The triple epidemic of influenza, covid and syncytial virus (RSV) is likely to put European hospitals under “severe pressure” in the coming weeks. This was warned by the European Center for Disease Control (ECDC), which signaled an early onset of the proliferation of two common seasonal viruses up to before the pandemic (influenza and syncytial, which causes bronchiolitis). CoV-2.
“The end-of-year holiday period, with social gatherings, shopping and travel, poses an additional risk of transmission of RSV and other respiratory viruses. Strengthening health systems and supporting health workers should be prioritized due to the risk of severe pressure on health systems in the coming months. Vaccination against flu and covid should also be prioritized among risk groups,” she said. in a note Andrea Ammon, director of the ECDC.
Circulation rates of the virus are not unusual, but they are earlier than typical dates. So much so that in Spain RSV seems to have reached its peak, according to the latest epidemiological report from the Carlos III Health Institute, which measures up to December 4. The flu is taking over, with a decisive rise, the coronavirus has remained at stable levels for weeks. This cocktail adds, according to the sentinel surveillance network (the one used for respiratory virus surveillance before the pandemic), 845.8 cases of respiratory infections per 100,000 population, about double compared to the same week last year.
This increased circulation of the virus is also what could cause a higher incidence of severe cases of strep A, according to the ECDC itself. Some countries, starting with the United Kingdom, have reported much higher than expected rates on these dates and at least nine deaths from this pathogen, one of the most common in humans and which in the vast majority of cases results in mild infections. In conjunction with viral infections, it can lead to a more concerning condition in some children, who bear the brunt of severe cases of strep.
Doctors consulted by this journal do not consider the situation to be entirely exceptional and see it as a return to the pre-pandemic winter viral outbreaks, which put health systems under strain every year. Pedro Gullón, of the Spanish Society of Epidemiology, recalls that “every year we have had a saturation” of emergencies due to influenza and bronchiolitis in children. “That doesn’t mean these infections aren’t worrisome, and hopefully it helps to not see the difficulties of dealing with high hospitalizations or RSV as something normal, as if they’re new every season.”
Along the same lines, Vicente Martín, professor of preventive medicine and member of the Spanish Society of General Practitioners (Semergen) manifests himself: “It is a peak which, although it does not go much beyond expectations, contributes to overloading the system”. Martín says that the situation is still far from the great waves of covid that have saturated primary schools “not so much because of the cases, but because of the bureaucratic duties of granting sick leave”.
To properly assist these cases in primary care, Semergen claims a “diagnostic capability” that doesn’t exist today. “Antigen tests are only indicated to detect covid in people over 60 and in healthcare workers. We have to tell the others to get it at the pharmacy. And they usually don’t take it well,” complains José Polo, its president. That is to say: Anyone can buy a test that distinguishes the flu from the coronavirus, but your doctor can’t do it in the office.
Neither hospital burden reaches the pandemic’s harshest levels and specialists believe it will stay away from those extremes. Although the number of people hospitalized for causes other than covid is at its highest level since the coronavirus broke out, it is partly offset by fewer hospitalizations due to covid, according to data from the Ministry of Health. And, while respiratory viruses are certainly contributing to an increase, there may be other causes that explain it, such as the operations that are being done now that have not been performed at other times during the pandemic.
ISCIII statistics show that today the flu is causing more hospitalizations than covid (2.5 against 2.3 cases per 100,000 inhabitants), although this may in part be due to greater circulation: 160 against 108 cases per 100,000 inhabitants. Between the two figures is the respiratory syncytial virus: 131 diagnoses for every 100,000 inhabitants, according to measurements made by primary care sentinel doctors.
Virus recommendations
Given the increase in infections, the ECDC is recommending to health authorities what Gullón describes as “fairly general” advice, such as communicating the risks to the public, raising awareness among health professionals, ensuring RSV prophylaxis for high-risk newborns or promote hygienic activities, such as wearing masks or adequate ventilation.
The center is also calling for an increase in vaccination against flu and covid. In Spain, the fourth dose (the second reinforcement) has not been exceeded according to the latest health data Half of the population over 60 years oldwhereby it is indicated to be more vulnerable.
The elderly population is also at risk of RSV, which, although it may be more severe in children under five years of age (particularly in infants under six months), “is considered an important cause of mortality in the elderly and those at high risk ”, recalls the ECDC.
