Getting sick can ruin your holidays. Here’s what to know to stay healthy

Washington’s unusually early and severe surge in respiratory infections this year could be slowing at last, but how residents fare in the new year heavily depends on how we spend the holidays, health experts said this week.

Washington’s season of respiratory illnesses got off to an alarming start this fall, quickly leading to overflowing hospital emergency rooms throughout the state. On one particularly chaotic night in October, an ER nurse in Silverdale called a nonemergency line at Kitsap 911, desperate for help in managing the waiting area.

Since then, RSV, or respiratory syncytial virus, has begun to stabilize, and some new state data shows influenza — at least the early surge — might not be far behind, according to state epidemiologist Dr. Scott Lindquist.

As of last week, about 22% of laboratory tests returned positive for the flu, compared to nearly 30% the week prior, 34% the week before that and 24% a week earlier, according to state data.

“It does appear to be peaking,” Lindquist said. “It’s stable. … But we’re starting to get into the holiday season, so the testing people seek really changes. People don’t go in for as many tests, they wait until the holidays and then after everyone’s been together, they get tested.”

Flu deaths, however, have continued to tick up. At least 40 Washingtonians have died this season, including three children. More than half were over 65 or had underlying health conditions, Lindquist said.

“We’re not out of the woods yet, though it does look promising that our early season appears to be peaking,” he added. “But it remains to be seen how well we, as the public, handle the upcoming holiday season.”

Flu deaths generally range anywhere from zero to 300 in a given season, Lindquist said. While the count was much lower last year and the year before because of pandemic mitigation strategies, about 114 were recorded in the winter of 2019. About 245 people died from the flu the previous season.

“It doesn’t necessarily mean [this year is] the worst season, it just means it’s an earlier season,” he said.

In 2019, only five Washingtonians had died from the flu at this point in the season.

COVID-19 hospitalizations are also starting to climb, averaging about 70 per day, compared to 40 per day in mid-November.

As holiday gatherings and travel peak, Lindquist and other health experts answered questions about how to protect yourself and what to expect in the coming weeks.

I have holiday travel plans. How concerned should I be about being in crowded airports? Should I try to avoid traveling altogether?

This year is expected to be one of the busiest holiday travel seasons since 2000. Public health officials are urging masking indoors and around crowds — especially at airports, where good air ventilation is less likely. But they’re not actively recommending against travel, unlike during previous winters, except for those who are immunocompromised, said Dr. Deborah Fuller, chief of infectious diseases and translational medicine at UW Medicine.

If you’re planning to fly, there might be some comfort in the fact that planes have good filtration systems, but health experts still recommend masking in-flight.

UW Medicine’s Dr. John Lynch added in a post on the medical school’s website last week that those with underlying health conditions should consider avoiding potentially crowded gatherings, particularly because some drugs, like Evusheld, that helped COVID patients early in the pandemic, are less effective against the virus’s new variants.

What steps I can take to protect myself during gatherings?

The top recommendation among health experts is to get a flu shot and COVID booster to strengthen your immune system, as well as masking indoors, washing hands, testing for the coronavirus and staying home when sick.

“None of these strategies — like wearing a mask, washing your hands, covering your cough, being home from work, getting your flu shot — are perfect, but all taken together give you your best chance for limiting risk,” Lindquist said.

For people who are immunocompromised and plan to attend a gathering, doctors also recommend everyone else be vaccinated and up to date on COVID boosters.

“Even if you test negative for COVID, viruses like flu and RSV can have serious consequences in small children, pregnant people and older or otherwise vulnerable individuals,” Dr. Seth Cohen, medical director of infection prevention at UW Medical Center-Northwest, said in the UW post.

How effective are this year’s flu vaccines? Is it too late to get one?

This year’s version of the flu vaccine is about as effective as it usually is, Fuller said. Usually, efficacy falls between 40% and 60% in the United States, offering a “significant amount of protection,” she said. This year, it’s hovering around 50% nationwide.

“That’s the good news,” Fuller said. “The vaccine is a pretty decent match to what’s going on.”

The flu shot, of course, isn’t perfect. It’s possible to get the flu even if you got a shot, but Fuller always counters with the same response: You’d be much worse off if you hadn’t.

Because U.S. flu vaccines are slightly modified every year depending on which strains are circulating, American researchers usually watch what happens in the Southern Hemisphere, whose flu season is six months before ours. They use that experience to update our version of the shot.

“When we hear about having a bad flu season, sometimes [vaccine efficacy] can be as low as 10%,” Fuller said. “That occurs when, in six months, additional mutations happen that make vaccines less effective.”

In Washington, it’s not too late to get a flu shot. While full protection might not kick in before the holidays, the vaccine will still boost your chances of staying healthy during the rest of the flu season, which often lasts until February, she said.

How many Washingtonians have been vaccinated against flu?

About half. According to the Centers for Disease Control and Prevention, about 51% of kids and teens in Washington had their flu shot as of November, compared to about 48% last year. About 50% of adults have also been vaccinated against the flu, compared to about 41% last year. 

The CDC’s Healthy People 2030 goal, an initiative designed to improve national health, aims to have 70% of Americans vaccinated against the flu.

Further data won’t be available until the end of the season, since the state Department of Health doesn’t share flu vaccination numbers until then and more detailed demographic breakdowns weren’t available through the CDC. 

What do COVID booster rates look like now? How effective are the new shots?

Rates for the updated COVID booster, which became available to most adults in early September, continue to lag in Washington. As of this week, less than 30% of eligible Washingtonians had sought the extra shot, compared to the 70% who received their primary vaccine series.

The shot is generally most effective at least two weeks after administration.

The lower numbers reflect a big change in attitudes toward boosters, despite the fact that the new shots have been shown to provide significant additional protection against COVID infection and severe symptoms. More research is required, however, to better understand how well the new booster will protect against any future variants, according to the CDC.