What to expect this winter

Last year’s respiratory system was a debacle. Will this year be the same?

Here are my thoughts.

Caveats: I do not have a crystal ball, and certainly when it comes to Covid, it’s hard to know what the pace of variants will look like.

But after talking to several physician colleagues, here are my thoughts (first the bad news, then the good). PLEASE read all the way through this post, because I want my ultimate message to be clear.

The bottom line

Although I wish I could say that I think this year will be tremendously better than last year, my realistic assumption based on current viral trends is that at least the early part of this respiratory season will be tough. 

I was initially reluctant to write this post for fear of worsening anxiety around health, but I think that sugar-coating things or pretending that we live in a different reality is not helpful - and it underestimates the resilience and capability of parents. Knowing (loosely) what to expect can help you create the support systems you may need going into Winter.

To elaborate:

The not-so-good news

There are several factors that make me concerned that the early part of this coming viral season will be tough. We’re already seeing cases of RSV and Flu, which is earlier than predicted, and earlier than most people have managed to obtain immunizations. The southern hemisphere’s winter season has been tough as well, and it can be a predictor of what is to come for us here. Last year in the US, we saw an early rise in flu and RSV, and so far those trends seem to be repeated.

Historically, respiratory season is tough because of these factors:

• The weather will get worse. Unlike in the summer, when we spend a good deal of time outdoors, having everyone congregate indoors contributes to the spread of illness.

• School. Every year, about 2-3 weeks after school starts, we see an upsurge in things like strep - for the obvious reason, which is that kids can be germ factories and like to share their germs.

• The holidays. People travel and spend a lot of time with family - this means that infections aren’t “contained” to local communities.

• Where we are mentally and emotionally. Many people are sick of mitigation measures, and (as evidenced by the amount of travel this summer), people want to take back their lives fully. Everyone wants to do the things they held off from doing the past few years. (note: I’m not saying that I agree with this.. I’m just making an observation of human behavior). There’s a lot of reluctance to mask, and given how little sick time we have left after all the illnesses in the early part of the year, there’s also going to be a temptation from parents to not take more leave than they absolutely need to.

The better news

All is not gloom and doom.

This year have some new weapons in our arsenal, and I think at least one of them will be a game-changer if we can implement it.

Part of why last year was so tough was that our C19 and Flu immunization rates in kids were abysmal (for flu shots in kids, the rates were only about 55%).

We have vaccines to protect us from the consequences of Flu & C19 (and hopefully the updated C19 shot will be more effective against the circulating strain) and there is new protection in the form of a monoclonal antibody to protect the most vulnerable infants from RSV (called Beyfortus - here is my separate post on this).

If everyone gets these shots per the recommendations, I suspect it will make a tremendous impact on how bad our winter season will be.

What else can I do to protect my kids?

Be smart. Be thoughtful. At the risk of sounding cliche, remember that an ounce of prevention is better than a pound of cure.

Use the measures you have — the most important of which is to get the vaccines you’re eligible for as soon as you can (September/early October).

And then use other strategies where possible too: ventilation, masking when needed, washing hands well, and staying away from sick people.  None of these strategies are sexy - but they work.

Remember, you can’t control everything. Kids do get sick - even if it sucks for them (and us) when they do.

We were caught off guard last year. My hope is that by being blunt and hopefully by creating realistic expectations, we can set ourselves up ahead of time with the support systems to handle this next winter like a pro.

Most importantly, remember: The vast majority of kids who get viral infections do well and recover without incident.

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And who knows? Maybe I’ll be wrong.

I kind of hope that I am. But either way, I think making sure you can call in reinforcements and set yourself up with a support system is important.

In all honesty, I continue to be astounded by the resilience of those in the parenting trenches with me. I don’t say this lightly: WE HAVE GOT THIS.

Bring it on, Winter.