Over the past two months COVID-19 cases have remained relatively stagnant, after decreasing slightly following a peak in September. However, now new hospital admissions are climbing back to 20,000 nationally, as infections are starting to rise again.
“The national trend is very concerning. That it never really went down and now its starting to go back up again,” Dr. Peter Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor College of Medicine.
“I’m just worried that we are going to start seeing an upswing into another wave,” he added. “I think we could be in for something more significant as we get closer to the holidays.”
Hotez said the potential spike was predicted in some ways with the recommendation of the new annual COVID immunizations for those older than six months and 12 years old, respectively, by the Food and Drug Administration earlier this year.
According to the Centers for Disease Control and Prevention, Moderna, Pfizer-BioNTech and Novavax vaccines are monovalent vaccines containing a component of the XBB.1.5 Omicron variant. This allows the vaccine to target circulating variants such as BA.2.86 and EG.5.
Hotez said JN.1 – a descendant of the BA.2.86 variant – is the variant that medical professionals are concerned about as it has several escape mutations which result in the body’s immune system being unable to recognize or respond to a previously known pathogen.
RSV and Influenza are also rising alongside COVID and other respiratory illnesses detected in the winter months. Hotez said that RSV, which more drastically affects younger and older patients, is already affecting nearby pediatric hospitals.
He added that he had been told that many of Texas Children’s Hospital’s pediatric intensive care unit patients were coming in with the virus.
The winter season will likely see a syndemic – or the integration of more than three pathogens at a time – somewhat similar to the “tripledemic” that occurred last year.
With the possibility of contracting more than one of these illnesses at once, Hotez said everyone should be making sure to get vaccinated for as many of these viruses as possible to protect against them and evade significant illness.
“Too often, I’ve been getting reports and emails from people who are saying they talked to their primary care physician – especially if they’re an adult – their internist or their family care provider, and they say, ‘Well, let’s wait and see about the vaccine,’ he added. “And I don’t understand the logic of wait and see because now’s when you want to get immunized.”
This would mean taking one of the new COVID immunizations, the recently released RSV, influenza and pneumococcal vaccines for most adults.
Hotez said data also suggests that getting the updated COVID vaccine – which less than 20 percent of Americans have – lowers your risk of the likelihood of developing long COVID by 30 percent or more.
This occurs when someone who initially has the virus continues to suffer from the signs, symptoms and conditions long after they were first infected. It can last for a few weeks, months or years.
According to Hotez, a lot remains unknown about long COVID. It can affect those regardless of age and is usually more common in those who are unvaccinated or under-vaccinated with older immunizations.
He added that patients should get vaccinated to protect against other health factors, as doctors have also found that COVID and influenza are linked to heart attacks.
Hotez said that these viruses create inflammation in the plaques in the coronary arteries of those infected, which break off, causing myocardial infarction to occur.
“When we think about influenza and COVID, we think of them as respiratory pathogens,” Hotez said. “But I’d like to remind people, these are also cardiovascular pathogens as well.”
Hotez is also watching a fourth pathogen called Mycoplasma pneumoniae, a bacterial and respiratory infection that can lead to pneumonia and respiratory-related symptoms. It hasn’t been detected in the United States, but Hotez said it is circulating in parts of China and Europe.
The bacteria can cause infection in younger adults and older people but usually poses more problems for younger age groups – especially when they have other viral infections such as COVID, flu or RSV.
“I think the most important thing to think about is getting as many different vaccines to take as many of these diseases off the table or reduce their impact as much as possible,” Hotez said.
This article appears in Jan 1 – Dec 31, 2023.
