Background
This flu season is bad compared to recent years. But it’s not just flu. COVID is still with us. Thankfully we are not seeing significant increases in rates, but it is also not decreasing. On top of that, the very common virus, RSV, or Respiratory Syncytial Virus, is at the highest levels ever seen in the US. RSV usually just causes a bad cold in older kids and adults, but even in a typical year, it is the most common cause of hospitalizations for young otherwise healthy children from infants through about 3 years old. Because of the current high Flu and RSV rates, in many areas of the country, pediatric advanced care units in hospitals are completely saturated.
While there is some debate, many epidemiologists believe that the lockdowns of the past 3 years have contributed to lowering general immunity to common respiratory viruses including Flu, RSV, and common cold viruses. Before the lockdowns, people were regularly exposed to these viruses and maintained a level of immunity that helped prevent or mitigate viral illnesses. As we have all learned with COVID, immunity against some viruses is short-lived, and after three years of fairly tight respiratory protections, our respiratory disease immunity is low.
Prevention
For Flu, it’s no coincidence that the US region with the lowest average vaccination rate, the Southeast, is also the region with the highest flu impact. It’s not a perfect correlation, but it shows that flu vaccines work. Please get a flu shot! You cannot get the flu from a shot and while you may feel a little under the weather for a day after the shot, that’s much better than being sick in bed for a few days with actual flu.
For COVID, at least get the basic vaccine. The primary series greatly reduces the rate of severe disease and impacts on hospitalization. Listen to my earlier discussions for my thoughts on boosters. On balance, while I’m in favor of boosters for many people but not all, the primary 2-shot vaccination series is the most impactful.
For the other seasonal respiratory diseases, there are no vaccines, at least yet, so protecting yourself is important.
We know that with COVID we went back and forth on whether or not surfaces are important contributors to spread, but for many other respiratory viruses, including flu, which is just about as important as COVID right now, there is no question that infectious particles on surfaces, do significantly contribute to transmission. That means that one of the biggest things you can do is hand hygiene: Wash your hands frequently, use hand sanitizer regularly, and wipe down shared surfaces before you touch them throughout the day, or use a napkin or such when you do touch shared surfaces.
Masks are much more debatable. I will not rehash the COVID mask debate, but for flu, many years of experience have taught us that masks are much more useful in preventing someone who has flu from spreading particles when they cough or sneeze rather than preventing someone who is not sick from catching it. As a general rule, flu particles don’t stay airborne long enough for masks to play a big role in preventing you from inhaling large quantities of particles. Some people are still more comfortable with masks and especially since COVID is still around, high-quality masks, like N95 or KN95, or KF94 may help you feel more comfortable.
The layered defense model against respiratory disease is still useful including vaccination, social distancing, avoiding being around ill people, avoiding being around others if you have cold or flu symptoms (even if mild), good hand hygiene, and paying attention to frequently touched hard surfaces are all good things to keep in mind and will help you reduce your risk of flu and other respiratory infections.