Eric Biondi, director of the Pediatric Hospital Medicine Division at Johns Hopkins Children’s Center in Maryland, says the beds there are full. The center even opened surge beds, but those are now full too. The children’s hospital is no stranger to fielding severe illness from RSV and the flu, but this year they’ve hit simultaneously.
“It’s been rough,” Biondi says. “The [RSV] spike happened quick. There was no flattening of the curve. It just went up.” Now, those cases have fallen off; RSV hospitalizations in the US steeply declined by the end of November to about 18 young children per 100,000, but that number is still high for November and December, compared to prior years.
But the flu continues to circulate. This year, the flu has already caused 78,000 hospitalizations and killed 4,500 people, the CDC estimates. It killed an estimated 25,000 people in the US during the winter 2019 to spring 2020 flu season. “Minimal flu activity” left the CDC without estimates in the winter of 2020 and spring of 2021, but the agency noted that less than 1 person for every 100,000 was hospitalized with influenza, compared to 66 people per 100,000 the prior year.
The threats are seen in Europe too, where the World Health Organization notes that flu season also got an early start. England is also seeing more than a quarter of influenza tests come back positive, and RSV hospitalization rates there are on the rise. German hospitals are strained with RSV infections. But babies in countries without robust medical systems are most at risk.
Once center stage, Covid is still circulating around the globe, although many people may have dropped their guard as schools went back and now the holiday season has begun. During the last week of November, hospitalizations for Covid-19 in the US averaged 4,200 each day—a 17 percent increase from the prior week, according to the CDC. Across Europe, Covid-19 cases saw a slight drop of 3.5 percent in late November.
Low vaccination rates compound the issue. By mid-November, just 40 percent of kids in the US had received a flu shot, according to the CDC. Only 12 percent of people ages 5 and older in the US have received updated booster shots targeting the Omicron Covid variant. Just under 15 percent of people in Canada have received a Covid booster since August. There is no RSV vaccine, although Pfizer is working on one and plans to submit it for approval to the US Food and Drug Administration before the end of the year. GSK has also submitted an RSV vaccine for older adults for review to regulators in Europe and the US.
Even though some hospitals are under stress, widespread closures of businesses and schools seem unlikely. Lockdowns spare medical systems from being overwhelmed, but they can lead to losses in educational attainment and income, and negatively affect mental health. But letting winter viruses circulate has its own economic costs.