“Triple disease” in CT? COVID-19 cases low but flu, RSV circulating

In terms of virus transmission, Connecticut faces good news and bad news this fall.

First the good news: In recent weeks, the state has seen declines in registered COVID-19 cases, the positivity rate, and hospitalizations, all at or near the lowest levels in months, with sewage monitoring confirming that transmission is relatively slow remains . The virus continues to circulate, but not nearly as rapidly as it did earlier in the pandemic.

Now for the bad news: as COVID has faded, respiratory syncytial virus (RSV) has come on earlier and more intensely than usual, and flu season also appears to have started ahead of schedule. Meanwhile, experts say COVID could rise again soon, perhaps starting with next week’s Thanksgiving holiday, which could result in what has been dubbed a “triple epidemic.”

“Transmission will definitely increase,” said Dr. Ulysses Wu, chief epidemiologist at Hartford HealthCare. “Whether it’s just COVID, whether it’s influenza, whether it’s RSV, I think we need to look at it in its entirety, those three diseases.”

In a typical year, RSV and influenza can strike in the fall but do not spread widely until the winter. This year, however, RSV Connecticut struck months ahead of schedule, causing a crisis at the state’s largest children’s hospitals. Meanwhile, the Centers for Disease Control and Prevention has been tracking far more flu cases statewide than is usual this time of year, with Connecticut being among the states currently experiencing “high” transmission.

While it’s not entirely clear why RSV and flu have risen earlier than usual, experts say it may be due to the population’s lack of immunity to the virus after two winters of masking and social distancing.

At the same time, COVID-19 has hardly gone away. Connecticut recorded 2,264 cases last week (not counting the likely many more picked up by home testing) and had 325 patients hospitalized with the disease, according to state data Thursday. The state reported 31 coronavirus-related deaths this week, bringing the total to 11,559 during the pandemic.

Experts say it hasn’t helped that only a fraction of eligible residents have received the latest COVID-19 booster shot, or that flu shot rates are lower this year than in previous years.

“Everyone is talking about the new normal and everyone wants to get back to the new normal,” said Dr. Tina Tan, vice president of the Infectious Diseases Society of America, on Friday. “Vaccines must be part of this new normal to prevent these individuals from contracting the circulating viruses and bacteria.”

So what does this mean for the way Connecticut residents are approaching Thanksgiving and the rest of the holiday season? Wu acknowledged that most people have abandoned precautionary measures and are not anxious to reintroduce them, but said he is not planning a large Thanksgiving gathering and that anyone seeing family should watch for signs of illness.

dr William Schaffner, a professor of infectious diseases at Vanderbilt University, said on a call organized by the Infectious Diseases Society of America that he plans to have everyone at their Thanksgiving table get vaccinated against COVID-19 and the flu, and that they’ll catch a COVID -Quick test on the morning of vacation.

As autumn rolls into winter, Schaffner said it might be time to “dust off” masks, especially for those who are moderately or severely immunocompromised, and reconsider social distancing.

“Rent the movie instead of going to the cinema,” he said.

Tan and Schaffner both predicted that the United States is heading for a “triple pandemic,” with RSV, flu, and COVID circulating in large quantities at the same time, leading to more illnesses than usual this winter.

Similarly, Wu said he expects the COVID and flu numbers to rise together as the weather cools. As three different viruses spread, he said he continues to wear masks in public, even if sometimes he’s the only one.

“I’m still a total fan of indoor masking,” Wu said. “It’s just common sense.”

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