Is It COVID-19, a Cold, or the Flu? What to Do as COVID and Flu Cases Surge – Boston University

Heading out on a crowded bus or train? It might be time to wear a mask after a recent surge in COVID cases, according to BU infectious diseases researcher David Hamer. Photo via iStock/sibway

COVID-19

Here we go again. Another winter, another COVID-19 wave. As many Americans try their best to move on from or ignore the coronaviruscalling quits on masking, skipping vaccinations, not bothering to testCOVID-19 is surging in the United States.

Current data suggests virus levels in Massachusetts recently hit peaks unseen since the Omicron variant burst onto the scene two years ago. According to the latest numbers from Massachusetts Department of Public Health, COVID-19 cases in the state jumped from around 2,000 a week in early November to nearly 6,000 a week by the end of December. Local physicians reported a continued rise in cases into January. The upswing has been driven by a new highly transmissible coronavirus variant, JN.1an Omicron offshoot thats now the dominant strain of the virus in the US.

Throw in flu and RSV, plus the usual wintry sniffles from colds, and we have all the ingredients for a lousy, laid-up winter. Just 18 percent of Massachusetts residents are up-to-date with their COVID vaccinations; 37 percent have had a flu shot.

To get the latest on the surge, whether we all need to dig out those masks again, and how to tell whether its COVID, the flu, or a cold causing that runny nose and sore throat, The Brink spoke with Boston University infectious diseases expert David Hamer. A BU School of Public Health and Chobanian & Avedisian School of Medicine professor of global health and medicine, Hamer is also a core director and researcher at BUs Center on Emerging Infectious Diseases.

Hamer: We are seeing more COVID cases nationwide, but its complicated. Part of the problem is the quality of the data that feeds into this. It used to be when everybody was doing active testing and using PCR tests, all that data fed into the public health systems. But now lots of people are doing home tests, and those dont end up being captured, so the data arent as good as they were two years ago at the heart of the pandemic.

But, that said, theres definitely a substantial increase of reported cases in Massachusetts, and the wastewater data had been creeping up, as well, so a lot of signs that theres more transmission. This has been the biggest spike weve had since Omicron. And compounding that, theres more flu being transmitted also. I think were looking at sort of a syndemic of multiple diseases. What to me is really interesting is that we havent had a big surge in COVID for a whileis it now starting to settle into more of a respiratory season pattern?

Hamer: Yes, is the short answer. Many hospitals in the Northeast, including Boston Medical Center [BUs primary teaching hospital], have gone back to masks. I have a clinic todayI had not been using a mask consistently, but I think its advisable [now], because theres a higher risk.

And then public transportation, less than 5 percent of people wear masks in my experience, but I started masking more about a month ago because I was watching the numbers, thinking I dont want to get COVIDor other respiratory viruses, for that matter. In crowded places where theres likely to be inadequate ventilation, right now is a good time to think about having a mask.

Hamer: The level of boosting is really pretty woeful relative to what it should be. The JN.1 variant has been on the risethe CDC estimated that almost two-thirds of COVID cases in the US now are due to this subvariant. The bivalent vaccine, the modified vaccine that we have available, was designed for other Omicron subvariants, but it cross-protects against this. People really should be thinking about having a booster if they havent had it.

Hamer: Its really hard to tell. Between more immunity among individuals due to COVID vaccines or having had natural COVID infections, possibly the evolution of the virus toward a milder [disease], causing more upper respiratory symptoms, theres so much overlap between the common cold, COVID, RSV, andsomewhatinfluenza. Usually, you have a fever with influenza, but not always now with COVID. A lot of patients Ive seen will only have a stuffy or runny nose, a little bit of a cough. They may not necessarily have a fever, severe fatigue, and other symptoms that would be more suggestive of COVID, or loss of sense of smell, which were not seeing as commonly anymore.

Any respiratory symptoms should trigger testing, because SARS-CoV-2 is so easily transmissible. You dont want your coworkers, your family members, to become sick, so its important to know.

Hamer: They should spend five days in relative isolationat home, if they canbefore they resurface. And then when they start going back out in public, or if they go back to work, they should ideally wear a mask with all external contacts for the next five days. This goes back to studies we did here at BU among studentsbut also in studies that colleagues of ours did at Mass General with an older population. On average, young healthy BU students would shed virus and, by day five, many of them had gotten down to levels where they had undetectable or very low levels of viral load. But some were still shedding virus out to day seven, eight, nine, or even 10. Usually, it was around seven or eight that they finished up. So, people are still infected for at least five to seven or eight days after an episode. And thats in young, healthy students; in an older population, the duration of viral shedding is more prolonged.

Hamer: There are still people who have long COVID. Theres a lot of evidence that suggests vaccination and treatments like Paxlovid may help reduce the likelihood of long COVID developing. The flip side of that is theres a lot of evidence that people arent accessing the treatments, theyre not using them. Theyre not for everybody, but for those who are older, have underlying diseases or certain risk factors, they should be used.

Hamer: Yeah, unfortunately, its not over. A lot of people I knew that were very, very careful for three years, when it seemed like everything was good, they started going back to their usual liveshaving more social interactions, not wearing masks in public placesand many people that had never become infected had their first infection. And Im one of them.

Hamer: Theres still a fair amount of COVID circulating. Theres also a rising risk of influenza, as well as other regular respiratory viruses, and people should be thinking about doing things that help reduce their risk. So, vaccination. If they become infected, testing; if they test positive, isolating. Also, if theyre at higher risk, speaking with their physician about having oral treatment. The public health service message is if you have cold symptoms, you should, if at all possible, try not to come to work or go to school.

This interview has been edited for length and clarity.

Need a COVID-19 rapid test? BUs City Convenience is now offering two rapid antigen tests for $9.99. Need a flu shot? Student Health Services will be hosting immunization clinics on January 24, 25, and 26check its website for details.

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Is It COVID-19, a Cold, or the Flu? What to Do as COVID and Flu Cases Surge - Boston University