COVID rates tick down again in Houston

Always a good headline to read.

COVID-19 data from the Texas Medical Center this week suggests the current wave may be subsiding, though experts urge caution as a new, highly infectious variant continues to circulate.

The average number of daily hospitalizations in the medical center had been rising steadily for a month, but dropped last week by about 20 percent, from 182 to 146. Regional COVID hospitalizations also have dropped from a five-month high of 1,002 on Jan. 5 to 836 on Monday, according to the Southeast Texas Regional Advisory Council.

Most significantly, the viral load in the city’s wastewater — the most reliable indicator of future virus spread — dropped by about 34 percent last week, according to data published Tuesday.

“I would be very surprised if we saw this (trend) reverse at this point,” said Dr. James McDeavitt, senior vice president and dean of clinical affairs at Baylor College of Medicine.

Even with a hopeful outlook, researchers cautiously are eyeing the progress of XBB.1.5, which public health officials say is the most transmissible form of COVID yet. It quickly has become the dominant strain nationwide. The variant accounts for 80 percent of cases in the Northeast, according to the Centers for Disease Control and Prevention, though it has yet to beat out other infectious strains in Houston and much of the South.

Here’s that wastewater dashboard again. We’re still at a very high level compared to the July 2020 baseline, but at least we’re going in the right direction now. Hospitalization rate is the bigger concern, but again as long as we’re now trending downward, the overall picture is improving. There’s an argument to be made that we shouldn’t obsessively track each new alphabet-soup variant, at least not while they’re all about the same level of lethality. The fact that successive versions are more transmissible than their predecessors are just how viruses work. I’m not sophisticated enough to make a judgment about that, but I have limited my worry to the prospect of a deadlier strain.

There are still other things to worry about:

The United States has faced a triple threat of respiratory viruses over the past few months, with COVID-19, the flu and RSV driving infections and hospitalizations in the Houston area and elsewhere.

Each of the three are capable of causing mild to severe illness by themselves. But it’s also possible to contract more than one virus at a time — and a new study suggests a coinfection may lead to more severe illness in young children.

The term “flurona” became popular on social media last year as a surge in COVID-19 and the re-emergence of the flu caused a wave of infections. However, doctors were seeing patients — particularly young children — with coinfections before the pandemic, said Dr. Amy Arrington, medical director of the Special Isolation Unit at Texas Children’s Hospital.

“It’s not uncommon that we see younger kids getting co-infected,” she said. “I think a lot of parents today in Houston can say they feel like their child’s been sick for the past few months straight.”

Younger children might be more susceptible to coinfections because they haven’t been exposed to a respiratory virus before, Arrington said. They may be getting infected at daycare, or from an older sibling who picked up the virus at school.

Coinfections are uncommon, but doctors might be seeing them more frequently this fall and winter for a few reasons, said Dr. Luis Ostrosky, chief of infectious diseases at UTHealth Houston and Memorial Hermann Hospital.

The collision of COVID-19, the flu and RSV, as well as other respiratory viruses like rhinovirus and enterovirus, has created more opportunity for infection, he said.

“Tripledemic” was the word I heard. Fortunately, RSV and flu rates have been dropping as well. You can still get a flu shot, and for sure you can and should get your bivalent booster. Hell, I’m ready for whatever the next generation COVID booster is now. I’ll be among the first in line when that becomes available. You are your only real defense here, so do what you need to do.

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