January 19, 2024 – The familiar symptoms are back – a runny nose, cough, aches, congestion and maybe a fever. If the at-home COVID-19 test comes back negative, go to the doctor to see in the event that they can determine what you caught. However, the everyday COVID and flu tests on the doctor's office also come back negative. It looks as if a brand new mysterious respiratory illness is making the rounds.
Instead, several typical respiratory viruses look like peaking at the identical time. Doctors are reporting high levels of COVID, the flu, and respiratory syncytial virus (RSV), in addition to other “flu-like illnesses” that cause similar symptoms, equivalent to colds, other coronaviruses, and parainfluenza viruses (which cause typical symptoms). Respiratory symptoms equivalent to fever, runny nose, cough, sneezing and sore throat).
“Respiratory viruses are still very high at the moment, as you would expect at this time of year,” said Dr. Brianne Barker, an associate professor of biology at Drew University in New Jersey, studies viruses and the body's immune response. “In addition, a significant number of patients appear to have multiple infections at the same time, such as flu and strep, which can cause confusion for patients when considering their symptoms.”
So what must you do? Wear a mask in public in case you think you’ve got symptoms, Barker said. Stay home in case you feel sick, especially if you’ve got a fever above 100°F (40°C) and have signs of contagiousness equivalent to chills and muscle aches. Antiviral medications — like Tamiflu for the flu and Paxlovid for COVID — can assist in case you get infected early enough, but otherwise an important thing is to remain hydrated and rest at home.
“The big picture is that we are in the heat of respiratory virus season, and the big player in the hospital right now is the flu, which seems to be crowding out everything else,” said Dhaval Desai, MD, director of hospital medicine at Emory Saint Joseph's Hospital in Atlanta. “I'm not sure if certain viruses are more aggressive or different this year, so it's hard to say exactly what's going on, but we've definitely seen a surge since mid-December and it hasn't stopped.”
What are the most recent trends?
The current COVID-19 surge appears to have reached its highest level because the Omicron variant infected thousands and thousands of individuals in December 2022 CDC COVID wastewater data. Test positivity appears to be stabilizing after rising since November, the CDC said COVID data tracker shows, although the speed was still high with 12.7% positivity in the primary week of January.
At that time, COVID-19 emergency room visits began to say no, although hospitalizations were still increasing and deaths increased 14.3% in comparison with the previous week. As of Jan. 6, the JN.1 variant is answerable for a lot of the spread and is reported to account for 61.6% of COVID-19 cases within the United States CDC variant data.
“COVID doesn't seem to be as bad right now as it was during Omicron, but the problem is that it's hard to compare because COVID cases are no longer being reported in the same way as before and we don't have that government data . said Bernard Camins, MD, infectious disease specialist and medical director of infection prevention at Mount Sinai Health System in New York City.
The good news, he said, is that hospitalization rates are lower than last year given the number of people infected, “so there's some immunity to that now.”
“The other good news is that we have treatments for COVID, such as Paxlovid, that most people can take for a long time if they talk to their doctor as soon as possible after infection.”
Flu rates, which fell through the peak of the COVID pandemic, look like back to typical levels, Camins said. This flu season began sooner than usual in 2023 and is anticipated to peak in the subsequent few weeks. The CDC's FluView shows that test positivity – currently at 14% – is increasing and hospitalizations and deaths are also trending up.
Likewise the CDC national trend data for RSV shows that cases have risen in recent weeks to last yr's peak, but now look like declining, particularly within the northeast and south.
Other viruses are also circulating, equivalent to adenovirus, which might cause colds, sore throats, diarrhea, conjunctivitis, and other symptoms. Parainfluenza viruses peaked in late November and experienced one other surge in late December. Rhinoviruses, which cause colds, have also returned to normal highs this season alongside the flu, Camins said.
“I have not become ill since 2021 and recently became infected with rhinovirus which has spread in my household. The symptoms were not severe but I still have a persistent cough,” he said. “The trick is that in previous years people were not exposed to the virus because of masking and other precautions, but now people are exposed to many of these viruses.”
What should we expect next?
Peak respiratory virus season is more likely to last throughout January and February after which taper off because the weather warms, allowing for outdoor activities, higher ventilation and better humidity.
“One of the reasons we see so many infections this time of year is related to humidity, when the respiratory droplets containing these viruses stay in the air longer and the immune response in our nose actually works less well in dry air,” says Barker said. “There is evidence that increasing humidity can help get rid of some of the viruses in the air and support our immune response.”
In the meantime, Barker suggests taking precautions, stocking up on at-home tests and staying home in case you're sick. She recently recovered from an upper respiratory infection and has decided to start out wearing a mask again in public places. She tested negative on every possible test at her doctor's office and doesn't wish to repeat that have.
“It reminded me how much I dislike having an infection,” she said. “I'm willing to wear a mask in the supermarket if I don't have to go through this again. I care about myself and others.”
Additionally, don't hesitate to get tested, especially if an antiviral might help, Desai said. After contracting a respiratory illness in November, he developed a high fever and sweats and decided to go to the doctor. He tested positive for influenza A, or H1N1, which was essentially the most commonly reported flu strain in late December, in keeping with the CDC's FluView.
“It has hit me harder than other illnesses in recent years, but I took antiviral medication and it cleared up in about four days,” he said. “My mother, who is immunocompromised and in her 70s, also got it, but took an antiviral even earlier and got over it within 24 to 36 hours.”
In the subsequent few months, it’s also not too late to get vaccinated against essentially the most common viruses, especially COVID, flu and RSV. The most vulnerable groups, equivalent to young children and older adults, could particularly profit from vaccination, Camins said.
“With RSV, for example, there are vaccines for pregnant women to protect their infants,” he said. “And while we don’t have good data to say whether the current COVID vaccine protects against infection, we do know that it still protects against serious illness and death.”
As 2024 progresses, experts look ahead to more practical home testing for COVID and the flu, higher flu vaccines, and latest research into the body's immune response to those respiratory viruses.
“Disease prevention is key, regardless of what is on the rise and what we are dealing with right now,” Desai said. “Think about your risk factors and what you're doing overall for your health and well-being this year – whether routine physical exams or cancer screenings, depending on your age. There is great power in staying healthy and advocating for ourselves when we are well.”