Flu season arrived early this year, and combined with RSV and COVID-19, caused a perfect storm of sickness ahead of schedule. New data from the CDC shows people of color have been disproportionately affected by the flu virus, with Black people being hospitalized at a rate nearly 4 times higher than the respective rate for white patients. Hospitalizations were also 30% higher for Native Americans, and 20% higher for Hispanics. “Yes, there’s no question about it that there are certain groups of Americans that have been at higher risk,” says White House Covid task force leader Dr. Ashish Jha. “We know that people who are poorer, people who are racial and ethnic minorities throughout the whole pandemic have been more exposed to the virus, have had less access to high-quality care. That’s been a major focus of ours, is to close that gap.”
Some of this may be attributable to lower COVID vaccination rates amongst those communities, and the CDC also points this is understandable considering the aforementioned poorer access to quality healthcare and distrust of physicians and the government. The CDC is urging everyone eligible to get a flu shot and boosters as soon as possible. “We’ve had two mild flu seasons and this means we might be ripe for a severe season, because people aren’t taking all the measures they took for COVID which also had an impact on the flu,” says CDC epidemiologist Carla Black. “People haven’t had natural disease in two years so there’s less natural immunity out there.”
“What happens in the weeks and months ahead will have a large impact on how the winter goes and really what happens this winter is largely up to us as the American people,” Dr. Jha said. “Don’t wait — get your new flu shot and your new COVID shot today. If Americans did that we could save hundreds of lives each day this winter. As the Commonwealth Fund just put out a new report, a new analysis, they estimate that we can save as many as 90,000 lives and nearly a million hospitalizations if most eligible Americans got their updated vaccines. Now, that is just based on vaccines alone, which are remarkable and going to make a very large difference. But if we do better, that if people get tested when they have symptoms — we know testing leads to a diagnosis, diagnosis leads to treatments. And treatments that we have available today for free keep people out of the hospital, keep people out of the ICU, prevent the worst outcome of all.” Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.
Medical experts are reassuring the public it is perfectly fine to get a flu vaccine and COVID booster at the same time. “According to data from the CDC, seasonal influenza activity is elevated across the country. We’ve seen two more influenza-associated pediatric deaths last week,” says Andrea Garcia, JD, MPH, AMA’s Vice President of Science, Medicine and Public Health.
“There are a total of seven pediatric flu deaths already reported this season. And the CDC estimates that flu, so far, has caused at least 4.4 million illnesses, 38,000 hospitalizations, and 2,100 deaths. We do know that an annual flu vaccine is the best way to protect against the flu, and the CDC recommends that everyone six months and older get that flu vaccine annually. And we think it’s also important to remember that patients can get the flu vaccine and the COVID vaccine at the same time.”
“Absolutely. The CDC is recommending that you get your flu shot and your booster shot at the same time,” says infectious disease specialist Sabrina A. Assoumou. “It’s safe—we know it’s fine to get both at the same time. And getting both at once means that you don’t have to go back for a second shot, something that may or may not actually happen… Experience with other vaccines has shown that the way our bodies develop protection, known as an immune response, and possible side effects after getting vaccinated are generally the same when given alone or with other vaccines.”
RSV cases have skyrocketed, putting immense pressure on hospitals and medical facilities. “If we look at CDC data, the RSV hospitalization rate is 10 times higher than usual for this point in the season,” Garcia says. “We know that more than three-quarters of pediatric hospital beds are in use nationwide. That’s up from about two-thirds over the past two years. And 171 out of every 100,000 infants younger than six months were hospitalized with RSV for the week ending November 12. That is more than double the RSV hospitalization rate for newborns last year and seven times the rate in 2018, which is the last complete season we saw before the pandemic.
“Last week heading into the holiday, we saw the American Academy of Pediatrics and the Children’s Hospital Association request a formal emergency declaration from the federal government to support hospitals and communities amid the alarming surge of pediatric respiratory illnesses, including RSV and influenza. The health care leaders wrote that we need emergency funding support and flexibilities along the same lines of what was provided to respond to COVID surges. And Oregon last week became the first state to declare an emergency in response to that RSV surge.”
Dr. Jha is recommending all older Americans get their booster shots. “We have seen over the last six months, eight months or so a clear shift towards more and more older Americans dying,” Dr. Jha says. “Look, this virus has always affected older Americans more, but in the last six, eight months, it’s become really quite extreme. Almost 70 percent of deaths are in people over 75. But the biggest issue here is, almost every one of these tests is preventable now.
“If people were up to date on their vaccines, and if people got treated if they had a breakthrough infection, we could get almost every one of those deaths — we could prevent almost every one of those deaths. That is our focus right now, is to try to do everything we can to lower that death. If you looked at, for instance, our death rates compared with many other high-income countries, some other countries have lower death rates than us. What differentiates and explains that? It’s almost all the rates of boosters among older people. That is the single determinative factor. There are other things that make a difference, too. As I mentioned earlier, treatments make a really big difference.”
The pandemic—and flu season—is still dangerous for people who are immunocompromised. “Even setting aside the emotional overtones, when a pandemic becomes endemic (though most recent estimates being that about 94% of Americans have had at least a brush with COVID to date), that does not mean that the pandemic is over, since each new variant represents its own distinctive challenges and threats,” says Mark Schlesinger, professor of health policy and a fellow of the Institution for Social and Policy Studies.
“By perpetuating the fallacy that the pandemic will have a clear finish line — and that line may be just around the corner — we risk delaying important work that needs to be done,” says Cary Gross, professor of medicine and public health and director of National Clinician Scholars Program at Yale. “We need to revamp and reinvest in our public health system to enable preventive options. We have to ensure access to healthcare and address the fact that our nation’s health care system is more fragile than we had thought.”
While COVID, flu, and RSV are all respiratory illnesses, they are spread differently. “With COVID, we have appropriately focused on air quality, but many of these viruses can also spread by touching contaminated surfaces, which makes hand washing and cleaning contaminated surfaces really important,” says Thomas Murray, MD, PhD.
“At the beginning of the pandemic, we were wiping down our fruit, vegetables, and everything with bleach, until we found out that COVID doesn’t spread through surfaces—but rather from sneezing, coughing, and expelling respiratory droplets and aerosols,” says Yale Medicine infectious diseases specialist Scott Roberts, MD. “RSV spreads much more through contaminated surfaces. A kid rubs snot on their hands and puts the hand on someone else, and then that kid puts their hand in their mouth, and they can be infected. Hand washing and cleaning surfaces are more critical with RSV than with COVID.”
Flu can be spread both by touch and through respiratory droplets, so Dr. Roberts recommends respiratory etiquette—”That means coughing into a tissue and disposing of it immediately in the garbage,” he says. “And if you or your child is sick, stay away from others until you are improving and fever-free,” says Dr. Murray. “And if you have a baby, especially a newborn, be very careful about who visits in their first couple months of life. You only want people who are washing their hands and have no symptoms to be near the baby.”
Follow the public health fundamentals and help end this pandemic, no matter where you live—get vaccinated or boosted ASAP; if you live in an area with low vaccination rates, wear an N95 face mask, don’t travel, social distance, avoid large crowds, don’t go indoors with people you’re not sheltering with (especially in bars), practice good hand hygiene, and to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.