The latest on preventing the big three respiratory viruses: COVID, flu and RSV

We’re entering a challenging time of year, when COVID-19, flu and RSV collide.

First, let’s look at preventing COVID-19. Boosters are available — in theory. While the supply of COVID-19 booster vaccines should be sufficient, there are reportedly issues with distribution, in part due to the shift of vaccine costs being handled through the private health care industry instead of the government.

There may also be more demand than was anticipated — a Kaiser Family Foundation poll found that nearly half of adults said they will “definitely” or “probably” get the new booster.

That’s more than double the approximately 20 percent of adults who received the bivalent booster shot. But as of early Tuesday, just around 11,000 Minnesotans had received the new booster, which is about 0.2 percent of the population.

If you have insurance, it should cover the cost of the shot. If you don’t have insurance, the vaccine should be available for free via the Bridge Access program, which is searchable at Vaccines.gov. The Minnesota Department of Health has additional low- or no-cost vaccine information.

Testing if you feel sick is another way to help prevent the spread of COVID-19. If you’ve already gotten your free at-home tests from the state of Minnesota and want more, the federal government is again offering free tests by mail.

Flu season could come early

If you’re considering a flu shot this year, you may want to get it sooner than later. While seasonal flu patterns can’t be fully predicted, we can look to the most recent flu season in the southern hemisphere for some idea of what we can expect.

The flu season started early in several South American countries this year, indicating we could have an early onset of widespread flu here as well.

Another report from South America indicated that this year’s flu vaccine reduced the risk of hospitalization by 52 percent during the first part of the flu season this year. This is up slightly from the year before, which had an early-season effectiveness of 47 percent.

Talk to your health provider or visit the department of health website for more information about getting this year’s vaccine.

New preventive options for RSV available this year

Last year a particularly high number of infants and young children were hospitalized with respiratory syncytial virus, or RSV, pushing many hospitals to capacity while also managing COVID-19 patients and flu patients.

That was in part because COVID-19 protective measures such as masking and isolating led to a decrease in natural immunity to RSV among infants and young children.

This year, however, health officials are optimistic for a milder RSV season since the Food and Drug Administration and the Centers for Disease Control and Prevention approved two new preventatives designed to protect and limit severe illness in infants.

The first is nirsevimab (or Beyfortus), a monoclonal antibody designed for infants up to 8 months old entering their first RSV season, and young children between 8 and 19 months who are at higher risk.

The second is Abrysvo, a vaccine designed to be given to pregnant people during the RSV season. Older adults are also at higher risk of severe illness from RSV. Fortunately, the CDC has also approved two new RSV vaccines for adults 60 and older.

If you think you or your young child may be eligible to receive an RSV vaccine talk to your healthcare provider.

COVID hospitalizations still low, but highest since early April

The latest data, released Thursday by the Minnesota Department of Health, indicate that hospitalizations related to COVID-19 continue to rise in the state.

As of the week ending Sept. 19, hospitals admitted an average of 29 people each day with COVID-19. Hospitalizations have increased steadily since early August, when there were around 10 COVID-19 admissions per day.

Daily admissions at this rate have not been seen since early April of this year.

In the context of previous years, hospitalizations are well below where they were this time during the past two years of the pandemic, especially for non-intensive care unit admissions.

In 2020 and 2021, hospitalizations started to dramatically increase around this time of the season, while in 2022 we were in the midst of the ‘high plateau’ that lasted through early 2023.

The seasonal trends of COVID are not yet apparent, so we don’t know whether the recent increase portends a larger surge.

COVID-19 levels in wastewater vary by region, with continued increases in the western and central parts of state

According to the University of Minnesota’s Wastewater SARS-CoV2 Surveillance Study, COVID-19 levels in wastewater continue to rise across much of the state, a persistent trend we have seen in recent weeks.

But there are some signs that the upward trend is slowing down in some of the study’s regions. The trendlines are more variable than we saw in our last update two weeks ago, at which point each region showed a four-week change of at least 100 percent.  

For the week ending Sept. 17, the South West and North West regions each experienced a change of more than 100 percent over the prior four weeks, 193 percent and 152 percent, respectively.

The South West region also has the greatest one-week change in COVID for this update at 120 percent. These indicators suggest that the upward trend in both regions will continue steadily.

The Twin Cities Metro and Central regions also show a continued increase but not quite as steep as the two regions in the western corners of the state.

The study’s North East, South Central and South East regions all show indications that the trend line is plateauing or starting a downward slope. The North East and South East regions each had a four-week change of 11 percent and 17 percent respectively, followed by a one-week change of zero percent and negative six percent. The South Central region had declines over both the prior four- and one-week periods.

These results somewhat coincide with what is happening nationally. According to the latest COVID-19 wastewater analysis from Biobot Analytics, the levels of effective COVID-19 virus in wastewater have declined nationally by roughly 20 percent from a relative peak on Sept. 6 to Sept. 20, their latest available data.

Trend lines also vary by region on the national level. Biobot Analytics shows that the Northeast U.S. has higher COVID levels in their wastewater on average compared to the Midwest, South and West, which are clumped together.

And the Northeast is experiencing a more modest decline than the steeper fall in the three other regions.

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