What’s in retailer for the upcoming respiratory virus season?

Final yr’s “tripledemic” of flu, COVID-19 and RSV left many people cautious of what the approaching respiratory virus season may convey. However this yr’s panorama is already totally different, with new vaccines and coverings, just like the game-changing antibody that protects children from RSV, providing new methods to tamp down infections and transmission.

On this Q&A, tailored from the July 28 episode of “Public Well being On Name,” infectious illness epidemiologist David Dowdy, a professor within the Division of Epidemiology on the Johns Hopkins Bloomberg College of Public Well being, discusses what we are able to study from final yr’s virus season, how and why this yr is likely to be totally different, and why vaccinations proceed to play a key function in figuring out how extreme the viruses’ toll might be.

Final yr we noticed an enormous respiratory virus season after a few years of not seeing as a lot flu and RSV. Ought to we be fearful about one other tough season this yr?

I believe individuals have purpose to be on edge. The COVID pandemic threw us all for a loop.

Final yr, we did have fairly a big spike in RSV, and the flu season was earlier however not essentially worse than standard. It is arduous to know precisely what is going on to occur this yr, however provided that COVID hospitalizations and deaths are at all-time lows, and persons are getting again to behaving as they did earlier than the pandemic, I believe we’re more likely to get again to the best way issues was once with respiratory viruses as properly.

We do not know for certain what is going on to occur. However we haven’t any proof to strongly counsel that issues are going to be a lot, a lot worse this coming yr than they had been pre-pandemic.

We have seen some studies of an uptick of COVID in some wastewater surveillance. What is going on on right here?

We’re seeing a slight uptick in wastewater surveillance, however it’s essential to sofa that within the most likely extra significant information on hospitalizations and deaths being at an all-time low. Each of the final two years, we noticed a noticeable summer time peak in COVID admissions and deaths. We actually aren’t seeing that in any respect this summer time, for the primary time for the reason that begin of the pandemic. So I believe that is general excellent news. So individuals should be getting sick, however they are not getting actually sick.

We additionally simply had the Fourth of July, when lots of people had been gathering. May that be why we’re anecdotally listening to about extra individuals getting sick?

That is actually attainable. A good quantity of immunity to COVID-19 now is because of individuals having gotten sick themselves, not simply the vaccine, and I believe that is offering some ongoing safety now. However actually we have seen this each of the previous two summers as properly: There was an enormous surge within the winter, after which a smaller rebound proper round this time—which, once more, we’re not seeing by way of critical sickness, however by way of instances we’d.

Final yr it appeared, particularly for households with youthful youngsters, that somebody was sick at any given time. Is that a part of this popping out of COVID? Do you assume we’d see that once more this yr?

There are most likely quite a few elements at play right here. To start with, I believe there’s some part of popping out of COVID. A yr or yr and a half in the past, heaps extra individuals had been sporting masks and nonetheless distancing themselves rather more than they’re now, so there was this added layer of behavioral safety. As soon as that went away, these viruses which were with us for hundreds of years got here again.

Since there are various of those viruses, you’d have one wave of 1 form of virus, after which one other wave of one other, so individuals would really feel like they had been at all times sick. That is much more true for younger children. For instance, those that had been infants throughout COVID season by no means had that chance to construct up that first layer of safety. However after all, in case you ask any mother or father who has had a child in daycare, even earlier than the pandemic, you are at all times a bit sick. Children are coming in and infecting one another after which bringing these issues residence, and that occurs in the summertime in addition to throughout the winter. There’s most likely a component of that as properly.

So what you are saying is that people are going to be people and viruses are going to be viruses. We’re simply paying much more consideration proper now.

I believe that is true. I do assume that throughout the pandemic we had been barely totally different people, so we did not have fairly as many of those viruses circulating. It took a bit time to get again to our standard methods, however I believe we’re fairly near being again there now.

What concerning the potential for an early flu season? Ought to individuals get flu photographs earlier?

The recommendation hasn’t modified. The recommendation is and has at all times been to get the flu shot in September or October, earlier than the beginning of the flu season, and the flu shot is designed to present safety all through the season. Those that take part in necessary flu vaccine applications, like well being care employees, are used to getting their flu photographs in September to October. Given the truth that we had an early flu season final yr, the place the flu actually spiked in November versus January/February prefer it often does, it is a bit extra related now. We most likely are a bit extra more likely to have an early flu season this yr—once more, simply because the final flu season was pushed early, too. And it would take one other yr or two for us to get again to the standard method of issues.

The third virus in our “tripledemic” was RSV. Some huge information simply got here out that there’s a new antibody for RSV. Are you able to inform us a bit bit about that?

On July 17, the FDA authorised a brand new antibody for RSV referred to as nirsevimab. That is the second antibody that is out there for cover in opposition to RSV. However not like the primary antibody, this one lasts longer. It is designed to be steady within the physique for 4 to 6 months, and it has been authorised not only for these infants who’re at highest danger, however for all wholesome infants as properly. We’re anticipating to see much more uptake of this antibody, and hopefully that may assist defend our youngest infants in opposition to RSV this coming winter.

COVID deaths and hospitalizations are down. Final yr’s flu season was early however in any other case not that totally different from what we have seen earlier than. What is the lesson to take into the upcoming respiratory virus season?

Get your vaccines. It is true that we’re seeing hospitalizations and deaths on account of COVID 19 declining, and for the primary time for the reason that starting of the pandemic, we’re seeing all-cause mortality beginning to normalize. All of that is excellent news. However we’ve to do not forget that these are nonetheless lethal viruses. Tens of 1000’s of individuals die from COVID and the flu each winter, and that is more likely to proceed being the case.

Simply because we’re popping out of the pandemic does not imply that we’re instantly immune to those different viruses, and we have to proceed to do what we are able to to stop these viruses from taking maintain. Meaning getting your flu shot when it is out there, getting your monovalent COVID vaccine when it turns into out there, getting your toddler youngsters these new antibodies for RSV, and in case you’re indicated to, getting an RSV vaccine your self. The best way that we stop the brunt of deaths from all of those viruses is to take every of those totally different steps in tandem.