Here in early 2023, it seems like everyone knows someone who got a virus for the holidays. Doctors' offices have phones ringing off the hook and the hospital is as busy as ever. What’s going on? Dr. Adam Weston, an infectious disease physician with Tufts Medicine Lowell General Hospital, provides some answers.
What are you seeing right now in terms of viral spread?
We’re seeing an uptick in COVID patients, but the general severity is much less than some prior surges and the great majority are not critically sick. Flu is the other big one we see most years and that seems to be starting to slow down. RSV was active earlier in the fall but is trending down. And then there are the run-of-the-mill respiratory viruses, and there are literally dozens of them and variations on those.
What is driving the spread this year?
A lot of what we are seeing is behaviors returning to normal. People are being exposed to things they haven’t been exposed to for a couple of years. We’re not social distancing, not masking and kids are acting as their normal selves and being vectors, bringing it all home. We’ve forgotten what a normal cough, cold and flu season looks like.
Did masking make us more vulnerable to colds this year?
We have very good understanding of this from COVID, which is a coronavirus. Many colds you get are some kind of coronavirus and the immunity to those coronaviruses is very short-lived. That’s why we have needed these booster vaccines. For many, the immune system has not been challenged. We didn’t have the routine exposures to all these viruses, so over time we don’t have as much innate immunity to fight those off.
If someone is feeling sick, when should they call their doctor?
It depends on your underlying health status. If you have a significant health condition or are immunocompromised in any way, you are at higher risk for more severe disease from COVID and flu. For those people, even if you are not that sick right now, you should call your doctor. If you are an otherwise healthy person and you are not having trouble breathing, you can eat and drink and get around, then you can probably weather it on your own. If you do start to have trouble breathing or have pain in your chest, call your primary care provider unless you feel it is life-threatening.
Do we expect things to peak soon or is this likely to be around all winter?
The hope is we’re seeing a peak. The way I track COVID is wastewater data, and that shows it peaked a few days ago, just after New Year’s, which makes sense. People get together for the holidays and it takes 2-3 days before you test positive. Flu and RSV are trending down as well.
Should people consider masking now?
That’s an individual decision. There is no harm in masking, but those folks who have significant underlying health conditions or are immunocompromised, it’s not unreasonable for them to mask in public, especially indoors. Or wear a mask if you just don’t want to get sick.
What else can people do to prevent getting sick?
The easy ones are washing your hands regularly, covering your cough with your elbow and staying home if you are sick. If you haven’t been vaccinated for flu or COVID, or received the most recent COVID booster, that’s the other thing you can do to help. The current booster is substantially better than even the original vaccine.
