Just in time for the holidays: COVID-19, flu, RSV make their return

CDC reports COVID-19 and other viruses are up in Georgia and around the nation, but not as bad as previous years
A COVID-19 sign is seen inside the CVS at North Decatur on Wednesday, Sept. 13. 2023. On Monday, the Food and Drug Administration approved the revised vaccines, anticipating their arrival shortly after a surge in COVID cases during the summer and just before the onset of flu season.

Miguel Martinez /miguel.martinezjimenez@ajc.com

Credit: Miguel Martinez

Credit: Miguel Martinez

A COVID-19 sign is seen inside the CVS at North Decatur on Wednesday, Sept. 13. 2023. On Monday, the Food and Drug Administration approved the revised vaccines, anticipating their arrival shortly after a surge in COVID cases during the summer and just before the onset of flu season. Miguel Martinez /miguel.martinezjimenez@ajc.com

Just as throngs of people hit the roads and fly the skies to be with friends and family for the holidays, a trio of now-familiar respiratory viruses are showing up again.

COVID-19, influenza, and respiratory syncytial virus, or RSV, have put a damper on holiday gatherings since 2020. This year, all three are causing a rise in emergency room visits and hospitalizations, but the numbers in the U.S. and Georgia are not as high as in previous years.

Georgia and 14 other states are listed as having a “high” number of respiratory illnesses, according to surveillance by the Centers for Disease Control and Prevention. The data is based on the number of people going to the doctor with flu symptoms — fever, plus cough or sore throat. That means it could include cases of people who are suffering from other viruses such as COVID or RSV.

While public health experts emphasize COVID is still very much us, many families are approaching the holidays just as they did before the pandemic. Most adults in the U.S. — about 75% — say they are not worried about getting COVID over the holidays, according to a recent survey by KFF, formerly known as the Kaiser Family Foundation. Only 31% said they are worried they will spread COVID to people close to them.

The public is divided on taking precautions this upcoming season, with half of adults saying they are planning to take at least one of several precautions to limit the spread of COVID this fall and winter such as taking a COVID test before vising with family and friends, while the other half are not planning to take any of the precautions asked about in the survey.

Centers for Disease Control and Prevention Director Dr. Mandy Cohen has been on a nonstop tour, traveling the country to promote the need for vaccines. She points to immunization as the best defense against severe complications and hospitalizations from circulating viruses.

This year for the first time, vaccines are available for all three of these circulating viruses.

“The respiratory and virus season is still upon us,” said Dr. Luke Lathrop, chief medical officer at SmartMED Drive-Thru Medical Care in Roswell. “The numbers of COVID are certainly lower this year compared to previous years but we’ve seen a good amount of COVID. It’s still with us.”

Here’s what to know ― and how to stay safe from COVID, the flu, and RSV this holiday season.

What’s the latest on the big 3 seasonal viruses in Georgia?

New COVID hospitalizations are up slightly in Georgia, but they remain low compared to previous holiday seasons. The expected post-Thanksgiving surge has been more like a bump this year, and is smaller than the modest national rise in COVID. In Georgia, new COVID hospitalizations totaled 365 for the week ending Dec. 2. That’s up from 341 the previous week, a 7% increase. Nationally, new COVID hospitalizations increased by 18% over the same period.

Meanwhile, the latest flu report for the week ending Dec. 9 in Georgia shows the percentage of people going to the doctor for flu-like symptoms has reached 5.8% of all doctor visits. Since the start of the flu season in October, 511 people have been hospitalized in the eight-county metro Atlanta region (Fulton, DeKalb, Clayton, Cobb, Douglas, Gwinnett, Rockdale, and Newton) through Dec. 9, the most recent data available. A year ago, the total number of hospitalizations for this time period was 1,581.

RSV is also showing a declining trend after a recent surge. The latest data, which is based on a voluntary reporting program that includes hospitals in metro Atlanta, shows the overall rate of hospitalization for RSV is 1.7 per 100,000 people for the week ending Dec. 9. That’s down from a rate of 2.6 the previous week.

Dr. Jayne Morgan, executive director of health and community education for Piedmont Healthcare, noted COVID is still the virus causing the most hospitalizations and deaths.

Morgan said there is a sense of urgency to increase vaccinations as hospitalizations for these viruses are rising across the country. At the same time, doctors are also noting an uptick in other illnesses including strep throat and pneumonias, especially in children. Morgan said vaccinations against the three major respiratory illnesses can help lower the risk of other illnesses. This is because if you are infected with any of these viruses, it weakens your immune system and makes you more susceptible to other circulating respiratory infections as well, she said.

Dr. Jayne Morgan, executive director of health and community education for Piedmont Healthcare, says vaccinations against the three major respiratory illnesses can help lower the risk of other illnesses.

Credit: Contributed

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Credit: Contributed

Could a surge still happen over the holidays?

Forecasting from CDC scientists predicts two possible scenarios for the holiday season. But neither forecast comes close to the staggeringly high levels of illness and hospitalization of the 2021-2022 winter season, when the original omicron variant dominated.

In both scenarios, COVID activity is predicted to be only “moderate.” That’s because most Americans — 97% according to the CDC — have some immunity to COVID through vaccination, infection, or both.

Which vaccines should I get and when?

COVID-19 Vaccines:

CDC recommends everyone 6 months and older get the COVID vaccine that was updated this year to protect against the potentially serious outcomes of COVID illness. New variants continue to surface, but the current formula still offers protection.

People who recently had COVID can hold off getting the vaccine for three months.

Flu vaccines:

Everyone 6 months of age and older should get vaccinated for the flu. Ideally, get the shot by the end of October but later is better than never. The seasonal flu vaccine is reformulated each year to tailor them to the virus types predicted to be most common in the upcoming season. Even when it’s not a perfect match, the shots can prevent serious illness.

RSV Vaccines

The CDC recommends the RSV vaccine for adults over 60 after having a conversation about it with their health care providers, something called “shared clinical decision-making.” Pregnant women are also recommended to get an RSV vaccine during their pregnancy. Babies born to mothers who get the RSV vaccine at least 2 weeks before delivery will have protection and, in most cases, should not need an RSV immunization later.

The CDC had recommended earlier all children under 8 months of age get an RSV shots, along with older infants at higher risk for severe disease. But due to an ongoing vaccine shortage, the CDC is now recommending doses be prioritized for children under 6 months of age and for infants with underlying conditions that place them at the highest risk for severe RSV disease.

How long do I have to isolate if I get COVID? What about the flu or RSV?

The CDC still says anyone who tests positive for COVID should isolate for at least five days. And for 10 days after testing positive, people should wear a high-quality mask such as a KN95 any time they are around other people.

So what if your holiday get-together falls within the first five days of testing positive? “Unfortunately, you’ve got to stay home,” said Lathrop. “You’d feel pretty terrible if your holiday gift to your family member was COVID. The same goes for the flu or whatnot,” he said.

Dr. Luke Lathrop, chief medical officer at SmartMED Drive-Thru Medical Care, says it's a good idea to get vaccinated and stay home if you are sick.

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Credit: custom

And it can get trickier for those who get COVID but test negative or get a rebound of symptoms later. When symptoms rebound, the recommended isolation clock resets.

When it comes to the flu, people with flu are most contagious in the three to four days after their illness begins. The CDC recommends people with suspected or confirmed flu (even without fever) should stay home for four to five days after the onset of symptoms or for at least 24 hours after the fever is gone.

People with RSV are usually contagious for three to eight days and may become contagious a day or two before they start showing signs of illness.

What can I do to make my holiday gatherings safer?

At this stage in the pandemic, Lathrop said testing is no longer necessary for every occasion. But if high-risk guests are attending, such as older family members, newborns, or the immunocompromised, it’s wise to have everyone test beforehand.

The best thing you can do according to Dr. Lathrop is get vaccinated and stay home if you are sick.

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