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We’ll be taking a break for the next two weeks to recharge (and recuperate after getting sick myself 🤧), but we wanted to share the latest data on respiratory viruses in time for holiday travels. Here’s the State of Affairs.
RSV: high and increasing
RSV continues to increase in New York and nationally. In New York City, there was a 30% increase in positive RSV tests during the week ending Dec. 7, compared to the prior week. We’re seeing a serious RSV surge, and it seems to be happening later than usual. During the past two seasons, RSV rates peaked in November and declined in December. (Looks like we are back to pre-pandemic trends.) This year, rates continue to rise, and it’s too early to tell when they might peak.
RSV continues to have the largest effect on children, but older adults are also at increased risk for severe RSV and hospitalization. The Centers for Disease Control and Prevention estimates that, nationally, there are 100,000–150,000 hospitalizations among adults age 60+ years due to RSV. While I’m not aware of public data for New York, we’ve seen recent increases in hospitalizations for people age 65+ years across the United States.
Because older adults are also at increased risk of severe RSV, it’s recommended that anyone age 75+ years get an RSV vaccine.
- The RSV vaccine is also recommended for those who are 60+ years and who have heart or lung disease, are immunocompromised, or who live in a nursing home.
- The RSV vaccine for adults is a single dose, given once — it’s not an annual vaccine.
In one of our recent posts, we discussed the importance of also vaccinating pregnant women and giving monoclonal antibodies to protect babies against RSV. (See the post here.)
The RSV vaccine works for older adults
A recent study published in JAMA Network Open showed that the RSV vaccine for adults age 60+ years was highly effective at preventing severe disease.
- In fact, the study estimated that the RSV vaccine had 90-91% efficacy at protecting against hospitalizations and emergency department visits for adults age 60+ years — that’s great vaccine efficacy.
With that kind of efficacy, high RSV vaccine coverage could cut the number for folks hospitalized annually from 100,000 to closer to 10,000.
The flu: moderate and increasing
Seasonal flu transmission is also ramping up in New York — the number of cases in the state increased by 53% during the week ending Dec. 7, compared to the prior week. Flu hospitalizations are increasing in every region of the state.
Like RSV, this year’s flu season in New York is off to a slower start compared to the last two years, with fewer positive tests and hospitalizations so far. I see two possible scenarios for this year’s flu season:
- A flu season with a similar number of hospitalizations compared to last year’s, but with a later peak. Last year, seasonal flu peaked in the last week of December. This year is shaping up to be more like pre-pandemic flu seasons. (In the 2018-19 and 2019-20 seasons, flu hospitalizations peaked in March and February, respectively.)
- We could also have a milder flu season overall, with fewer hospitalizations compared to last year. In the 2021-22 season, flu hospitalizations were much lower overall. But we were masking up a lot more that winter. We don’t know yet if the slow start is just pushing everything back, or if it’s a sign that we’ll have a milder year. Either way, it’s a good time to get vaccinated, since flu is rising.
You may also have seen national headlines about H5N1 (bird flu). This is a type of flu, but not like the seasonal strain. It hasn’t spread from human to human yet; those at risk are people with direct contact with sick animals (dairy, wild birds, and poultry). New York hasn’t detected H5N1 yet in humans or dairy herds, but I predict it’s only a matter of time given that more and more states are finding it. If/when that happens, I’ll be back with a deeper dive.
Covid-19: minimal but increasing
Covid-19 levels in New York state are minimal, but expect an increase soon. Nationally, Covid-19 levels have risen from minimal to low, and this trend is likely to carry over to New York in the near future.
Covid-19 continues to pick up in New York City, where wastewater shows that levels are increasing.
Reduce your chances of infection while traveling
These tips to stay healthy while traveling generally apply, regardless of what is circulating.
- Mask up while traveling. This includes on the subway, at airports, train stations, and when boarding or deboarding for a flight.
- Planes typically have good air filtration when moving. However, air filters are not usually run at full strength when the plane is stationary or during taxiing. This means that during boarding and deboarding, when everyone is close together waiting, air circulation is minimal, and the risk of being exposed to a respiratory pathogen is higher. This is a good time to mask up, as I plan to do.
- Well-fitting filtration masks like N95s are the best, but a KN95 or a surgical mask are still good options.
- Ventilate and filter air to help reduce transmission. When you’re indoors together, turn on an air purifier, use a fan, or open a window.
- Stay home if you feel sick. I know it’s really hard around the holidays, but this is the most important way to protect vulnerable friends or relatives who may be over age 65, pregnant, or immunocompromised from getting sick.
Bottom line
Though they came late, RSV and flu are here and on the move in our communities. Respiratory virus transmission will likely increase over the holidays as many of us travel and expand our social networks. However, we still have several tools to stay healthy. I hope you all have a happy and restful holiday!
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.
