Fears of US ‘twindemic’ of flu, RSV grow with or without COVID-19

Flu and RSV are both increasing and early this year, possibly paving the way for a ‘tripledemic’ if COVID cases rise.
view from hallway into a room where two people are seated, one person is getting a shot in the arm
An employee of GGD Haaglanden injects a patient with a coronavirus booster vaccination at a clinic in The Hague on October 13, 2022. – The new vaccination is offered because the government is taking into account a new wave of coronavirus infections in the autumn. Photo by MARCO DE SWART/ANP/AFP via Getty Images

Story at a glance

  • Flu and other respiratory illnesses are on the rise and early for their season.

  • More children are being hospitalized than usual for RSV and other illnesses. 

  • COVID-19 cases and hospitalizations are plateaued for now, but wastewater surveillance indicates that they could be on the rise.

Fears of a U.S. “twindemic” are growing as the nation deals with children’s hospitals crowded with cases of respiratory syncytial virus (RSV), which comes just as the number of people with the flu also rise across the country.

Experts have been talking about a “twindemic” in connection with a simultaneous surge in COVID-19 and flu cases. The worry was that winter waves of COVID-19 would coincide with the regular flu season and that the combination could pose a threat to health systems.  

Thankfully, COVID-19 cases and hospitalizations have leveled off in the United States — although that could change as temperatures drop and people move indoors. If that happens, even more pressure could be placed on hospitals.

COVID cases are on the rise in some parts of the country, signaled by wastewater surveillance, suggesting that we could potentially be on the verge of a “tripledemic.”

The Centers for Disease and Prevention has said that cases of RSV are rising in multiple regions of the country, while the nation’s children’s hospitals have reported being overwhelmed with RSV.

The rising number of cases has set off alarm bells for parents worried about hospital space.

“The Seattle Children’s Emergency Department (ED) continues to see record volumes in pediatric patients in October,” Tony Woodward, medical director of emergency medicine at Seattle Children’s Hospital, said in a statement obtained by Changing America.

“Currently, the month of October has demonstrated volumes that are usually only seen around the mid-winter season, when they are typically at their highest of the year due to viruses.” 

RSV normally starts appearing in late November with its regular season running until April.  

Infectious disease specialist Diego Hijano at St. Jude in Memphis told The Hill that they are currently seeing equal cases of COVID, flu and RSV. 

A big factor this winter season is the fact that for millions, COVID-19 protections have gone out the window.

Fewer people are wearing masks or social distancing today than a year ago. That could cause complications if COVID-19 does come back hard again this winter.

A COVID and flu twindemic didn’t seem to happen the past two COVID winters, likely because people followed public health guidelines by staying away from large gatherings and wore face masks.

There was also a general worldwide drop in the prevalence of flu and other respiratory illnesses as people around the world stayed inside and there was limited international travel.

Now, people are traveling again and generally being less cautious.

President Biden declared COVID-19 to be over in September, a statement his own health team pushed back upon.

The risk to many people who get COVID-19 may be less given the prevalence of vaccinations, which make serious cases much less likely.

Yet, there are concerns here too because of vaccine hesitance in the United States.

According to Our World in Data, 80 percent of the U.S. population has had at least one dose of a COVID-19 vaccine, though only 68 percent of the nation’s population is fully vaccinated, according to data kept by The New York Times.

A much smaller portion of the U.S. public — 34 percent — has been boosted.

Those are the figures that are making experts worried that the nation could see a jump in cases later this year.

Europe often gives a preview of what to watch for in the United States when it comes to COVID-19 tends, and cases are rising on that continent. The emergence of new omicron subvariants is another worry.

The fact that people are traveling around again was expected to increase rates of the flu this year and the signs of rising cases are widely apparent.

This year saw a significant flu season in the Southern Hemisphere, where winter is from June through August. Experts typically watch what happens in Australia’s flu season to get a sense for what may happen in the Northern Hemisphere. 

Flu cases are rising earlier this flu season in the U.S. than typically expected, according to data from the Centers for Disease Control and Prevention (CDC). Flu is also rising early in the U.K. and other countries. 

The CDC and other health groups are advising people to get boosted for COVID-19 and to get the annual flu shot to provide protection from that seasonal sickness.

“The best thing parents can do to keep their kids and themselves healthy and safe are to keep doing all their good handwashing and precautions we’ve learned over the last couple years when people are sick, as well as getting their flu vaccines and bivalent COVID boosters when they are able,” a representative of Doernbecher’s Children’s Hospital at Oregon Health & Science University said in an email.

This story was updated at 1:03 p.m.