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If it seems like you and everyone you know are sick right now, you’re not imagining it.

And yes, it may have something to do with the fact that many people have been wearing masks and avoiding others for over two years.

But that’s far from the whole story.

Researchers say there are a host of factors influencing the current misery, including chance, specifics of the immune system, and the direct and indirect effects of the pandemic.

Why are so many people sick right now?

Viral outbreaks naturally vary, with some years worse than others, but COVID-19 has certainly affected natural patterns, said Dr. Ofer Levy, a pediatric infectious disease specialist who leads the precision vaccine program at Boston. Children’s Hospital.

“It seems to me very likely that whatever has happened with the pandemic with travel etc. has changed some of those patterns,” he said.

The peak of respiratory syncytial virus, more commonly known as RSV, appears to have passed – although it is unclear whether it came earlier than normal this year, as it did in 2021, when it was peak in the summer, or if there will be another peak later in the season.

The US flu epidemic could also be earlier this year rather than more severe, as happened in Australia over the summer, said Michael Osterholm, an epidemiologist who directs the Center for Infectious Disease Research and Policy. from the University of Minnesota.

The flu may have already peaked in a few places, with hospitalizations dropping last week from the week before.

Although the flu vaccine seems like a good match for the strains circulating this year, the most commonly circulating strain, H3N2, is known to cause more severe illness.

And “vaccine fatigue” has kept flu vaccination rates below average this year. Only 26% of American adults and 42.5% of children had been vaccinated against the flu as of December 1. 9.

“The dynamics are really complicated, so it’s no surprise that we’re seeing something different this year,” said Al Ozonoff, a pediatric infectious disease researcher at Boston Children’s Hospital and the Broad Institute of Harvard and MIT. “COVID has really upended all the standard relationships between viruses and it will take some time for them to recalibrate and fall into a stable equilibrium.”

Are we done with COVID-19?

Unfortunately, the pandemic is not over yet and it is not known when it will be.

“We’re seeing an unusual increase,” Osterholm said, with COVID-19 deaths up 71% in the past three weeks and related hospital and intensive care bed usage up 22% . “The bottom line is that it’s not done,” he said.

Although the virus continues to evolve, so far researchers aren’t worried about new variants.

The booster shots target both the original virus and the BA.5 variant that circulated earlier this year, but the current variants aren’t that far off, said pathogen researcher Dr. Jeremy Luban. at UMass Chan Medical School.

Otherwise, healthy people who have been vaccinated or infected in the past year should have good protection against serious diseases, he said. “There is no evidence that the virus is evolving away from this immune protection.”

Masking may have a small impact

If the previous masking factors in the current disease outbreak, Ozonoff doesn’t think it has much effect. Studies do not show large differences between areas that had strict masking and those where masking was not applied.

But it is theoretically possible.

Generally, people are exposed to the flu when they are infected or vaccinated. They might get a natural boost if exposed to a similar strain some time later. Because people wore masks and avoided crowds in recent years, the strain of flu and other viruses currently circulating could be different enough to make us sick.

“For a pathogen like RSV, we rely on annual or multiple exposures to RSV to boost our immunity on a very regular basis,” said Dr. Kristin Moffitt, pediatric infectious disease expert at Boston Children’s Hospital. “Before the pandemic, we were all going through this.”

Masking prevents these minor exposures and could be one of many factors involved in the current disease outbreak.

“We kind of had this perfect storm,” she said, where “the population-level immunity needed to hold off or to keep infections from skyrocketing was less than it normally would have been and at the same time everyone came back, fully unmasked for normal around the same time the weather was starting to turn cold.

Has COVID Weakened Our Immune System?

Again, this is theoretically possible, but unlikely to be the whole explanation. Duane Wesemann, who does research at Brigham and Women’s Antibody Hospital and Harvard Medical School, both in Boston.

The immune system registers its exposures, so having COVID-19 antibodies has probably changed it in some way. But it’s also sturdy enough to withstand a few years of isolation, Wesemann said.

COVID-19 was a more serious threat than the flu, RSV or the common cold, so it made sense to protect ourselves against it – even if it might have made us a little more vulnerable to less serious illnesses now, he said. -he declares.

“We always win here.”

How can I avoid getting sick?

The same strategies that worked during the height of the COVID-19 pandemic still work, and layering them will be more effective than doing just one, experts said.

These strategies include vaccinations. Flu and COVID-19 vaccines are safe and effective in preventing serious illnesses, but not all infections.

Masking can help, especially indoors in crowded spaces with poor ventilation, Levy said.

Stay home if you are not feeling well.

Wash hands frequently with soap and for at least 20 seconds.

For family gatherings, especially if they include babies, or elderly or immunocompromised people, it makes sense to get a quick COVID-19 test just before getting together. Every insured person is entitled to eight free tests per month, and the federal government has just reopened its covid.gov/tests portal to allow people to request four additional tests by mail.

Dig deeper

Contact Karen Weintraub at kwintraub@usatoday.com.

Coverage of patient health and safety at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.