Why it seems everyone is getting sick this winter
One health issue has been on the minds of many readers in recent weeks. As Emilie from Florida wrote: “It seems everyone everywhere is sick at once.”
“My neighbors and all my friends have come down with coughs and colds,” Emilie explains. “My grandkids are back at school, and already they’re sick again. Myself, I have a cough from before Christmas, and a week ago, I had sore throat and body achiness. Is this what other people are experiencing, too? Is there more virus activity compared to pre-covid days?”
Yes, and probably yes. What Emilie describes is reflected in data from the Centers for Disease Control and Prevention. Covid-associated hospitalizations have been trending up since before Thanksgiving. Rates of coronavirus in wastewater is reportedly “very high”; they might even be higher than they have ever been since the initial omicron surge. Flu activity is also high, as are medical visits for respiratory illnesses.
I expect these numbers to be elevated for at least a few more weeks. Gatherings over winter holidays and new year festivities have further spread viruses, which continued as people returned to work and school.
In the meantime, many are experiencing what Emilie is reporting. Corinna from Oregon is also concerned that many of her loved ones are ill. “Could this still be due to the ‘immunity gap’ from missed infections during the pandemic?”
The immunity gap hypothesis is that social distancing, masking and other covid precautions reduced exposure to other viruses. When these mitigation measures stopped, people had decreased immunity to pathogens they normally would have picked up and therefore had more illnesses and became sicker as a result.
I think this hypothesis explains the higher-than-usual rates of hospitalization because of the respiratory syncytial virus (RSV) last winter. It’s also possible that some people who have only recently relaxed precautions are “catching up” and getting more illnesses now.
Another reason it might feel as if there is more virus activity compared with before the pandemic is that covid-19 is now embedded in the milieu of pathogens. There are more than 200 viruses that cause the common cold, plus influenza and RSV. Add covid to the mix, and there is almost certainly more viral activity during peak season compared with previous years.
“With three kids in elementary school, I can’t recall a single week in the last couple of months where one of them or my wife or I haven’t been sick,” wrote Anne from D.C. “Initially, we were testing for covid every time someone got sick, but now we don’t because we’d basically be testing every day. What’s your thought process for people with school-age kids on deciding when to test?”
Like Anne’s kids, mine have gone through several bouts of respiratory illnesses since the start of the school year. It often felt like they were just getting better when they’d come down with something else.
For most schoolkids and other generally healthy people, it might not be possible to test for the coronavirus and other diseases every time they show symptoms. Even if they do, they must keep in mind that the test might be negative because it’s too early in the course of illness for the virus to be picked up; a second or third test might be necessary, which is not practical for families with multiple kids who are getting runny noses a couple of times a month.
But there are two groups of people who should keep testing early and often. The first are those who are eligible for antiviral treatments. Paxlovid and other antivirals must be started early in the course of illness to be effective, and those who know they would take antivirals should find out as soon as possible if they have covid.
The second are those planning to see vulnerable individuals in person. These people should refrain from visiting while ill and take a rapid coronavirus test just before the visit.
Jim from Virginia wrote that he recently had covid. “It’s been a month, and I have the same symptoms again: Runny nose and I’m all stuffed up. Sore throat. I feel feverish, though my temperature is normal when I measure it. My doctor says this is another run-of-themill virus – not covid – and that I should let it run its course. Do you agree?”
I do. Some people recovering from covid develop rebound symptoms (with or without taking Paxlovid), but these tend to be in the 7 to 10 days after symptoms emerge. Jim almost certainly isn’t experiencing a rebound this far out from his recovery. Also, this is probably not a reinfection; he should have excellent protection from covid and is unlikely to contract it in the near future.
The most likely scenario is that he picked up another virus – one of hundreds in circulation. Thankfully, most of these illnesses resolve on their own, and people will improve with rest, hydration and over-the-counter medications such as Tylenol and ibuprofen.
Leana S. Wen is a professor at George Washington University’s Milken Institute School of Public Health and author of the book “Lifelines: A Doctor’s Journey in the Fight for Public Health.” Previously, she served as Baltimore’s health commissioner.