“It has seemed unrelenting over the past three years,” stated Ann Burke, vice chairman of medical affairs for Holy Cross Health within the Maryland area.

The covid-19 pandemic upended vacation plans in 2020 and 2021. While coronavirus stays a critical concern, this yr two different frequent respiratory viruses, influenza and RSV, are wreaking havoc — notably within the DMV, which is without doubt one of the areas with the highest flu activity in the country.

Ahead of Thanksgiving gatherings, medical doctors like Burke are urging individuals to take precautions like masking in crowded public areas and on airplanes, protecting coughs and sneezes, washing palms, and getting a flu shot and covid booster dose.

“Wash your hands and get your vaccine,” Burke stated. “Try to help us out.”

Burke additionally gave a warning for households with newborns, that are notably susceptible to devastating penalties from RSV: “I strongly recommend families with a newborn child restrict the number of visitors in their home. I know this is a really unpopular statement.”

As RSV and influenza have skyrocketed, covid has reached a plateau.

The District and Maryland are reporting similar levels of new cases as last year around this time, and Virginia’s weekly new cases are slightly lower than last year. But cases began to rapidly rise around Thanksgiving last fall when omicron emerged and created a record-setting spike in cases. So far, signs point to a much milder wave of covid cases this winter, according to epidemiologists and virologists who are monitoring the covid-19 variants currently circulating.

CDC warns of tough winter as flu, RSV and covid collide

With vaccines now widely available for all age groups and 68.7 percent of Americans through the primary coronavirus vaccine series, public health precautions that were previously required are now mere recommendations. Local officials have dropped mask mandates and testing requirements. Most school districts have ditched strict masking rules and jettisoned complicated testing and quarantine programs.

Vulnerable populations also have access to extremely effective antiviral treatments like Pfizer’s paxlovid that had not yet been authorized by the Food and Drug Administration last fall.

Still, few Americans have received an updated bivalent booster shot and strains on health care infrastructure remain.

“We still have around 400 individuals who are hospitalized with covid,” stated JinLene Chan, Deputy Secretary for Public Health Services for the Maryland Department of Health. “It hasn’t gone away.”

Chen said that people can safeguard their holiday plans and protect loved ones by taking precautions ahead of indoor gatherings. Wearing masks in crowded public spaces in the days leading up to a holiday celebration, washing hands, and staying home if you feel sick can prevent all three respiratory infections from spreading to other people.

“Getting the flu and covid shots are important,” she stated.

Already, the District, Maryland and Virginia are among the 16 U.S. jurisdictions that the Centers for Disease Control and Prevention says are coping with “very high” rates of influenza-like illness in what may be shaping up to be the most severe and early-onset flu season since the 2009 swine flu epidemic. And a spike in RSV has led to more sick children than can be accommodated in local pediatric intensive care units.

“It’s much too early for us to see a lot of influenza,” said Andy Pekosz, a virologist, professor, and vice-chair of the Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health. The story is the same for RSV, he added. The early and rapid uptick in cases may be a sign that these respiratory viruses will run rampant this fall and winter, prompting a severe and lengthy season for illnesses that can be deadly for some vulnerable populations.

“That’s the worst case situation — it’s coming in sturdy and can final lengthy,” Pekosz stated.

RSV results in between 6,000 and 10,000 deaths in adults over 65 and 100 to 300 deaths in kids beneath 5 every year, according to the CDC. Influenza killed between 12,000 and 52,000 people yearly between 2010 and 2020. But the previous two years have seen extraordinarily gentle flu and RSV seasons — maybe as a result of coronavirus mitigation efforts helped tamp down the unfold of different viruses as nicely, Pekosz stated.

Children and adults who get RSV sometimes expertise cold-like signs together with runny nostril and sneezing, however extreme circumstances can develop fevers, wheezing and even require air flow to keep up oxygen ranges. The flu normally brings fever, chills, physique aches, cough, runny nostril, sore throat, complications and fatigue.

What’s the difference between RSV, the flu and covid-19?

In the week ending Nov. 12, Maryland reported 5,144 positive influenza exams and Virginia reported 2,607. The District had 593 confirmed cases of influenza. The charges of flu-like sickness throughout the DMV are already as excessive or larger than the standard peaks seen a lot later within the flu season, round late January by March.

It stays to be seen if circumstances will proceed to rise, however epidemiologists say the very gentle flu seasons of 2020 and 2021 could have left massive parts of the inhabitants with little immunity in opposition to the virus.

Travelers who could also be leaving the DMV and returning after Thanksgiving ought to test on the degrees of respiratory viruses at their vacation locations, stated Montgomery County Acting Health Officer James Bridgers.

“Check the local health department if you’re travelling outside of the DMV and be mindful of any respiratory illnesses that you may be going into,” he stated. That is particularly true for individuals headed to the south or states like California, Colorado and Texas, the place influenza and RSV have unfold quickly and much sooner than anticipated by medical doctors and epidemiologists this yr.

In Virginia, hospital and pressing care visits for RSV and flu-like sickness have practically quadrupled in latest weeks, stated deputy state epidemiologist Laurie Forlano. Those numbers could hold climbing as individuals more and more collect indoors as temperatures cool and holidays method. Coronavirus, which is just barely up in Virginia during the last week, can also unfold extra.

“It’s a little too soon to tell, I think, where that’s going to go as the weather gets colder,” Forlano stated. “We tend to be inside or around other people more and that can help these viruses transmitted from one person to another.”

Even as winter approaches, some jurisdictions, like Arlington County, have applied plans to cut back coronavirus testing and county-sponsored vaccination clinics as demand has tapered off in latest months. Arlington introduced that its testing kiosks will shut by the top of November, and its county-run vaccine clinic will completely shutter on Dec. 17. Virginians can seek for vaccine clinics and test sites inside 100 miles of their zip code on the Virginia Department of Health web site.

Forlano stated closing these public assets is a part of a transition towards treating coronavirus like different diseases — together with influenza — which are routinely handled by physician’s workplaces and pharmacies. People will nonetheless have the ability to entry vaccines, boosters and fast exams at pharmacies and get PCR exams from well being care suppliers, she stated.

“The good news is that we’re in a much different place today than we were … two years ago with covid-19,” she stated. “We have plans in place should more testing become necessary, but I’m glad that we have a much different and more robust landscape for both testing and vaccines at this point in time.”

Montgomery County, Md., has not yet begun to wind down coronavirus testing and vaccination centers — but the county may consider doing so in January after the holiday season comes to a close, said Bridgers. Maryland’s most populous county expects to see consistent demand for testing, vaccines and boosters through the end of the year, he added. In the week ending on Nov. 13, more than 900 people got covid vaccines in Montgomery, including more than 200 administered at county-run sites, and the county performed more than 900 covid tests, Bridgers said.

How to use at-home covid tests and where to find them

“We’re urging people as we go into the holiday season to make sure they’re up to date on their vaccinations,” and get examined for covid-19 earlier than gathering with household and buddies, Bridgers stated.

Pekosz agrees that coronavirus tests are a smart idea before gathering for Thanksgiving dinner, but warned that a single rapid test does not guarantee safety. Taking at least two tests over several days — called serial testing — will give a more reliable result. But no rapid test is perfect, Pekosz said, and anyone who feels even a little bit unwell should stay home.

“People want to see their families,” he said. “Maybe they’ll ignore that scratchy throat or sniffle or fever that they have. But you can transmit [these viruses] before you actually show symptoms. Even with the slightest sign of symptoms, people should be more weary.”