These days, many conversations in Spain revolve around a family member, friend or colleague who has a stuffy nose, cough, cold or all of these symptoms at the same time. The impression that everyone gets sick in winter returns every year like clockwork, for simple seasonal reasons. The cold and lack of ventilation in closed rooms mean that viruses such as flu and Covid find ideal conditions for their spread. The feeling of being trapped in an endless spiral of infection at this time of year increased after the pandemic, when masks and social distancing served their purpose in protecting the population from the flu. But is it true that colds affect us more severely and more frequently than before?
“It is normal that cases increase at these appointments and that they continue to increase. “In health centers today, many patients come for consultation for colds and respiratory infections, although in most cases they are not serious cases,” explains Dr. Leovigildo Ginel, Secretary of the Society's Respiratory Diseases Working Group. Spanish family doctors (SEMERGEN). The doctor emphasizes that it is normal for the immune system to have to get used to the coexistence of more viruses after the pandemic winters – when flu, colds and colds have practically disappeared in favor of Covid-19.
According to the Carlos III Health Institute, in week 49 of 2023, the Constitution Bridge, the rate of acute respiratory infections increases, hospitalizations due to influenza and Covid-19, while hospitalizations due to respiratory syncytial virus show decreasing fluctuations (RSV) infection. However, case numbers currently do not exceed those of last winter, although experts prefer to remain cautious considering that the infection season has just begun and will peak in January and February.
As far as experts know, respiratory viruses have not become more aggressive in recent years. The epidemiologist at the Hospital Clínic of Barcelona Toni Trilla finds a plausible cause in the so-called “immune debt”. “Since we were not exposed to other pathogens during the coronavirus period, it is possible that now that they are circulating again they will hit us harder because we have lost training,” he emphasizes. This, and the fact that containment measures such as masks and social distancing were no longer in place, has resulted in the population being re-exposed to viruses that they were no longer used to.
“When a virus circulates heavily, as was the case with SARS-CoV-2, it is normal for the others to stop circulating. This is called ecological competition,” agrees Magda Campins, head of preventive medicine at the institute, to Vall D'hospital. Hebron. Taking into account the fact that in a normal flu season, 25% of the population gets the flu, the epidemiologist estimates that in the next two to three years the population will have recovered the pre-pandemic level of immunity. “This calculation clearly does not apply to very young children, who do not reach the level of acquired immunity that adults have by the age of six,” he adds.
Immunity, both natural, which develops after an illness, and that obtained through the vaccine, is temporary because viruses often mutate. “It is possible that a person exposed to the circulating virus this year will no longer have protection next year. That’s why a vaccination is never too much, even for younger people who don’t have any previous illnesses,” emphasizes Campins. According to the Ministry of Health, more than 1.7 million people, 60% of the population over 80 years old, have received the vaccine adapted to the sub-variants of Covid-19 this season. Although the big news is the first baby vaccination campaign against RSV, it causes the vast majority of cases of bronchiolitis in infants and results in one in 56 babies who suffer from it being hospitalized.
More viruses in circulation
One of the things that has certainly changed is the panorama of virus circulation, which has become more complex since the arrival of the coronavirus. “We will never have a situation exactly the same as before Covid,” admits Amparo Larrauri, head of the surveillance group for influenza and other respiratory viruses at the National Epidemiology Center of the Carlos III Health Institute. “SARS-CoV-2 is another pathogen that will remain and that competes with the spread of other viruses at this time of year.” Larrauri explains that in the last two seasons, in the months of October to December, the spread of the flu viruses SARS -CoV-2 and RSV have been observed, which could lead to the perception of a larger number of respiratory processes in the population.
Greater attention to respiratory symptoms would also be a key factor in enhancing this feeling. Experts emphasize that after the pandemic, when a small cough was more than enough to set off all alarms, the population's awareness of the dangers of infection increased. “We are all more sensitive. We notice the symptoms and when we have Covid we worry about not visiting our grandparents,” says Salvador Peiró, director of health services research at Fisabio.
Julián Domínguez, head of the preventive medicine service at the Ceuta Hospital, recognizes that every time there is a new wave of epidemics we assume very few common cases and as soon as the number starts to grow, the subjective feeling arises that everything in the world is is sick. “If two or three infected patients meet in a hospital ward at the same time, it is said that there are many infected people, although in reality the data in the weeks before or after is completely normal,” he indicates.
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