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Happy (early) Thanksgiving! As many of us get ready to travel and spend time with loved ones this week, it’s a good idea to check in on the state of respiratory viruses and share tips to stay healthy this Thanksgiving. I’m personally looking forward to indulging in some pumpkin pie, guilt- and respiratory virus-free. 🥧
Covid-19: minimal
Covid-19 transmission has continued to decrease across New York. Levels are “minimal.”
It’s the same story in the city — transmission of Covid-19 is low. Good news for travelers: Covid-19 transmission is also low in the Midwest and West, and minimal in the South and Northeast.
Influenza and RSV: low but increasing
Influenza (flu) is increasing in New York; the number of cases in the state increased by 12% compared to the previous week. The biggest increases are happening in New York City and the metro area.
Laboratories report that positive RSV tests are also increasing in New York state and New York City. Younger kids, especially infants, older adults, and people with weakened immune systems are at greatest risk for severe RSV. If this is you, consider taking extra precautions this week.
Other viruses: circulating
Even though we are seeing low levels of Covid-19, influenza, and RSV, the percent of clinic visits for general fever, cough, or runny nose is similar to last year — people are still showing up sick to clinics.
Two viruses are the likely culprits: enteroviruses or rhinoviruses, which cause the common cold. It turns out the common cold is, well, common in New York right now.
Walking pneumonia: increasing
Nationally and in parts of New York, clinics are seeing more children with walking pneumonia, a respiratory illness often caused by the bacteria Mycoplasma pneumoniae (and other pathogens). Symptoms include fever, sore throat, and persistent cough, but in severe cases, lungs can fill with fluid, causing difficulty breathing.
Walking pneumonia is harder to track because healthcare providers aren’t required to report cases. This year, the Centers for Disease Control and Prevention put together a national surveillance system of hospitalizations to track walking pneumonia — and it’s much higher right now than previous years (it flares every 3-5 years.) There’s no reason to think it’s any different in New York. The largest rise in cases is among children ages 1 to 4.
Because it’s caused by a bacteria, severe Mycoplasma pneumonia cases can be treated with antibiotics, but most people fully recover without them. The CDC has helpful information about walking pneumonia here.
Avoid getting sick leading up to the holidays
Regardless of what is circulating, things you can do to stay healthy generally apply across all viruses and bacteria.
- It’s not too late to get vaccinated. Immunity helps prevent infection for Covid-19, flu, and RSV. It’s also a great time to ask family members if they are vaccinated.
- Find locations using the NYC Vaccine Finder, including sites offering free vaccines for people without insurance.
- Vaccination locations throughout the rest of New York state can be found at Vaccines.gov.
- RSV vaccines and monoclonal antibodies are also available for a subset of people (pregnant people, older adults, and babies).
- Mask up in the days leading up to the holidays to prevent bringing a virus to the celebration. Well-fit filtration masks like N95s are the best, but I find I’m less likely to wear these for long periods of time, so I’ve settled for a surgical mask or KN95. I’ll be wearing a mask at the airport and on the plane, and I have started to use one when I remember in the subway.
Reduce spreading infection during holiday events
- Stay home if you feel sick. This is the most important way to avoid spreading illness, especially to vulnerable friends or relatives who may be over age 65, pregnant, or immunocompromised.
- Ventilate and filter air to help reduce transmission. When you’re together indoors, open a window, use a fan, or turn on an air purifier.
- Test at home for Covid-19 and flu. Tests are more accurate if taken when symptoms are present (in which case, stay home to reduce spread regardless). Rapid tests can catch about 40% of asymptomatic infections if two tests are taken 48 hours apart. This is a good way to take extra precaution before visiting someone who’s immunocompromised.
- Four free rapid tests from the U.S. Department of Health and Human Services can be ordered here and mailed to you.
- There is now an Food and Drug Administration-approved combined Covid-19 and flu rapid test. It is helpful to test for both because the earlier you find out if you have flu or Covid-19, the earlier you can call your doctor and get started on antiviral treatments.
Get treatment if you do get sick
- If you have symptoms or test positive, assume you are contagious and stay home.
- At-home rapid tests. If you test positive, you are infectious. Stay in isolation and wear a mask (preferably an N95) around others for at least 5 days or until you test negative.
- Antivirals can help reduce severe illness, especially if you are over age 65.
- Paxlovid helps treat Covid-19 but should be taken within 5 days of symptom onset.
- Tamiflu helps treat influenza and should be taken within 48 hours of symptom onset.
Bottom line
Respiratory season is starting to pick up, and it will likely be intensified this Thanksgiving and thereafter because we are increasing our social networks. But there are tons of ways we can stay healthy and still celebrate with loved ones. Happy Thanksgiving, all. I’m very grateful for this community :)
Love,
Your Local Epidemiologist
Dr. Marisa Donnelly, a senior epidemiologist with wastewater monitoring company Biobot Analytics, has worked in applied public health for over a decade, specializing in infectious diseases and emerging public health threats. She holds a PhD in epidemiology and has led multiple outbreak investigations, including at the California Department of Public Health and as an Epidemic Intelligence Service Officer at the Centers for Disease Control and Prevention. Marisa has conducted research in Peru, focusing on dengue and Zika viruses and the mosquitoes that spread them. She is Healthbeat’s contributing epidemiologist for New York in partnership with Your Local Epidemiologist, a Healthbeat supporter. She lives in New York City. Marisa can be reached at mdonnelly@healthbeat.org.
