It’s that time of the year when everyone seems to know someone who is under the weather. Respiratory illnesses, not just COVID-19, have been on the rise.
Experts say your best defense remains the same: Keep up to date with your vaccinations, consider taking steps to limit your exposure to large indoor crowds and wearing a well-fitting mask at public gatherings, and talk with your health care provider if you are feeling sick.
If you have COVID-19, or another respiratory infection, health experts say you can return to work or school sooner. New recommendations from the U.S. Centers for Disease Control and Prevention (CDC) suggest returning to normal activities when, for at least 24 hours, symptoms are improving, and if a fever was present, it has been gone without the use of fever-reducing medication. (Previous guidance from the CDC recommended people who were infected with COVID-19 remain in isolation for five days.)
Now the CDC says that once people resume normal activities, they are encouraged to take additional prevention strategies for the next five days to curb disease spread, such as taking more steps for cleaner air, enhancing hygiene practices, wearing a well-fitting mask, keeping a distance from others, and/or getting tested for respiratory viruses. Enhanced precautions are especially important to protect those most at risk for severe illness, including those over 65 and people with weakened immune systems, according to the CDC. Click here to read more from the CDC.
Note: The updated CDC guidelines do not apply to health care facilities. Click here for the latest Mount Sinai visitor policy.
“It’s the season for respiratory viruses,” says Bernard Camins, MD, MSC, Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai and the Medical Director for Infection Prevention for the Mount Sinai Health System. “It’s no longer all about COVID-19. That is now just one of a number of respiratory viruses we need to contend with.”
In addition to COVID-19, health authorities are watching a number of respiratory viruses that are circulating: influenza or seasonal flu (there are actually two forms of it this year); respiratory syncytial virus (RSV); and the common cold (rhinovirus). Taken together, they can make for a difficult season for patients and health care providers alike.
Mount Sinai cardiologists are warning about the risk of heart problems this winter. Click here to read more
For COVID-19, the New York City Department of Health and Mental Hygiene reports hospitalizations in New York had surged at the end of December to their highest levels in about a year, following a smaller upturn in September. But the numbers were about half of what they were during a surge a year ago, and they are about one-tenth of the number in January of 2022 during the last big surge.
Bernard Camins, MD, MSC
Vaccinations for COVID-19 and the flu may not completely prevent you from becoming infected, but they are likely to keep you from getting seriously ill and requiring hospitalization. For both of these illnesses, it’s not too late to get vaccinated if you have not already done so. The flu season typically extends until spring.
RSV commonly causes mild, cold-like symptoms in most healthy adults and goes away after a few days. However, for infants and older adults with pre-existing conditions like heart disease or lung disease, RSV can cause severe disease and even death. The CDC recommends the RSV vaccine for adults 60 and older. The vaccine is also recommended for expectant mothers towards the end of their pregnancies so their newborns will have antibodies against RSV. The last preventive measure is a monoclonal antibody against RSV administered to newborns less than 8 months old.
Dr. Camins’ general recommendations for keeping healthy remain unchanged:
- Those at risk for complications from respiratory infections may want to wear a more protective mask in crowded areas, such as riding the bus or subway or shopping. A surgical mask provides some protection but not as much as a high-quality N95 or KN95 mask.
- Wash your hands frequently especially when you get home or arrive at work.
- Individuals at high-risk should talk with their health care provider and have a plan for how to get antiviral medications if they become infected with COVID-19 or the flu, as these prescription medications must be taken within the first days of symptom onset. Those at high-risk include older adults, those with chronic medical conditions, such as diabetes, and those with reduced ability to fight infections, such as those being treated for some cancers.
Dr. Camins offers these additional key takeaways:
Staying home: If you are feeling very sick, you should stay home, especially if you have a fever. You may go to work when you’re feeling better, and you may want to wear a mask until your symptoms fully resolve to prevent infecting your co-workers. There’s no need for extended isolation at home as people were doing in the midst of the COVID-19 pandemic, he says.
Taking medications: Talk with your provider about medications if you become infected. Anti-viral mediations make good sense. Paxlovid™ (nirmatrelvir/ritonavir) for COVID-19 can help adults who may be at high risk for more severe illness. Anti-viral medications such as Tamiflu® (oseltamivir) for seasonal flu can lessen symptoms and shorten the time you are sick, and they can be helpful for those at risk of complications.
The new variant: The latest variant of the virus that causes COVID-19, JN.1, does not seem to be any more worrisome than others that came before it, and existing treatments work well against it. “We will probably continue to see more variants as the virus that causes COVID-19 mutates,” says Dr. Camins. “You just have to accept there is always going to be a new variant.”