Concerns of a 'tripledemic'

According to data from CDC, levels of respiratory illnesses are currently either "high" or "very high" in most U.S. states. "After the holidays, after we've traveled and gathered, we are seeing what is pretty typical of this time of year, which is a lot of respiratory viruses," said CDC Director Mandy Cohen.

COVID-19

Currently, a new omicron subvariant called JN.1 is driving a large number of new COVID-19 cases across the United States. JN.1 is the most prevalent COVID-19 variant at the moment, making up around 60% of new COVID-19 cases in the country as of Jan. 6.

COVID-19 hospitalizations have also been rising in recent weeks. According to CDC data, around 46.7% of counties nationwide are seeing moderate to high COVID-19 hospital admission rates. For the week ending Dec. 30, there 34,798 new COVID-19 hospitalizations, a 20.4% increase from the week before.

Although COVID-19 hospitalization rates are lower now than in previous years and there is less severe illness overall, health experts are still encouraging people to practice safety precautions, such as using masks and staying home when they're sick, and to get vaccinated when possible. Currently, only 19% of adults and 8% of children have received the newest COVID-19 vaccine.

Flu

Flu cases and hospitalizations are also on the rise across the country. For the week ending Dec. 30, there were 20,066 new patients admitted to the hospital with the flu. There was also a 17.5% increase in patients testing positive for the flu.

"The influenza virus is the thing that's really skyrocketing right now," says Steven Stack, public health commissioner for the state of Kentucky and president of the Association of State and Territorial Health Officials. "Influenza is sharply escalating and driving more hospitalizations."

Much like with COVID-19 vaccines, uptake of the flu vaccine also seems to be lower than in previous years. According to CDC data, almost 8 million fewer were vaccinated against the flu by mid-December compared to the same period in 2022.

So far, CDC estimates that there have been at least 10 million flu cases, 110,000 hospitalizations, and 6,500 deaths this flu seasons. There have also been 27 pediatric flu deaths.

RSV

Although CDC data suggests that RSV test positivity peaked in November, RSV is still elevated in some areas of the United States. For example, Tennessee recently reported its highest number of confirmed RSV cases in more than a year. The Kansas City area of Missouri has also reported an increase in positive antigen and PCR tests for RSV.

Although there are two RSV vaccines available for older adults, uptake has been low. As of mid-December, only 10% of nursing home residents had received an RSV vaccine.

A preventive monoclonal antibody called Beyfortus meant to protect infants from RSV has also been in short supply since October. CDC has advised doctors to reserve their doses of the treatment for patients with the highest risk.

Health systems are reinstating mask mandates

As respiratory viruses continue to spread across the country and drive hospitalizations, health systems in several states have reinstated mask mandates to protect their staff and patients.

In Massachusetts, Mass General Brigham and UMass Memorial Health are requiring staff to wear masks while making them optional for patients. At Boston Medical Center, staff, patients, and visitors who show symptoms of a respiratory illness or are in clinical areas are required to wear a mask. Berkshire Health System and Baystate Health are requiring everyone to mask up in their facilities.

In Illinois, three of Rush University System for Health's hospitals — University Medical Center, Copley Medical Center, and Oak Park Hospital — have policies similar to Boston Medical Center, but also require people to wear masks in waiting and registration areas.

NYC Health + Hospitals in New York City is requiring masks at its 11 public hospitals, 30 health centers, and five long-term care facilities. Similarly, the Los Angeles Public Health Department said all healthcare facilities in Los Angeles County have reinstated mask mandates.

Other health systems that have implemented mask mandates again include MultiCare in Washington State and Main Line Health in Pennsylvania.

Aside from masking requirements, Marcus Plescia, CMO for the Association of State and Territorial Health Officials, said there should be a greater push to vaccinate healthcare workers.

"That's important not just because we don't want health care workers to get sick and give it to their patients but also, you know, when you have a lot of health care workers getting sick, this whole capacity thing becomes problematic," Plescia said. "Because what we're hearing now is that hospitals are less concerned about not having enough beds. They're more concerned about having enough health care workers to staff those beds." (Choi, The Hill, 1/7; Appleby, KFF Health News, 1/8; Huang, "Shots," NPR, 1/5; Martichoux, The Hill, 1/5; Bettelheim/Millman, Axios, 1/5; DeSilva, Modern Healthcare, 1/5; CDC COVID Data Tracker, accessed 1/8; CDC Weekly U.S. Influenza Surveillance Report, accessed 1/8)

Given the influx of respiratory diseases in the United States, health experts are advising caution. Here are five ways you can keep safe this winter.