective.
Still, the VA鈥檚 Al-Aly said that was published in November 2022 found that getting covid more than once raises an 鈥渁dditional risk of problems in the acute phase, be it hospitalization or even dying,鈥 and makes a person two times as likely to experience long covid symptoms.
The Canadian survey also found a higher risk of long covid among those who self-reported two or more infections. Both studies have their limitations: Most of the 6 million in the VA database were male and older, and the data studied came from the first two years of the pandemic, so some of it reflected illnesses from before vaccines became available. The Canadian survey, although more recent, relied on self-reporting of infections and conditions, which may not be accurate.
Still, Al-Aly and other experts say taking preventive steps, such as getting vaccinated and wearing a mask in higher-risk situations, can hedge your bets.
鈥淓ven if in a prior infection you dodged the bullet of long covid,鈥 Al-Aly said, 鈥渋t doesn鈥檛鈥 mean you will dodge the bullet every single time.鈥
