America shrugs off its twindemic

Illustration of a person with a suitcase walking towards a door with a large warning sign above it.

Illustration: Gabriella Turrisi/Axios

The much-feared twindemic — or even tripledemic — of respiratory viruses is here, but Americans are too COVID-weary to care.

The big picture: Influenza in the Southeast and RSV infections in several regions are filling up hospital wards and causing some facilities to cancel elective surgeries and bring back triage tents.

  • Although less lethal than COVID-19, viruses pose a major threat to children and immunocompromised adults. And we’re still in November, with the threat of new COVID variants still looming as people plan indoor gatherings and bolster holiday travel.

But: Americans are good at normalizing risk and have been less and less willing to change their personal behavior since the Delta wave of the pandemic.

  • The creeping threat of another viral outbreaks have also been pushed aside by elections, economics, war and natural disasters.
  • “If you don’t have children and are a young healthy adult, it’s going to be hard to convince you to mask to protect the population as a whole,” said Yale infectious disease specialist Scott Roberts.
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Driving the news: Much of the current focus is on RSV, or respiratory syncytial virus, which affects large numbers of children and has strained hospitals for weeks.

  • Boston Children’s Hospital postponed some elective surgeries to ease the crush, while Johns Hopkins Children’s Center began using triage tents to handle caseloads, as it did during the worst of the pandemic.
  • Children’s National Hospital in Washington, DC, at one point in October had 18 children waiting in a pediatric intensive care unit, according to the Washington Post.

Meanwhile, seasonal flu is on the rise through the Southeast, hospitalized thousands and stressed some emergency rooms and urgent care centers.

The intrigue: COVID is actually the least worrisome part of the triple threat right now. Cases are down, the new variants seem no more lethal than Omicron, and there are plenty of treatments and vaccines.

  • And yet, COVID is still on track to be the third leading cause of death in the U.S. this year, behind heart disease and cancer, according to the Peterson-KFF Health System Tracker, which projects 230,000 American lives lost to the virus in 2022 through September alone.
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Go deeper: Public health experts say another year of the pandemic threat has left many Americans determined to use their personal experience as a guide. The question is whether they can sort through disorders with similar symptoms – and see past themselves.

  • “It’s more important than ever to not go to family activities if you’re sick, even if you test negative for COVID,” said Courtney Gidengil, a pediatric infectious disease physician and director of the RAND Corp.’s Boston office. “You can have the flu, you can have RSV, and it’s important to be thoughtful about that.”

  • “The way I thought about it three years ago, where everyone’s behavior affects everyone else’s risk, was appropriate and felt very right in the heat of the pandemic, before we had the kinds of tools we have now,” said Bob Wachter, president of the association. Department of Medicine at the University of California, San Francisco. “At this point I’m not passing moral judgment on people. People are exhausted, they want to get back to their lives.”
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The bottom line: Public opinion polls show that about 20% of Americans still worry about the pandemic and public health more broadly, said Ipsos head of research and senior vice president Chris Jackson.

  • It will be difficult to reach the rest to send messages about a new threat because of people’s tendency to look inward. “It kind of comes down to understanding and social trust, which has been frayed for many years,” he said.
  • Plus, he said, “Americans are so tired of being afraid that even when they see [a health threat] their eyes blow over.”

Tina Reed and Caitlin Owens contributed to this report.

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