CDC Media Telebriefing: Update on Respiratory Disease Circulation Transcript

Press Briefing Transcript

Friday, November 4, 2022

Please Note: This transcript is not edited and may contain errors.


Welcome and thank you all for standing by. At this time all participants are in a listen only mode until the question and answer portion of today’s call. At that time if you would like to ask a question, please unmute your line, press star one and record your name clearly when prompted. As a reminder, please limit your questions to one question and one follow up question. Today’s call is being recorded. If you have any objections, you may disconnect at this time. I would now like to turn the call over to Benjamin Haynes. Thank you, you may begin.


UAB and thank you all for joining us today to discuss what we are seeing with respiratory diseases and what people can do to prevent their spread. We are joined by Dr. Jose Romero, the director of CDC National Center for Immunization and Respiratory Diseases, who will have opening remarks and the Assistant Secretary for Preparedness and Response, who will discuss resources available to support hospital systems under strain from an earlier than usual start to the respiratory virus season. Following these remarks, we will be joined by other CDC experts for the question and answer session. I will now turn the call over to Dr. Romero.


Thank you very much. Good afternoon or good morning everyone depending on where you’re calling in from. And thank you for joining us as we discuss the many respiratory viruses and their diseases that circulate year round in the United States, but are seen at higher level. In the fall in winter, the federal government stands ready to support local health systems. And you’ll hear from Assistant Secretary O’Connell about resources we have on standby to help. In the past two years, respiratory viral disease activity has been highly impacted by COVID-19 resulting in the circulation of other viruses, often being a typical in nature. We suspect that many children are being exposed to some respiratory viruses now for the first time, having avoided these viruses during the height of the pandemic. Currently, the United States is experiencing a resurgence in the circulation of non COVID 19 respiratory viruses. Specifically, CDC has tracking elevated levels of influenza, as referred also referred to as flu, respiratory syncytial virus known as RSV, and Rhino viruses and animal viruses. However, it’s important to note that COVID-19 is not gone, and CDC is continuing to track via the virus and its known variants. As of November for more than 97 million COVID-19 cases have been reported in the US. Weekly cadence counts have been trending downwards and have leveled off in the last three weeks. CDC has multiple surveillance systems to track respiratory viruses. One of those systems tracks the percentage of visits to outpatient medical providers and emergency departments, or a fever plus cold or sore throat, which are collectively called influenza like illness or IOI. Thanks to this tracking system, we know that ili activity is high in the United States for this time of year. Different surveillance systems tell us that different viruses are all contributing to respiratory disease that we’re seeing right now. Our laboratory surveillance networks show that laboratory confirmed influenza activity has been increasing over the past several weeks. In the southeast of the United States, nearly 20% of respiratory specimens are testing positive for influenza virus, mostly influenza A h three and two viruses, which in the past have been associated with more severe seasons, especially for young children and older individuals. In the mid Atlantic, and Midwest, region three and five, we are seeing a growing proportion of h one n one viruses. There are also early signs of influenza causing severe illness in precisely these two groups of individuals this season with higher hospitalization rates reported in CDC flu, hospitalization that works for both groups, as well as all ages overall compared to the same time last year and in previous years. In fact, we’re seeing the highest influenza hospitalization rates going back a decade. Sadly this week. We are also reporting the second influenza related pediatric deaths of this season. Moving on to RSV, or respiratory syncytial virus, this is a common respiratory virus that usually causes cold like symptoms. And most children experienced a mild case before they are two years of age. Diagnosis and Treatment of RSV are well understood among healthcare providers, most older children, adults adolescents recover within one to two weeks of infection. However, RSV can be serious, especially for infants and older adults. It is the most common cause of bronchial itis, and inflammation of the small airways of the lungs, and pneumonia in children, less than one year of age in the United States. Children ages four to four years and younger are the most likely to be hospitalized. Secondary to RSV infection. People with RSV usually show symptoms symptoms within four to six days of becoming infected.


The CDC tracks RSV activity using several surveillance systems including the National respiratory and enteric viruses surveillance system, the RSC hospitalization surveillance network and the new vaccine surveillance surveillance network. RSB activity continues to increase nationally, but varies regionally. RSV laboratory tests detection through the N r e. S. S, are increasing in all 10 HHS regions except regions four and six, which include the southeast and south central parts of the United States, or specifically, Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, New Mexico, North and South Carolina, Oklahoma, Tennessee and Texas. luminary data indicate that a decrease in Region eight as well, which includes Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming. These three regions saw a decrease in the proportion of PCR. Polymerase Chain Reaction tests positive for RRSP in the week ending October 22 2022, week 20 week 42 following pics that occurred during the week, ending October 8 2022, for region four and October 15 2022. For reasons six and eight. In mostly regions, it seems like RSV is trending downward, and influenza is beginning to increase or surge. As previously noted, all of these numbers are significantly higher than seen at the same time in previous years. Which is why I want to turn next to what we all can do, including parents and clinicians to prevent and slow the spread of these respiratory viruses. Importantly, CDC will soon issue a Health Alert network communication or hon to 1000s of healthcare providers to communication highlights diagnostic testing, treatments, and our best prevention tools vaccination. We have vaccines for two of the three viruses, we’ve talked about influenza, and COVID 19. Vaccines for COVID, 19, and influenza are safe, effective and can lower the risk of illness and protect against severe complications. Stay up to date on your vaccinations. Both the yearly influenza vaccine and updated COVID 19 vaccine is essential to make sure you and your family are protected. I want to underline that with the holidays around the corner vaccination is your best protection against infection. As a reminder, while most individuals only need one dose of annual flu vaccine, the CDC recommends that children younger than eight years of age who are receiving the influenza vaccine for the first time get two doses of the vaccine for best best protection and your health care providers know about this. Also, I want to mention what parents and caregivers should be on the lookout for in terms of emergency warning signs. For children and young infants. It’s hard to tell the difference between influenza COVID-19 and other respiratory viruses just by looking at symptoms alone. If your child is experienced, experiencing any of the following warning signs, you should seek medical attention right away. And these are fast breathing or trouble breathing, blues lips or face chest pain, muscle pain, and that can be shown in the child by he or she refusing to walk or crying excessively if you pick them up, dehydration shown a by no urine over an eight hour period, a dry mouth or crying without tears. A child that is not alert or interactive when awake. Before I hand off to Assistant Secretary O’Connell, I would like to take a moment to discuss ways to minimize the risk of respiratory infections in general.


One of the strategies for helping to reduce the burden of On our hospitals is to do what we can to prevent respiratory disease, respiratory infection. This is essentially this is especially important if you are a person at high risk for some of these viruses. And these persons includes infants and young children, individuals, 65 years and older, pregnant people and people with certain underlying chronic conditions. As I said before, first and foremost, vaccination is the best defense in the prevention of influenza and COVID 19. However, people should also practice everyday preventive measures such as cough, hygiene, or etiquette that is covering your coughs and sneezes, staying away from individuals who are ill, and frequent hand washing or using alcohol gels. People who also may also choose to wear a well fitting mask as an added precaution. Finally, with influenza and COVID 19. We also have antiviral drugs that can treat the infection for both adults and children. These work best when started early in the infection, so it’s important to seek prompt medical attention to begin early treatment. Our health alert will include information for clinicians on testing to treat. Thank you very much. And now I’d like to hand it off to Secretary Assistant Secretary O’Connell.


Thanks so much, Dr. Romero. And thanks to all of you for joining us today at Asper. We are working with our state and local partners on managing the surge of respiratory illness by helping to mitigate hospital capacity issues. We are monitoring capacity across the country sharing best practices to reduce the strain on systems and standing by to deploy additional personnel and supplies as needed. As soon as we started seeing the increase of respiratory illness in several regions of the country, Asper immediately reached out to our partners on the ground to better understand what they were seeing. Through this outreach. And in collaboration with our CDC partners, we are tracking trends, and the number of cases of respiratory viruses. The number of emergency department visits, the number of inpatient admissions and the number of Intensive Care Unit admissions. This allows us to anticipate surges peaks and valleys and hospital bed capacity. We are also closely monitoring the supply chain for any potential shortages. All of this helps us to identify and work closely with those health systems that are or will experience stress and strain as a result of RSV, flu and COVID. We have also begun convening town halls across our 10 regions, bringing together pediatric experts, children’s hospital leaders, local and state emergency managers, public health leaders, as well as other key local, state and federal partners to hear directly from them and to capture and to share best practices. During these town halls and in other venues. We are sharing technical expertise, resources and clinical tools from Asper funded preparedness programs, including the pediatric disaster care centers of excellence, regional disaster health response systems, and the Asper Tracy Information Portal. We also have additional tools such as personnel and supplies that Asper that we are readying for deployment should they be needed. This next level of surge response assistance may be available in some circumstances, when the demand on a jurisdiction exceeds its capabilities and available resources. At that point, we will work with that state or jurisdiction on whether to deploy our National Disaster Medical System teams or another of our staffing surge tools to help decompress their hospitals. If such a situation begins to emerge, we will make deployment decisions using our standard interagency process, which evaluates incoming requests validates them and ensures that the appropriate assistance is provided when available. This evaluation process involves many of our response partners such as FEMA and DOD. And in addition to personnel Asper also manages supplies that might be used as a part of a response. And we do this through the Strategic National Stockpile medical supplies including PPE, and ventilators continue to be available from the SNS upon state request. To date, no state has requested this level of support, and additional personnel or supplies. But we stand ready as the entire administration to work with them should these resources be needed. I want to take a minute in closing to thank states and providers across the country who are saving lives and using innovative strategies to support their health systems. With increased RSV infections, a rising number of flu cases and the ongoing burden of COVID-19 in our communities. There’s no doubt that we will face some challenges this winter. But it’s important to remember as Dr. Romero said that RSP and flu are not new. You and we have safe and effective vaccines for COVID 19 and the flu, which I encourage as did he, you to go out and get today if you haven’t already. Asper CDC and all of our federal partners are closely working with states to ensure that they have the resources they need to keep our communities in our country healthy now and throughout this winter. And with that, I’ll turn it back to you. Thanks so much.


Thank you Dr. Romero and Assistant Secretary O’Connell. As we move into the question and answer period. I want to introduce our other experts who are available for questions. First is Dr. Barbara man, Acting Director of CDC has proposed Coronavirus and other respiratory viruses division. Dr. Meredith macmorrow medical officer and CDC is proposed Coronavirus and other respiratory viruses division. Dr. Ben silk Acting Chief of the surveillance and Prevention Branch in CDC has proposed Coronavirus and other respiratory viruses division, and Lynette Brammer epidemiologist in CDCs flu division. I’d also like to note that Assistant Secretary O’Connell will only be available till 1230. And with that we are ready to open up for questions IV.


At this time, we will begin the question and answer portion of today’s conference. If you would like to ask a question, please unmute your phone, press star one and record your name clearly when prompted. If you need to withdraw your question at any time, you may use star two. Again, that is star one to ask a question. And as a reminder, please limit your questions to one question and one follow up question. For our first question. We’ll go to the lineup Erica Edwards from NBC News. Please go ahead.


Hi, thanks so much. My first question is when you see such early and fast spread of these respiratory viruses, what might that tell us about the rest of the season? Do you think that these viruses will sort of spread quickly and then burnout? And then my follow up is we went RST has been circulating widely for weeks now. Was there something new this week that prompted CDC to hold this briefing? Thank you.


Dr. Romero, do you want to take that one?


Sure. I’d be happy to, you know, mitigation efforts led up across the country during the we saw during the pandemic and as people begin to congregate more to stop wearing masks, it’s not surprising to see this increase in respiratory virus circulation. You know, in the previous years, atypical presentations of atypical seasons, due to mitigation against COVID. left a large swath of the United States population uninfected. So we’re seeing more RSV because in the last past two years, we’ve not seen infections in children as we have previously. And so these children, if you will, need to become infected to move forward because it’s a disease very common in children. So we’re talking about it now, because people have a lot of questions. We want to answer the questions that are out there and reassure the American public that there are ways to prevent this. And that is prevented just by taking the vaccine for COVID. And for influenza, and that we have ways of preventing RSV infection by washing your hands avoiding contact. And if family wishes, they can use masks. But those those are the reasons why we’re talking about it. Now. Back to you.


Next question, please.


Next, we’ll go to the line of Helen brands will from stat please go ahead.


Hi, thanks so much for taking my question. I actually have to ask the person then I’d like to ask a follow up, please.


You know, in seeing so much flu,


this early in the season is obviously startling. But a lot of flu is not the same as a lot of severe flu. Are you folks seeing any metrics that are making you worried that this could be a severe season as well as an early season? Or is it still too soon to tell?


But do you want to answer that question?


Sure. I’d be happy to so far. Right. What we know right now is that we are seeing an early season. As far as how severe the season will be. We’re just going to have to wait them follow the season. But right now we’re not seeing anything that would lead us to believe that it is more severe. It’s just early right now. Thank you. And the other question I have is do you have any indication yet about what flu vaccine uptake is like so far this season?


Let’s see. This is one that I can take that also if you’re okay. With that, right now based on claim state of flu vaccine coverage among adults 18 years and older is lower compared to this time last season. For adults, we’re about 5 million doses administered down behind where we were this time last year. For Children coverage looks about the same as this time last year, but there was, but that’s still a 6% drop in coverage compared to before the pandemic. And also we’re seeing about 5% fewer pregnant people haven’t been vaccinated now compared to this time of year. And that worries us because flu shots given during pregnancy helped protect both the pregnant parent and the baby from flu. And vaccination has been shown to reduce the risk of flu associated acute respiratory infection in pregnant people by up to a half.


Next question, please IV.


Next, we’ll go to the line of finit neuropathic from Washington Post, please go ahead.


Hi, I’ve got two questions. First consumer just explained the big picture of what all this means. And are you what does it mean for the upcoming winter season for hospitals are expecting it to be worse than it was in the last two in the last two winters? Because Because of COVID. And then, separately, one of the questions that I’ve just been hearing from people is, isn’t what’s happening with RSP evidence that the COVID lockdowns weren’t good for kids that they should have been having exposure, these these kind of these kind of viruses before they’re getting sick and math like they are now. What do you say is that? Dr.


Moreau, do you want to take that in? Assistant Secretary O’Connell maybe addressed the schools part? Or hospitals? I’m sorry.


So, you know, I think we are, this is not unexpected, these these numbers of cases that we’re seeing at this time. We did not see the virus for two years. And this increased number of cases is to be expected, given the number of individuals that are susceptible to the virus at this time. We’re not seeing it this time, more severe cases of disease. And so we will continue to monitor this over the upcoming weeks.


Overdue us, Secretary. Thank you so much, Dr. Romero. So last year, you know, to your question, we did see increases in in cases through the winter, we were rounding from the Delta surge and COVID into the Omicron surge. And we had an early RSV season, we had a big flu season. So this is something that we did see experience and manage our way through last winter, which gives us some confidence and how we’re able to approach what we’re seeing now. But we are watching this happen. And we are continuing to sit on the tools that I mentioned, working with hospital systems on best practices, some mitigation strategies to help us strain including the load leveling, making sure that within our hospital coalition’s one hospitals for another hospital in the same coalition can accept the patients are also leaning into telehealth doing some of the initial assessments through telehealth and not having folks walk into the hospitals and take a bed. So we’re continuing to have these conversations and apply many of the lessons we’ve learned throughout the pandemic as we look at the strain we’re starting to see on the hospital system. But we are, you know, cautiously confident that having worked through two of these seasons already. We have the tools in place, and we know what triggers and what levers we need to pull. Should things continue to increase in this way. Next question, please. Next we’ll go to the line of Brenda Goodman from CNN. Please go ahead. Hi, thanks


for doing the call. I have a question. Because cases of RSV and the flu are increasing so much earlier than usual. Do you can you characterize for us like where vaccination stands? I know you said that it’s on the tracker now. It says something like 8.4% of people have gotten their COVID their updated COVID boosters. Are you worried about that? Are you worried about where vaccination stand in comparison to infections at this point in the season? And then obviously that there thanks.


That command you want to take that into Yeah. Sorry.


Happy to take that question. We really encourage people who have not yet gotten an updated vaccine for this fall, to go out and get one, it’s the most important thing that you can do to protect yourself against COVID. And at this point where we’re seeing so many other respiratory viruses, causing illness as well, that makes it all the more important that people get that vaccine as soon as possible if they haven’t already.


Next question, please. Next, we’ll


go to the line of Ron Lin from Los Angeles Times, please go ahead.


Thanks for taking the call. Can you explain the potential reasons for why RSV is more significant in some tasteful foods more severe than others? Is it unusual for there to be such a divergence in what viruses dominating and separately on a national basis regarding hospital on ER available capacity? Specifically, do you know what states are being hit the hardest? And the compared to the worst levels of COVID? Or is it more mild than that? Thank you.


Then I can take the first part if you want to. Perfect, thank you, sir. So this, what we’re seeing across the United States is not unusual for RSP. And in a typical season, we would see RSP start in the south east corner of the United States and work its way upwards towards the north west. And activity in RSP. Is is regional, and even even local, at a state level. So so this is not unusual to see these different, different levels across the country over.


And I’m happy to take the hospital question, if that would be helpful. We are seeing through the question. And as Dr. Romero just mentioned, some of the regional impacts of the current increases. And our mid Atlantic states, New England states, Washington State are currently experiencing significant capacity strain right now. But as this, you know, as these illnesses sort of roll over the country, we know that those that are currently experiencing strains now will reduce and other parts of the country will uptake. And this is not dissimilar from what we saw this time last year as we were beginning to manage out of the Delta surge and into the Omicron surge. So we’ll just continue to watch that closely. But that gives you a sense of some of the states and regions that were watching very carefully right now. Next question.


Next, we’ll go to Madison molar from Bloomberg News, please go ahead.


Hi, when looking at the


flu surveillance setup from October, the week ending October 22, versus the newly released data from the week ending October 28. It looks like there were, you know, nearly a doubling in cases, hospitalizations and deaths. Is that normal over a one week period is that, you know, because of increased surveillance, more awareness, people, you know, hearing about this in the media and going to the health care providers. Can you give us a little bit of context about those really steep increases over the last week? Thank you. Dr. McMorrow,


do you want to take? Oh, I’m sorry. Lynette.


Yeah, thanks. Um, I don’t think it’s a issue with recognition. This is the the estimates are based on hospitalization data. And it’s not unusual when influenza season begins in particularly on a local level for activity to increase pretty rapidly. And so this is this is normal for what we can we see during a flu season.


I do we have time for two more questions.


Absolutely. Our next question comes from Mike Stobi. From the Associated Press. Please go ahead.


Hi, thank you for taking my question. One is a kind of a follow up to Ron lens question I was going to ask why. Yeah. Why in the southeast we’re seeing signs of RSV fading but flu surging so much is the answer to that that the RSV mood cycle wave earlier than the flu wave. And the second question I had was about what’s the clearest statement It can be made about how early this flu season is. You talked about the hospitalization rates are the high I, if I understood you correctly, the hospitalization rates are the highest. They’ve been this early in the season and more than a decade. I think. In the past, sometimes when we think about flu season actually hitting the nation in full force, if the deaths in the preceding week that were due to pneumonia, influenza exceeded a predetermined epidemic threshold, but COVID has been thrown in that mix. If we pass the epidemic threshold, are we in full swing in a is flu season hit the country nationally? How are you describing that?


Thank you. Ben, do you want me to take take the first try at this? And then if we need to add more to it?


Yes, absolutely. And document Morrow or Lynette can weigh in if they need to.


Right. So So for influenza, we have crashed, we have crossed the epidemic threshold. I mean, we’re seeing more than more cases. And we would expect at this at this time. So why is RSV fading in influenza coming on? Yeah, we generally see a cycle of or a succession of viral infections in a given season, right. So so you will see, for example, RSV increase and then fade away to a lower level as flu increases. And so I think what we’re seeing then is this cycling of, of infections, part of it has to do with the fact that you’ve now infected enough people that that you’re not able to infect a whole bunch more after that. A lot of these infections have mild right and don’t show up in the hospital. And so I think that would that would explain what we’re seeing with regard to two RSV, and it’s cycling of RSV, followed by influenza. And I think I talked about the flu issue. But back to you guys.


Thank you, and are Yeah, absolutely. Our last question comes from Meg Winget are from the Denver Post. Please go ahead.


Hello, thanks for taking my question. I wanted to ask about in terms of your preparedness and, and resources, what you have specifically for Children’s Hospital hospitals, since they’ve been hit disproportionately now, and so much of the system is really set up much more for adults. And as a follow up, would you be able to send the send around the spellings of the people who spoke but weren’t listed in the initial press? Thing? Thank you.


Yeah, yes, make? Absolutely we’ll send around the list of names and spellings. And in regards to your question about the hospitals or preparedness that Assistant Secretary O’Connell dropped, but you can follow up with Asper. After this call, they’re happy to answer that question for you.


I’d like to thank Assistant Secretary O’Connell and Dr. Romero for taking the time today and appreciate you are joining us for this briefing. If you have further questions, please feel free to call the main media line at CDC. It’s 404-639-3286 or you can email Thank you.


Thank you all for participating in today’s conference. You may disconnect your line and enjoy the rest of your day.


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