Given that we are living through THREE global health emergencies (COVID, polio, and monkeypox), new vaccines are being approved, new outbreaks are occurring, and the reality that being healthy is indeed a radical selfless act of loving others (read: we need to redefine what it means to be healthy), “Three Things Thursday” highlights three things I am paying attention to as an epidemiologist each week.
Hoping these posts help to educate and empower you
to be healthy and create healthy communities.
As we prepare for the holiday season to begin next week and as those of us in a snowbelt prepare for inches (and in some cases feet) of snow1 that will force many activities indoors, we each need to take responsibility for creating healthy communities. We all must participate in the work to slow the spread of infectious diseases and keep each other from getting sick. In order to do this, please —-
Get vaccinated.
We all need to receive our COVID-19 booster (3-4 months after your last shot or most recent infection) and our annual flu vaccine. The new COVID booster is highly effective against severe illness and death (more below). And the flu shot reduces the risk of being admitted to the ICU by 82%.Stay home when you are sick.
As we are facing a tripledemic, there is no such thing as just a sore throat or just a little cough. A cough, sore throat, headache, fever, and runny nose are all symptoms of the three diseases behind this tripledemic. Regardless of what virus is causing your symptoms, it is best to stay home until you have been symptom-free (without medication) for at least 48 hours. And when you return to work/school, wear a mask for a couple of days to prevent others from getting ill.
Wear a mask when necessary (not always).
Masks can be worn as a form of protection or prevention. If you want to avoid exposure to a respiratory virus, a well-fitting n95 or kn95 mask will reduce your exposure to virtual particles and decrease the likelihood of you becoming sick. If you have to be in a crowded indoor environment with poor air circulation, a mask will provide you with protection. Additionally, an individual can wear a mask to prevent others from contracting their illness. I highly recommend wearing a mask for ~5 days after you’ve been sick to ensure you are not sharing your illness with others. And if you cannot stay home while you are symptomatic (maybe you don’t have paid sick leave), please wear a well-fitting mask at all times and do not take it off while you are around others.
Practice proper hygiene.
Both influenza and RSV are spread via respiratory droplets. And those droplets can live on surfaces for several hours. To prevent the spread of these diseases, we all need to practice sneezing and coughing into our elbows (to prevent droplets from landing on surfaces). We also need to properly wash our hands and avoid putting our hands near our eyes, nose, and mouth.
It’s ok to stop reading here! Or you can ask a question —
Or continue. Today’s three things Thursday —-
Cases of RSV & Flu Continue to Increase
Cases of Respiratory Syncytial Virus (RSV) — a mild illness that produces cold-like symptoms in adults but can cause pneumonia and bronchitis in young children — continue to increase across the United States. The rate of hospitalizations among children with RSV is still really high; however, hospitalizations did decrease during the past week.
As RSV cases increase, so do cases of influenza.
Influenza A is by far the most common type of flu circulating.
On the other hand, there has been no increase (or decrease) in COVID cases across the US, and wastewater levels nationally are declining (or at least stabilizing). Please note: COVID is still out there and still causing illness, hospitalizations, and death.
If you are home with a fever, sore throat, stuffy nose, and cough — how do you know what is causing your symptoms?
The only way to know is to get tested. You can rule out COVID with a negative home test. But to really know what is causing your illness, you need to be tested (a PCR test is the most accurate). There are antivirals for the flu and COVID. So there is value in knowing what is causing your illness.
And don’t forget that rhinoviruses, which cause the common cold, are also spreading and could be causing your illness. Be sure to follow steps 1-4 above to stay healthy and prevent spreading any virus to another person.
Masking = Low-cost, Highly Effective Intervention
Researchers in Boston published a really great study on the effects of masking in the New England Journal of Medicine this week. The study looked across all K-12 schools in the Boston area during the 2021-22 academic year. The researchers found that schools that kept a masking mandate in place during March-June 2022 saw significantly fewer cases of COVID-19. In fact, schools without a mask requirement experienced more than 12,000 additional cases of COVID resulting in 17,500 missed school days for students and 6500 for staff.
In reviewing the study, Meagan Fitzpatrick, an epidemiologist and infectious-disease transmission modeler at the University of Maryland School, Baltimore (my alma mater!!), called the study well-designed and well-executed. Additionally, she said —
“The difference in COVID risk between districts with and without masking is striking,” she wrote in an email. If anything the study underestimates how well masks control disease, because even in schools with no mandate, some students and staff members probably continued to wear masks.”
The study findings do NOT support universal mask-wearing all the time. Instead, they provide clear evidence that during periods of high transmission — in the local community or within the school — that masking is a low-cost, highly effective intervention to prevent disease spread and keep kids learning in person.
Positive Results from Moderna
Also published in this week’s New England Journal of Medicine are the results from Moderna’s phase 2/3 clinical trial that is testing the safety and efficacy of the new bivalent COVID booster shot. The study included 511 adults (ages 19-89), who had all previously received the primary series of COVID shots plus two of the original boosters.
Researchers found that the new bivalent boost induced significantly higher neutralizing antibodies2 against BA.4 and BA.5 (compared to the original booster shot, which is no longer available). Additionally, in a subset of 40 participants, the bivalent vaccine showed robust (read: really good) activity against the new BA.1.1 subvariant that is quickly spreading.
This is all really good news!
Additionally, the researchers found that individuals receiving the new bivalent booster experienced fewer side effects post-vaccination (compared to the second and third doses of the Moderna vaccine). Approximately 76% of participants experienced pain at the injection site (no surprise), 50% reported fatigue after being vaccinated, and (just) 4% reported a fever.
This is further evidence that the COVID vaccines and new bivalent boosters are safe and effective. Please, please, please get vaccinated.
Questions? Anything you need or want to know as we head into Thanksgiving week? Please let me know —
Winter is in full effect here in NW Pennsylvania. Our kids have a 2-hour delay this morning because lake-effect snow is falling (and I’m assuming the salt trucks and plows were not ready this early in the season). The view from my dining room looks like this —
Neutralizing antibodies are specialized antibodies/proteins that bind to a virus in your body and prevent the further spread of disease. We can measure antibodies in the blood.