Entering the Christmas season of last year, Rising cases of Covid-19 overwhelmed hospitals. This year, hospitals they have been overwhelmed by a combination of Covid, respiratory syncytial virus (RSV) and flu. Along with RSV, the record number of flu cases pushing children’s hospitals near capacity is a worrying sign that the current flu season will be the worst in years. Faced with a particularly acute crisis, pediatric hospitals have called upon President Joe Biden will declare an emergency to provide more resources to respond to the current surges.
This “tripledemia” of flu, Covid and RSV is a reminder that even when the pandemic ends, the threat of seasonal respiratory viruses remains. Fortunately, our set of coping tools is similar to what works alone to suppress covid, starting with the most basic and flexible level of protection: masking. When and where respiratory viruses are increasing, mask mandates must be reinstated.
It is difficult for people to obtain adequate, high-quality risk information and apply it in a society that has reverted to pre-pandemic norms.
Skins work, and more importantly, they don’t need to work perfectly to have a positive impact. A recent study found that Boston school districts that had lifted the mandates averaged 45 more Covid cases per 1,000 students and staff than those with mandates. Other evidence has suggested that masks are also effective against influenza, with some scientists suggest that widespread masking during the first two years of the pandemic contributed to the record low flu rates and RSV observed in those years.
RSVa respiratory illness that causes cold-like symptoms and can be especially serious for young children and the elderly, spreads through the air like Covid but also through contact on surfaces. This means that RSV, for which a vaccine is still being developed, developed – can be mitigated by wearing masks and washing hands.
in a typical year, RSV causes up to 80,000 hospitalizations and 300 deaths among children younger than 5 years, and up to 10,000 deaths and 120,000 hospitalizations among adults 65 years and older. As with the flu and now with covid, individual adverse outcomes are rare relative to the number of cases, but further spread and more infections mean more people experience serious outcomes. Even with the pandemic receding, an average of 300 people are still dying from covid every day. Unvaccinated people face six times the risk of death according to recent databut many people who die now are also vaccinated.
Unfortunately, as mask mandates and public health messages have faded and complacency or resignation takes hold, voluntary public compliance with healthy behaviors like wearing masks and receiving booster shots is declining, while companies continue Back sick leave and remote work policies.
Hospitals remain overwhelmed as they face the chronic stress of recent years. and personnel issues. Although children’s hospitals bear the brunt, the entire system is struggling and emergency room Wait times have increased. Masking may not prevent all infections, but preventing any infection helps ease the burden.
Mask mandates not only stop the spread of disease, but also have useful psychological benefits. It is difficult for people to obtain adequate, high-quality risk information and apply it in a society that has reverted to pre-pandemic norms. Promoting the use of masks through official messaging (ideally supported by the free provision of high-quality masks such as N95s) removes the onus on people to find out “what is safe”.
Even if governments do not apply broad mandates, institutions and events can apply their own. The Supreme Court recently ruled that the Transportation Security Administration effectively have the authority to command masks. Studies show that when two people mask up it is more effective than when one person masks up, and a mandate preempts the discomfort of having to ask people to cover up or having to disclose a high-risk condition.
From our experience with Covid, disease mitigation should be an ongoing practice that can be dialed in as needed rather than a switch that is turned completely on or off. We should always encourage the use of masks during fall and winter seasons (as these respiratory viruses tend to spread more efficiently in cooler climates due to changes in humidity and the time people spend indoors) and in crowded places like public transportation and grocery stores.
Behaviors such as hand washing (especially relevant to RSV) and staying home while sick should also be promoted, along with policies that allow people to do so. seventeen states and countless cities have already required paid sick leave of some form; the federal government should do the same. These policies have the potential to facilitate cultural and behavioral change in the way we approach disease and public health, even in «quiet» years.
Understanding that viruses will continue to be a threat reduces the “covid is over” mentality and adds more pressure on Congress to sustainably fund mitigation measures. Currently, the Covid response is Under threat because Congress has not reached an agreement on a spending package. As a result, covid vaccines may not be free next year and the development of the new generation of intranasal covid vaccines in the US could suffer without more funding.
This partisan gridlock and congressional inaction also translates into anemic efforts to enforce clean air standards, even though adequate ventilation can limit the spread of airborne pathogens. The White House is promote such effortsbut without strict building codes and funding for renovations, such upgrades are left to the discretion of individual building owners.
We are all tired: of the pandemic and the resulting disruptions to our lives, of taking mitigation measures, and of being sick. But we cannot sit still while our health systems are challenged again. And even when this challenge passes, we will have to deal with future waves. The pandemic has taught us that levels of community transmission of respiratory diseases can increase rapidly and unpredictably. Fortunately, it has also taught us how to take steps to lessen its dangers.