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Experts warn that the U.S. is headed for a ‘syndemic’ this winter

U.S. headed for a 'syndemic' this winter, medical experts warn – Dec 7, 2023

Medical experts are warning that the U.S. could face a “syndemic” winter as respiratory viruses surge and temperatures plunge.

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A syndemic is not unlike the “tripledemics” that health-care systems have grappled with the past two winters — when multiple pathogens, like COVID-19, RSV and the flu converge in a population. A syndemic, however, considers how interacting epidemics have increasingly adverse effects on communities that face systemic and structural inequities.

Raj Rajnarayanan, assistant dean of research and associate professor at the New York Institute of Technology campus in Jonesboro, Ark., told Fortune in a recent interview that the United States is a “sitting duck” when it comes to the threat of a syndemic.

“Strained hospital capacities, workforce exhaustion, burnout, a lack of effective therapeutic tools, poor communication, a lack of compliance [with COVID precautions], a lack of continuity planning, and the pervasive influence of social determinants of health,” only make the nation’s delicate health infrastructure more fragile, he said.
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So far, in Canada and the U.S., respiratory viruses are on the rise as cold and flu season ramps up, but it’s difficult to predict just how bad the season will get and how it will compare to previous years.

In the Public Health Agency of Canada’s (PHAC) latest FluWatch Report, ending Nov. 25, they said that illness activity remains “within expected levels typical of this time of year.”

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The report, which includes PHAC’s flu numbers from Aug. 27 to Nov. 25, says there have been 7,594 reported cases of influenza across Canada, 97 per cent of which were from influenza A.

Global News has reached out to PHAC for additional information but did not hear back by publication time.

Last year’s flu season — which typically runs from November to March in Canada — saw much higher numbers by this time, with a surge of COVID, RSV and flu viruses across the country, especially among children.

While RSV and the flu typically emerge later in the fall and winter seasons, both surged early in the 2022-2023 season, meaning all three viruses peaked around the same time.

The shaded area represents the maximum and minimum number of influenza tests or percentage of tests positive reported by week fromseasons 2014-2015 to 2019-2020. Screengrab / Fluwatch / PHAC

Children’s hospitals across Canada reported significant surges in patients, which led many to cancel major surgeries in order to redeploy staff to help in overcrowded emergency departments and intensive care units. The situation was exacerbated by low and sometimes non-existent supplies of children’s pain and fever medications.

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“Last year really showed what happens when we go a few years without seeing our normal viral trends,” Dr. Karen Acker, pediatric infectious diseases specialist at New York–Presbyterian Komansky Children’s Hospital, told Fortune.

Dr. Brian Conway, medical director of the Vancouver Infectious Disease Centre, told Global News last month that this season will like “be one of concern,” but “nowhere near as bad as obviously the late onset that we had in 2021 and 2022.”

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Since the summer, health-care systems across Canada have been bracing for another surge.

Some jurisdictions have increased staffing and bed capacity, while others are redirecting patients with less severe symptoms out of emergency rooms and into cough and cold clinics, urgent care or primary care.

With files from Global News’ Katie Dangerfield

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