With Record Holiday Travel, Will Record Covid-19 Infections Follow?

With travel record expected over the Thanksgiving weekend, life seems to be returning to normal. Indeed, it is easy to assume that the Covid-19 pandemic will disappear. But is it just wishful thinking? People are still infected with SARS-CoV-2. Covid-19 can also lead to hospitalization and death. New variants, such as BA.2.86 and the recently described JN.1, are troubling. And let’s not forget the influenza virus and RSV. So, should we be worried about traveling for the holidays?

Let’s start by looking at the numbers.

According to the Centers for Disease Control and Prevention, there were 16,237 new Covid-19 hospitalizations in the United States during the week ending November 11, 2023. During this same week, the CDC also reported 544 deaths from Covid-19. These numbers may seem large. And, of course, we need to remember that each number represents a person. Those 544 deaths represent 544 people who will not be celebrating Thanksgiving. But are those numbers really that big?

During the comparable week in 2022, the CDC reported 23,803 Covid-19 hospitalizations and 2,200 deaths. For the same week in 2021, the numbers were 37,474 and 7,159. Clearly, the absolute numbers are down significantly. The death-to-hospitalization ratio has also decreased significantly. During this week in 2021, the hospital death ratio was 0.19. In other words, about 19% of people hospitalized with Covid-19 died. In 2022, this rate has dropped to around 9%. Now, the rate is below 3.5%. This comparison is certainly not perfect; a myriad of factors influence this measurement. But it suggests that the severity of the disease has decreased in recent years.

Does this mean we have nothing to worry about?

The short answer to this question is no. We need to be vigilant. In 2021, hospitalizations and deaths began to increase at the end of November and peaked in mid-January 2022. The same trend occurred between November 2022 and January 2023. We should expect the same pattern this winter. Hospitalizations and deaths will likely increase over the next two months. However, there is no immediate reason to believe that we will experience a surge comparable to those seen during the last two years.

Of course, a new variant could change the entire calculation. We saw that happen when Omicron first emerged. Currently, two existing variants could be problematic. The BA.2.86 variant has caused concern since it was first identified in July, mainly because it differs significantly from its predecessor. And an offshoot of this variant, JN.1, is also attentive.

Unfortunately, data on these variants are scarce and inconclusive. In a recent paper published in Nature, the researchers reported that BA.2.86 shows a strong affinity for its receptor on human cells, suggesting that this virus could be transmitted effectively. These researchers also noted that BA.2.86 is not particularly resistant to existing antibodies, which suggest that infections called encounters may not be a major problem. We know that the prevalence of BA.2.86 and JN.1 remains low.

What about other respiratory diseases?

Although Covid-19 remains the respiratory infectious disease of greatest concern, we should not forget about other respiratory infections. In its most recent weekly influenza report, the CDC says flu cases are on the rise in many parts of the United States, as they typically do this time of year. The same is true for confirmed cases of RSV. Current levels of influenza and RSV infections, however, are not unusually high.

So, what can we conclude about the holiday trip?

After the Thanksgiving holiday, we will almost certainly see an increase in Covid-19 cases. The same is true for influenza and RSV. Here’s the bad news. The good news is that basic mitigation strategies continue to be effective. Early evidence suggests that the latest Covid-19 vaccine provides some protection against current variants of SARS-CoV-2, including BA.2.86. Similarly, the influenza and RSV vaccines, although not perfect, provide protection against these viruses. Masks work. And always washing your hands is a good idea. For people visiting friends and relatives at risk, such as the elderly, basic mitigation strategies like these can have a big impact.

In some respects, we are beginning to enter a post-pandemic era. But Covid-19 is not gone. Probably won’t go. Instead, we need to live intelligently with it.

follow me Twitter.