Flu, RSV and Covid may have peaked.  But the threat is not over.

Flu, RSV and Covid may have peaked. But the threat is not over.

ER visits related to three of the most disruptive viruses—the flu, respiratory syncytial virus, and covid—are declining across the country.

But does that mean the dreaded “triple epidemic” is over? Hardly, experts say. Viruses are notoriously difficult to forecast.

“We’ve all learned in the last two years that when you try to predict COVID, you get slapped in the face,” said Dr. Katie Passaretti, vice president and chief corporate epidemiologist at Atrium Health in Charlotte, North Carolina.

Still, hospital emergency room visits for the biggest viral threats began declining in December, and the decline continues this month. This is especially true for the flu.

The children contracted double viral infections.

Trying to guess what the flu will do between now and the end of flu season is “dangerous,” warned Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center in Nashville, Tennessee. “It is impossible to predict what will happen next.”

As most families already know, the flu and other viruses have been especially hard on children compared to adults, according to a study released Thursday by the Centers for Disease Control and Prevention.

Schaffner is a co-author with Dr. Christine Thomas, an epidemic intelligence officer at the CDC who works with the Tennessee Department of Health.

“We were very curious to see what this year would be like” after several years with almost no flu, Thomas said.

Their report focused on 4,626 people in Tennessee who had a flu test in mid-November. The researchers found that the flu spiked early and hit children hardest. Children were twice as likely as adults to test positive and tended to be sicker, especially if they were infected with multiple viruses at once, such as the common cold in addition to the flu.

A separate study from earlier this week found that children hospitalized with covid had more severe symptoms if they also had another virus.

Children ages 5 and younger are at risk because their tiny immune systems may not have been exposed to many common viruses during the pandemic.

“If you have a double infection, it tends to make you a little sicker, you’re likely to stay in the hospital a little bit longer,” Schaffner said.

Flu hospitalizations for very young children in Tennessee have already reached the highest levels seen in other bad flu seasons, at 12.6 per 100,000, the new study found. This is similar to what has been reported nationally.

But this season is not over. While most flu cases so far have been A strains of the virus, B strains tend to appear in the spring.

“I suspect we will have more bumps in the road in this respiratory viral season,” Passaretti said. She was not involved in the new study.

Few of those tested for flu in the Tennessee report were vaccinated. Only 23% of children and 34% of adults had received their flu shots.

And having influenza A does not offer immunity to the B strain. That is, a person can get the flu twice in one season.

“That’s one reason to get vaccinated,” Schaffner said. “The flu probably won’t go away completely until we get to the beginning of summer.”

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