Trending Clinical Topic: Virus Collision

Ryan Syrek


July 17, 2020

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From a so-called "doomsday scenario" to insights into how COVID-19 is affecting those with HIV, a focus on the intersection of serious viruses became this week's top trending clinical topic.

In the United States, the Centers for Disease Control and Prevention (CDC) reported that the ongoing pandemic has had a detrimental effect on routine pediatric vaccinations. Declines were noted in recommended noninfluenza childhood vaccines as well as measles-containing vaccines over a similar period last year. The downward trend began the week after a national emergency declaration regarding COVID-19. The World Health Organization (WHO) has observed similar concerns on a global level, with diphtheria, measles, and polio risk rising for millions of children (see Infographic below).

Thus, experts argue that a comprehensive plan is needed to avoid a "perfect storm" of infectious diseases. With childhood vaccinations "well below baseline," Melinda Wharton, MD, MPH, director of the Immunization Services Division at the CDC, stresses that children who have had delays in receiving vaccines must catch up as quickly as possible. The urgency is not only because of immediate concern for potential outbreaks of diseases like measles but because a flu-and-COVID "collision" is expected this fall.

Lawrence O. Gostin, JD, a professor at Georgetown University's O'Neill Institute for National and Global Health Law, stated that COVID spiking during a bad flu outbreak this year could lead to "50% or 100% more hospitalizations on top of those from the flu." An editorial in Science Magazine points to an enormous strain on hospitals should influenza and coronavirus epidemics peak around the same time this fall.

Physician recommendations are recognized as a strong motivator for vaccination. Experts are urging them to use this influence to prompt parents to follow vaccination schedules for children and for patients to get flu shots.

When it comes to the intersection of COVID-19 and HIV, recent news has been mixed. An analysis conducted in New York City found that people living with HIV who are admitted to the hospital with COVID-19 are no more likely to die than those without HIV. The findings support the lack of association between HIV and COVID-19 severity seen in a cohort study from Spain, a case study from China, and a case series from New Jersey.

A greater concern is the disruption of HIV services due to the pandemic (see Infographic below). These disruptions, more than COVID-19 itself, are life-threatening for some of the people at greatest risk for HIV acquisition and poor outcomes.

The intersection between SARS-CoV-2 and other viruses is a major concern, especially with fall fast approaching, and explains why "virus collision" is this week's top trending clinical topic.

Read more clinical information about COVID-19.


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