Flu season continues to intensify in the US, and holiday gatherings could make it worse

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By Deidre McPhillips, CNN

Americans gathered for Thanksgiving last week amid a flu season that’s worse than any has been in more than a decade, and experts continue to urge caution as multiple respiratory viruses circulate at high levels nationwide.

A growing number of US states — now 33 — are experiencing “high” or “very high” respiratory virus activity, and seasonal flu activity continues to be “elevated across the country,” according to the US Centers for Disease Control and Prevention.

In the week ending November 19, nearly 1 in 10 deaths nationwide (9.4%) was due to pneumonia, influenza or Covid-19 — well above the seasonal baseline of about 6%. And the CDC estimates that there have been at least 6.2 million illnesses, 53,000 hospitalizations and 2,900 deaths from influenza this season.

Flu and RSV, another respiratory virus that especially affects children, have hit harder and earlier than usual this season after the Covid-19 pandemic disrupted the past two seasons and as the nation eases back on prevention measures.

While flu continues to ramp up, RSV has shown signs of slowing nationwide, but test positivity rates are still higher than they’ve been in years, and cumulative hospitalization rates are about 10 times higher than typical for this point in the season. Less than two months in, the RSV hospitalization rate this season is already nearing the total RSV hospitalization rate from the entire 2018-19 season.

Thousands of people are still dying from Covid-19 each week, too.

The latest surveillance data does not capture Thanksgiving week or the effects of holiday gatherings. Covid-19 cases, hospitalizations and deaths reached record high levels during last year’s holiday season — and this holiday season could also bring a rise in spread.

Although experts expect this year to be better than the last, they stressed the importance of preventive measures in the days leading up to Thanksgiving to help prevent the spread of all respiratory illnesses.

“We have seen, in some regions, RSV numbers starting to trend downward. Flu numbers are still on the rise. And we are concerned that after holiday gathering, lots of people coming together, that we may see increases in Covid-19 cases as well,” CDC Director Dr. Rochelle Walensky said last week on CNN. “It’s all in a summary to say do everything you can to prevent it by getting your vaccines.”

CDC data shows that just 12% of eligible people in the US have gotten their updated Covid-19 booster, and about 1 in 5 people nationwide is still completely unvaccinated. Flu shots are lagging, too, with millions fewer vaccinations at this point in the season than in the past two years.

There is no vaccine to protect against RSV, however, and children’s hospitals remain more full than usual despite improving trends in virus spread.

Pediatric hospital beds have been more full than usual for months. Children’s health leaders called this month for a formal emergency declaration from the federal government to support hospitals and communities amid an “alarming surge of pediatric respiratory illnesses, including respiratory syncytial virus (RSV) and influenza, along with the continuing children’s mental health emergency.”

With the holiday season — and flu season — underway, Dr. Anthony Fauci warned of the potential for an emergency situation.

“When you have very little wiggle room of intensive care beds, when you have like almost all the intensive care beds that are occupied, it’s bad for the children who have RSV and need intensive care. But it also occupies all the beds, and children who have a number of other diseases that require intensive care or ICU, they don’t have the bed for it,” Fauci, director of the National Institute of Allergy and Infectious Diseases, said on CBS’s “Face the Nation” on Sunday. “So if you get to that situation, that’s approaching an emergency.”

Still, Dr. Ashish Jha, the White House Covid-19 response coordinator, said he is confident that the US will get through the surge of respiratory viruses.

“In terms of hospital capacity, we have been in touch with every jurisdiction around the country. We have been very clear, if you need extra help, the federal government is ready to help, ready to send in support staff, ready to support, send in additional supplies,” Jha said on CNN last week. “I am confident we’re going to get through this, particularly if people step up and protect their families by getting the Covid and flu vaccine.”

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