It’s the same every year. As soon as it gets cold, people take refuge indoors. The windows are closed. People stop walking or cycling to work, turning to crowded buses and subways. We retire to where it is warmer, and our breath condenses on the windows of houses, offices, schools and means of transport. Basically, we create, theperfect environment for virus reproduction.

When the respiratory virus season begins, the scenario is usually quite predictable. In the Northern Hemisphere, patients begin to be hospitalized around October after contracting theinfluence or the respiratory syncytial virus (Rsv). Thousands of people fall ill and many of them die, but except for the most extreme wave years, health systems in Europe and North America are in no danger of being overwhelmed.

There pandemic, however, it undermined this predictability. Covid-19 has added another virus to the seasonal mix and this year the flu e the RSV are coming back with arrogance. There may be adouble or even a triple epidemic, where all three viruses strike simultaneously, disease escalates and health systems creak under the pressure. And the signs indicate that this scenario is already underway.

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The surge in the RSV

In the United States, for example, several hospitals are already fullwith a number of children infected by the Rsv and other viruses far greater than would be expected at this time of year. The U.S. Centers for Disease Control and Prevention (CDC) don’t track RSV-related cases, hospitalizations, and deaths as they do for flu, but hospitals across the country have reported spikes that typically they are registered in December and January. In the week that ended on 29 October almost one in five tests for the RSV it tested positive, with a percentage that has doubled in the space of a month. In general, the higher the percentage of positive tests, the more common the virus is in the community. In the three years leading up to the pandemic in October it had tested positive in average only 3 percent of tests.

IS one of the consequences of the pandemic. Over the past two years, RSV and flu have been contained thanks to individual protection measures taken to combat the coronavirus: wear a face mask, wash your hands and isolate yourself. Between the start of the pandemic and March 2021, the weekly positivity rate for RSV tests in the United States remained below 1 percent compared to the pre-pandemic period, according to data from the CDC.

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Side effects

In July of this year, some experts reported in the scientific journal The Lancet that the benefits of these precautions taken against the pandemic could end up having a negative side this winter. According to experts, reducing exposure to common endemic viruses such as RSV and influenza risked creating a “immune gap“in people born during the pandemic or who had not previously developed sufficient immunity against these viruses.

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