two years into COVID vaccines

After yet another period of high community risk level for COVID here in Broome County, New York, we have just today returned to medium level. After a post-Thanksgiving spike in infections, we experienced a hospitalization spike which had increased our community risk level. With the US health system also dealing with an early, hard-hitting flu season and RSV, the dreaded triple-demic, in some areas hospitals are reaching capacity and sending patients to other locations. Additionally, infection rates are predicted to rise as family and friends gather for Hanukkah, Christmas, and New Year celebrations in the coming weeks.

This comes at a time when only 14.1% of people five and over in the US have received the new bivalent COVID booster, which was designed to better combat the Omicron BA.4/5 variants and is proving effective against the current dominant strains, BQ1 and BQ1.1, which are part of the BA.5 lineage.

Furthermore, a recent study indicates that the US vaccination program likely saved 3.2 million lives and prevented 18.5 million COVID-related hospitalizations. The vaccines are estimated to have averted nearly 120 million infections. Another recent study shows that in the two years of COVID vaccine availability in the US, the excess death rate among Republicans is significantly higher than among Democrats, mirroring the difference in vaccination rates, a sad reflection of the politicization and misinformation around vaccines by many prominent Republicans.

It’s horrifying.

The mistrust sown over the COVID vaccine among Republicans seems to be spreading to other vaccines as well. A newly published survey finds that over 40% of Republican or Republican-leaning respondents oppose requirements for the MMR (measles, mumps, rubella) for school children.

This does not bode well for public health measures. It’s frightening how many people will believe politicians or media figures rather than doctors and public health experts on these important issues. People have been infected because they weren’t up to date on vaccinations. People have been hospitalized, developed long COVID, experienced complications, or died at higher rates because they refused vaccines or boosters. The data show this.

Please, get a bivalent COVID booster if you are eligible. Begin or continue the primary vaccination series if you haven’t completed it. If you get symptoms, test immediately and contact a health professional if you test positive to see if antiviral medication is right for you. Don’t go out and expose others if you sick with COVID, flu, or anything else. Mask indoors when infection levels for COVID, flu, RSV, etc. are high in your area. Avoid crowds. Increase ventilation. Wash hands and avoid touching your face – more for flu/cold prevention than COVID. Try to eat and sleep as well as possible.

If you are someone who has been getting health information from pundits, please turn to your personal health care provider, public health department, or national health organizations, such as the CDC. Look for data and advice from public health experts, not anecdotes.

For readers outside the US, turn to your public health experts to see what measures are available and appropriate for you.

Reminder to all: COVID 19 is still a global pandemic. Act accordingly for your health, your household’s and community’s health, and global health.

Triple whammy

There are a lot of people sick with respiratory viruses here in the US.

We are still struggling with COVID. Today’s (Oct. 28, 2022) statistics from the Centers for Disease Control show a weekly case count of 265,893 with 2,649 deaths. The case count is almost certainly low, as many at-home positive tests are never reported to health departments and some jurisdictions don’t gather data at all. The uptake of the reformulated boosters has been poor, with only 7.3% of people age five and over having received an updated booster.

While the community risk level map shows the majority of the country in the low (green) level, the community transmission rate is substantial or high in much of the county. You can see the various maps using a drop down menu here. The community transmission rate is based on case counts and/or positive test results; the community risk map also includes data on other factors, such as hospital admissions and stresses on the health care system. A personal illustration: Although the community risk level in my county (Broome in New York State) has been low in recent days, I have had a rash of friends being sickened with COVID. This is explained by our community transmission rate being high, which is the highest of four levels. (As I was writing this post, the maps were updated. Due to the emerging strains on the health care system, our county community risk just shifted from low to high.)

Meanwhile, the flu season has hit earlier and harder than usual. The predominant strain is H3N2, which is known to have a high incidence of complications, especially among young children, elders, and the medically vulnerable. Like many other illnesses, the effects of inflammation from the flu raise the risk of heart attack and stroke for weeks following the initial infection, further endangering not just personal health but also the stability of medical institutions, such as hospitals. So far this flu season in the US, the CDC reports 880,000 flu cases, with 6,900 hospitalizations and 360 deaths. Generally, flu season starts in October but this year it is running about six weeks earlier than usual.

The third virus that is currently surging is RSV (respiratory syncytial virus). For most people, RSV is like a cold but for infants, young children, and elders it can progress to lung infections. These can lead to hospitalization and even death, especially among elders. Unfortunately, there is not yet a vaccine against RSV. I actually participated in a clinical trial for one a few years ago but none has yet reached a level of effectiveness to be approved.

The triple whammy of COVID plus flu plus RSV has already pushed some pediatric hospitals to the edge of their capabilities. Ironically, the RSV rate is a critical factor. Because so many infants and young children were isolated due to COVID risk and lack of day care/school interaction during the pandemic, there is a much larger group than normal that is vulnerable to RSV infection.

There is also concern that the rate of new cases of all three viruses may climb even higher as the weather gets colder and people spend more time indoors.

Some things that people can do to help: Vaccinate as appropriate. Wash hands frequently. Avoid touching your face. Cover coughs and sneezes. Stay home and away from people as much as possible if you get sick. Mask in crowded places or avoid going to them. Get adequate rest and eat healthy foods. If you develop symptoms, talk to a health care provider so you can get testing and supportive treatments to help keep you from developing more severe symptoms and avert a hospital stay, if possible.

I know some level of sickness is inevitable but we can help cut down the case numbers if we watch out for ourselves and our communities.