question 4

4. What about respiratory virus infections which get admitted to hospitals?

People hospitalised due to respiratory viruses (not including Covid) are generally hospitalised either with  RSV (Respiratory Syncytial Virus) or with influenza. RSV causes bronchiolitis mostly in young children but also in elderly people. 

In summer 2021, after most Covid mitigations were taken away across the UK, there was alarm about an unprecedented summer and autumn wave of child infections with RSV, a virus that normally spreads during the winter. However, the 2021 wave of RSV subsided before winter set in. Considering 2020 and 2021 together, lockdown and Covid mitigations during the first year resulted in far less children being hospitalised overall. In 2022, the RSV wave once again happened earlier in the year, but once again started falling much sooner than would previously have been the case. The 2022/23 RSV wave in England (similar to that in Scotland) looks set to be smaller than that during any of the three winters prior to the Covid pandemic as far as hospitalisations are concerned. (Note: RSV levels have continued to fall since according to UKHSA data)

The same, that is a different seasonal pattern for RSV infections but no overall rise, was reported in several other states or countries that removed Covid mitigations in 2021 or 2022, such as California. On the other hand, in Denmark there is evidence of an overall increase in hospitalisations from RSV in 2022, but one affecting mostly babies born after mitigations were taken away, or older children, who would likely have had RSV when they were younger. Also, an unusually large number of RSV hospitalisations amongst children is being reported from Sweden. It is not clear how many of those children were hospitalised with simultaneous RSV and Covid infections.

The rate of flu infections remained very low in the winter of 2021/22 due to Zero Covid policies in much of East Asia and in Australia and New Zealand throughout 2021. Australia’s 2022 flu wave started and subsided earlier than expected, rather than being unusually severe overall.

In the UK, too, the 2022/23 flu season started earlier than had been the case pre-Covid. As of late December 2022, it is clear that the flu wave is larger than in the two years preceding Covid, but not clear that it will end up equal to or worse than the flu wave of 2017/18.

How severe different flu waves are certainly depends on prior immunity – and specifically on how effective the type and take-up of flu vaccines are. According to a Public Health Scotland spokesperson, there is concern that flu hospitalisations may be linked to a flu strain “believed to have mutations that could make vaccines less protective”. 

Of course, people are now being infected with Covid on top of all the viruses that were circulating previously, and many are contracting Covid several times a year. 
There is strong evidence that people fare worse if they are simultaneously infected with flu and Covid. The absence of any mitigations against airborne viruses (Covid, flu, RSV, etc.), and rampant cross-infection in hospital and care settings, make simultaneous infections much more likely, causing more deaths and hospitalisations.