Every year is in the same way. As soon as it gets cold, people gather indoors. The windows are closed. Commuters give up walking or cycling, opting for overcrowded buses and trains. Our whole world is moving back to warmer climates, our air is on the windows of houses, offices, schools, and transport, showing how we have closed ourselves off. We create, in short, a perfect breeding ground for viruses.
When the respiratory virus season begins, it is often predictable. Patients begin to be admitted to hospitals with influenza or respiratory syncytial virus (RSV) around October in the northern part of the world. Thousands of people get sick, and many die, but in such an extraordinary year, the health systems of Europe and North America are rarely at risk of being overwhelmed.
But the epidemic has disrupted this prediction. It has added a virus to the seasonal mix, and the flu and RSV are coming back this year with a vengeance. A “twin” or “tripledemic” may be on the way, with all three viruses hitting at once, infections multiplying, and health systems strained. There are already signs that this is happening.
Many hospitals in the US are at capacity, caring for many children with RSV and other viruses, more than would be expected at this time of year. The US Centers for Disease Control and Prevention (CDC) doesn’t track RSV cases, hospitalizations, and deaths like it does with the flu, but hospitals across the country have been reporting spikes in cases in December and January. About one in five PCR tests for RSV came back positive in the week ending October 29, when the rate doubled in a month. In general, the higher the number of tests that come back positive, the more common the virus is in the community. Three years before the outbreak, only about 3 percent of tests came back in October.
This is the collapse of the plague. Over the past two years, RSV and influenza have been kept at bay because of the precautions people have taken against the coronavirus: wearing a mask, washing hands, and social distancing. Between the start of the epidemic and March 2021, the rate of weekly RSV tests remained below 1 percent, according to the CDC — below what it was during the epidemic.
In July this year, health experts warned in The Lancet that the benefits of preventive measures against the epidemic may have negative consequences in winter. Reducing exposure to common viruses like RSV and influenza, experts argued, would pose a “vulnerable risk” in people who were born during the pandemic or who had never developed adequate immunity to these viruses.
This prophecy now seems to be coming true, as children are getting these viruses for the first time, not developing enough immunity, and getting very sick. Rachel Baker, an assistant professor of epidemiology at Brown University in Rhode Island, said: “We’re seeing older children getting RSV that they would have gotten when they were younger.” Lancet comment piece. “This is putting hospitals in a difficult position.”