Colds and other common viruses are rebounding in New Jersey as people relax the precautions that helped limit the spread of COVID-19 — and incidentally kept a host of more garden-variety illnesses at bay.
Influenza and respiratory syncytial virus (RSV) dipped to record lows during the pandemic. Few missed the usual coughs and sniffles last winter.
Their return — however unwelcome — is another sign of the return to normalcy.
The state Health Department says the level of RSV and other respiratory viruses has been “higher than would typically be expected for this time of year.”
While the state health department can’t anticipate “the likely spread, peak, or duration of activity with any certainty,” it will continue to monitor the trend, said Dr. Ed LIfshitz, medical director of the division of communicable diseases.
Increased testing to rule out COVID-19 has detected viruses that previously might have been shrugged off. Some, like RSV, have appeared outside their normal seasons.
A few infants have been hospitalized with RSV in North Jersey. And more such illnesses are expected when students return to their classrooms and office workers to their workplaces in the fall.
‘A different world now’
Health officials have doubled down on advice to stay home when sick and get tested for COVID-19. They urge people to get vaccinated for COVID, to minimize the chance that any respiratory symptoms would actually be COVID.
With the highly transmissible Delta variant of the coronavirus expected to become dominant in New Jersey over the next few weeks, it will be important to distinguish between COVID and these other illnesses.
“We’re in a different world now,” said Dr. Ashwin Jathavedam, an internist with Leonia Medical Associates and chief of infectious diseases at Englewood Health. “Most of these are mild infections, things that, pre-pandemic, you wouldn’t have thought twice about.”
Jathavedam encourages his patients to get tested for COVID if their symptoms mean it’s a possibility. Protocols used by many school systems, too, require a negative COVID test result — or a 10-day quarantine period — if a student develops respiratory symptoms, a cough, fever, or sudden loss of taste and smell.
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For a Fair Lawn mother whose six-year-old daughter came down with a runny nose and low-grade fever at the end of the school year, the quick turnaround on test results was welcome. Jessica Garrett took her daughter to the doctor for a COVID test on the second day she was sick.
“Luckily these tests come back the next day,” Garrett said. Her daughter’s result was negative, and the fever soon broke. “Parents are quicker to bring their kids to the doctor right now,” she said. Her daughter received remote instruction for a couple of days, and then returned to school.
Garrett wasn’t as concerned about COVID as she might have been a few months earlier, because the rate of COVID infection has decreased significantly. “These kids are together more now. You have to remember there are other things out there,” she said. “With COVID, we forgot about that.”
Common colds are ‘thriving’
The relaxation of social-distancing requirements and reduction of mask-wearing have brought back conditions that enable viruses to flourish. And children who have been socially isolated have not developed natural immunity to a host of infectious diseases and remain susceptible.
“Typical common cold viruses are thriving now,” said Dr. Jeffrey Bienstock, managing partner of Pediatricare Associates, with five offices in North Jersey. “The ability to spread these viruses is dependent on someone coughing on the next person,” he said. People cluster more closely now, without masks as a barrier.
In another Fair Lawn family, a cold spread from one boy to his younger brother and then to their mom earlier this summer. Normally, said Rachel Steiner, the boys’ mother, she wouldn’t have considered her first son’s symptoms severe enough to merit a visit to the pediatrician.
But knowing the disruption that results from a potential diagnosis of COVID-19, she said it was important to rule COVID out with a test. His result was negative.
While their activities in summer camps and playgrounds can contribute to the spread of illness, children aren’t the only ones who can anticipate a resurgence in common illnesses.
Outbreaks among children and adults
Adults, too, are affected. Three long-term care facilities reported outbreaks of non-COVID respiratory infections in June, the state Health Department said — up from none in May.
In England, two weeks after primary and secondary schools reopened last September, researchers found a sharp increase in rhinovirus infections among adults. Children were known to be “key drivers of transmission to adults,” the researchers said, and this was further evidence. They cautioned that the findings also have implications for the spread of influenza, for which children are also known to be effective transmitters.
In Hong Kong, the increase in outbreaks of upper respiratory tract infections after the reopening of primary and secondary schools, kindergartens, child care centers, and nursery schools was so great that some had to close again. This occurred despite precautions within the schools that included limited group activities, separation of desks, cancellation of lunch hours, and mask wearing. Researchers noted that masks may not protect against the spread of rhinoviruses in exhaled breath.
In Australia, RSV surged after physical distancing precautions were relaxed. The peak of the recent RSV surge was higher than in each of the previous seven years. And the average age of infected children was also older, suggesting that their lack of exposure meant they were still susceptible to the virus. The researchers warned that the Northern Hemisphere may face a significant rise in RSV, which can also be life-threatening for the elderly.
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Last month, the federal Centers for Disease Control alerted health officials in southern states about reports of increasing RSV infections outside the normal fall and winter season. Pediatricians should test more broadly for RSV in patients with acute respiratory symptoms, but who test negative for COVID-19, the CDC said.
Noting that in a typical year, RSV causes 14,000 deaths among those over 65, it recommended that “health care personnel, child care providers, and staff of long-term care facilities should avoid reporting to work while acutely ill — even if they test negative for SARS-CoV-2.”
Few cases of flu, RSV last year
Dr. Cheryl Panem, a pediatrician at the DePaul Ambulatory Center in Paterson, part of St. Joseph’s Health, said two babies in the group’s practice had been hospitalized with RSV in the last month. “We didn’t have any cases at all in the winter,” she said.
Influenza, too, was way down; “barely any patients tested positive” for it, she said. In New Jersey and across the United States, the recent flu season was historically mild. The state reported only one severe case of flu in a child, compared with an average over the last six flu seasons of 48. Only one child died of influenza nationally, and none in New Jersey.
“I think we’re in the beginning of a resurgence in all of these things,” Panem said, listing viruses such as rhinovirus, adenovirus, parainfluenza virus, and enterovirus, that generally cause respiratory symptoms. They may appear similar to COVID, a concern while coronavirus is circulating and children are unvaccinated. For some patients, they may cause serious illness.
Panem tells her patients’ parents that “if there is a suspicion of exposure to COVID, they still have to treat their kids like we did during the height of pandemic — continue to wear masks, continue to decontaminate all surfaces in the home, and wash hands frequently.”
Whether it’s COVID or the common cold, she said, a high fever and symptoms of respiratory distress — rapid or difficult breathing, chest tightness, flaring of the nostrils— are signs the child may need emergency care.
To prevent the spread of all such communicable diseases, it’s time to get back to basics.
“The best strategy,” said Amita Avadhani, a director at the Rutgers School of Nursing with a doctorate in nursing practice: “Don’t touch your face. Be diligent with handwashing. Clean shared surfaces.”
Lindy Washburn is a senior health care reporter for NorthJersey.com. To keep up-to-date about how changes in the medical world affect the health of you and your family, please subscribe or activate your digital account today.