Infectious illnesses beginning to decline
COVID-related deaths in California dropping, and positivity rates for flu and RSV heading back toward zero
Notice how less crowded the cold, flu and COVID-19 aisle is at your local pharmacy?
In California, respiratory virus season is winding down. Fewer colds, coughs, fevers and sick days are interrupting our day-to-day lives now than in late December and early January, when the big three respiratory viruses were all peaking in the Golden State.
Last year was COVID-19's least deadly, with 6,900 deaths in California, still far outpacing the 400 flu deaths the state saw in the same period.
With just a few weeks left in the season, flu and RSV positivity rates and hospitalizations are headed back toward zero, where they tend to stay for much of the year. COVID-19's curve is also on the way down this month but will be more of a roller coaster in the next six months than the other respiratory viruses.
“RSV and influenza have a very well-defined seasonality to them, from late fall through March typically,” said Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley's School of Public Health. COVID-19 tends to be at its worst in the winter months, but “COVID has not yet established seasonality,” and we can see peaks in transmission of the virus in the spring and summer as well, he said.
By early February COVID-19 positivity rates, the percent of tests that come back positive, were down to 7.1%, from a peak this season of just over 12% at the beginning of January. Influenza has dropped more dramatically, down to about 6.5%, after reaching nearly 19% at the end of December.
Hospitalizations for both, and for respiratory syncytial virus — or RSV — are down to a fraction of their recent peaks, according to data from the California Department of Public Health.
“Flattening the curve,” was a rallying cry for much of the early COVID-19 pandemic, a call to collective action to help stop the spread of the coronavirus which has now killed nearly
1.2 million people in the United States. But since it was first charted, the COVID-19 curve has been everything but flat.
Since 2020, California, and communities around the world have experienced distinct spikes in transmission of the novel coronavirus each year, rather than the one big winter spike pattern the other respiratory viruses tend to follow.
And while this flu season has been relatively unremarkable, comparable to average years before the pandemic, COVID-19 deaths are still far outpacing deaths from the other viruses we contend with regularly.
Since Oct. 1, the official start of the virus season, 460 people in California have died of the flu. Meanwhile, 2,400 died from COVID-19, even now that we have widespread vaccination.
The threat of hospitalizations from a respiratory virus is lower this month than any time since December, but we are not quite out of the woods yet, Swartzberg cautioned. “The respiratory virus season is waning,” he said, but there is always a chance of a lateseason surge in influenza B, a different strain than what's been going around, and COVID-19 remains at “medium” levels according to wastewater data in Santa Clara County.
California officials announced in January a shorter recommended isolation period following a positive COVID-19 test, from five days to one — 24 hours without fever. Those who test positive but have no symptoms no longer have to isolate, they just have to wear a mask for 10 days or until they test negative, according to the state guidelines. California, once one of the strictest states in the country for COVID restrictions, is leading the pack when it comes to loosening its guidance, and the Centers for Disease Control and Prevention is poised to follow suit.
The California Department of Public Health said the change was to better align the state's guidance with that for other respiratory illnesses such as RSV and influenza.
“The reason for these changes is that we are now at a different point in time with reduced impacts from COVID-19 compared to prior years,” the California Department of Public Health said.
As Californians have built up immunity through previous infections and vaccines, the dramatic decline in related deaths is unmistakable over the last three years. In 2021 there were 45,000 COVID-19 deaths. The next year there were fewer than half as many deaths, around 21,000, and the annual total dropped again in 2023, to a third of that.
Overall deaths in 2023 were lower than any year since COVID-19 crowded the scene, and flu deaths have been lower this year than last year's tripledemic panic. All things considered, Swartzberg thinks we're in a good spot: “I'd say let's enjoy where we are, right this moment.”