Common colds are back in NY as masks come off and COVID precautions loosen

Colds and other common viruses are rebounding in New York and other states as people relax the precautions that helped limit the spread of COVID-19 — and incidentally kept a host of more garden-variety illnesses at bay.   

Influenza and respiratory syncytial virus (RSV) dipped to record lows during the pandemic. Few missed the usual coughs and sniffles last winter. 

Their return — however unwelcome — is another sign of the return to normalcy. 

Indeed, federal health officials sounded the alarm last month that cases of RSV and other respiratory viruses have been higher than expected for this time of year.

The Centers for Disease Control and Prevention urged states to ramp up testing due to the unseasonable infections, especially in the South. The cases hit New York beginning in March and have lingered through the summer months, federal data show.

CDC noted “at this time it is not possible to anticipate the likely spread, peak, or duration of activity with any certainty.” 

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In New York, for example, the five-week average of RSV cases hit a recent high-point of about 27 cases for the week ending April 17, CDC data show. But the weekly count still hovered around 15 cases throughout June.

In contrast, the five-week average of RSV cases in New Jersey hit a high of about 8 for the week ending May 29, lingering at around 5 cases weekly into July.

Meanwhile, increased testing to rule out COVID-19 has detected viruses that previously might have been shrugged off, experts said. And more such illnesses are expected when students return to their classrooms and office workers to their workplaces in the fall.   

'A different world now'

Respiratory syncytial (sin-SISH-uhl) virus (RSV) starts out looking like a common cold but it is the number one cause of bronchiolitis, a serious inflammation of the airways. Children under 2 years old are most at risk.

Health officials have doubled down on advice to stay home when sick and get tested for COVID-19. They urge people to get vaccinated for COVID, to minimize the chance that any respiratory symptoms would actually be COVID.

With the highly transmissible Delta variant of the coronavirus expected to become dominant in New York over the next few weeks, it will be important to distinguish between COVID and these other illnesses.

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“We're in a different world now,” said Dr. Ashwin Jathavedam, an internist with Leonia Medical Associates and chief of infectious diseases at Englewood Health in New Jersey. “Most of these are mild infections, things that, pre-pandemic, you wouldn’t have thought twice about.” 

Jathavedam encourages his patients to get tested for COVID if their symptoms mean it’s a possibility. Protocols used by many school systems, too, require a negative COVID test result — or a 10-day quarantine period — if a student develops respiratory symptoms, a cough, fever, or sudden loss of taste and smell. 

For one New Jersey mother whose 6-year-old daughter came down with a runny nose and low-grade fever at the end of the school year, the quick turnaround on test results was welcome. Jessica Garrett took her daughter to the doctor for a COVID test on the second day she was sick.  

“Luckily these tests come back the next day,” Garrett said. Her daughter’s result was negative, and the fever soon broke. “Parents are quicker to bring their kids to the doctor right now,” she said. Her daughter received remote instruction for a couple of days, then returned to school.  

Garrett wasn’t as concerned about COVID as she might have been a few months earlier, because the rate of COVID infection has decreased significantly. “These kids are together more now. You have to remember there are other things out there,” she said. “With COVID, we forgot about that.” 

Common colds are 'thriving' 

Influenza and the common cold both wreak havoc on the respiratory system, but are caused by different viruses.

The relaxation of social-distancing requirements and reduction of mask-wearing have brought back conditions that enable viruses to flourish. And children who have been socially isolated have not developed natural immunity to a host of infectious diseases and remain susceptible.  

“Typical common cold viruses are thriving now,” said Dr. Jeffrey Bienstock, managing partner of Pediatricare Associates in New Jersey. “The ability to spread these viruses is dependent on someone coughing on the next person,” he said. People cluster more closely now, without masks as a barrier.

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In another New Jersey family, a cold spread from one boy to his younger brother and then to their mom earlier this summer. Normally, said Rachel Steiner, the boys' mother, she wouldn’t have considered her first son’s symptoms severe enough to merit a visit to the pediatrician.  

But knowing the disruption that results from a potential diagnosis of COVID-19, she said it was important to rule COVID out with a test. His result was negative. 

While their activities in summer camps and playgrounds can contribute to the spread of illness, children aren't the only ones who can anticipate a resurgence in common illnesses.

Outbreaks among children and adults 

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Adults, too, are affected. Three long-term care facilities reported outbreaks of non-COVID respiratory infections in June, the state Health Department said — up from none in May.   

In England, two weeks after primary and secondary schools reopened last September, researchers found a sharp increase in rhinovirus infections among adults. Children were known to be “key drivers of transmission to adults,” the researchers said, and this was further evidence. They cautioned that the findings also have implications for the spread of influenza, for which children are also known to be effective transmitters.

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In Hong Kong, the increase in outbreaks of upper respiratory tract infections after the reopening of primary and secondary schools, kindergartens, child care centers, and nursery schools was so great that some had to close again. This occurred despite precautions within the schools that included limited group activities, separation of desks, cancellation of lunch hours, and mask wearing. Researchers noted that masks may not protect against the spread of rhinoviruses in exhaled breath. 

In Australia, RSV surged after physical distancing precautions were relaxed. The peak of the recent RSV surge was higher than in each of the previous seven years. And the average age of infected children was also older, suggesting that their lack of exposure meant they were still susceptible to the virus. The researchers warned that the Northern Hemisphere may face a significant rise in RSV, which can also be life-threatening for the elderly.

In the U.S., the CDC noted that in a typical year, RSV causes 14,000 deaths among those over 65. It recommended that “health care personnel, child care providers, and staff of long-term care facilities should avoid reporting to work while acutely ill — even if they test negative for (COVID-19).” 

Few cases of flu last year 

Rommel Lashely, a call specialist in the 211 center at the United Way of Westchester and Putnam in White Plains, works on a call Jan. 31, 2018.

Influenza, too, was way down. In New York and across the country, the recent flu season was historically mild. The state reported only 4,915 positive flu test results, drastically down from more than 107,000 last season. Only one child died of influenza nationally, and none in New York.

“I think we’re in the beginning of a resurgence in all of these things," said Dr. Cheryl Panem, a pediatrician at the DePaul Ambulatory Center in New Jersey, listing viruses such as rhinovirus, adenovirus, parainfluenza virus, and enterovirus, that generally cause respiratory symptoms.

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Further, the cases may appear similar to COVID, a concern while coronavirus is circulating and children are unvaccinated. For some patients, they may cause serious illness.   

Panem tells her patients’ parents that “if there is a suspicion of exposure to COVID, they still have to treat their kids like we did during the height of pandemic — continue to wear masks, continue to decontaminate all surfaces in the home, and wash hands frequently.” 

Whether it’s COVID or the common cold, she said, a high fever and symptoms of respiratory distress — rapid or difficult breathing, chest tightness, flaring of the nostrils— are signs the child may need emergency care.  

To prevent the spread of all such communicable diseases, it’s time to get back to basics. 

“The best strategy," said Amita Avadhani, a director at the Rutgers School of Nursing with a doctorate in nursing practice: "Don’t touch your face. Be diligent with handwashing. Clean shared surfaces.”

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David Robinson is the state health care reporter for the USA TODAY Network New York. He can be reached atdrobinson@gannett.com and followed on Twitter:@DrobinsonLoHud