Masking over the last two years slowed the spread of respiratory illnesses like influenza and respiratory syncytial virus or RSV, a highly contagious common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults. RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States.

COVID-19 is also still circulating, said Dr. Andi Shane, the medical director for pediatric infectious diseases at Children’s Healthcare of Atlanta. 

“Although we are seeing very low rates at the moment, we’re likely to see a surge in the winter in a few months as people start to travel again,” she said.

While surges in disease are expected, Shane said Children’s is seeing two to three times the number of pediatric cases as usual.

Data from the Georgia Department of Public Health for the week ending Oct. 8 shows 3,526 of a total 4,563 cases of influenza-like illness occurred in people age 24 and younger. Compared to the same week last year, influenza-like illness is much higher this year than last.

“What’s a little bit different about this one is that it’s been rather sustained and long,” she said. “This seems to be much more sustained because we had some circulation of respiratory viruses during the summer and also, of course, COVID-19 as well, which thankfully at the moment seems to be seems to be relatively low.’

Flu season is also hitting much earlier and much harder than in previous years.

Georgia is in the high category for influenza-like illness spread, and only the District of Columbia has more cases. Georgia and D.C. are leading the nation in cases.

Dr. Felipe Lobelo, the director of epidemiology for Kaiser Permanente Georgia, previously said that relaxing the mitigation efforts, which helped prevent transmission of influenza as well as coronavirus, the past two winters makes it more important for folks to get their flu and COVID shots before the end of October.

“How much of an uptick in COVID are we going to see starting in October and November, as we’ve seen every winter so far?” he asked. “And, also, you know, is flu going to come back?”

Early in the pandemic, many people working in public health were worried about a so-called twindemic, constituting the combined impacts of COVID-19 and influenza. This is a concern for the 2023 winter as well, Lobelo said.

Lobelo said it’s safe for people to get both COVID and flu shots at the same time.

Vaccination is the mainstay of prevention, Shane said, adding that Children’s Healthcare has consistently seen that children who require hospitalization have not been vaccinated against COVID-19 or influenza.

Experts highly recommend that children, as soon as possible, not only get their primary series of two doses of COVID-19 vaccine but also a booster, which helps to make sure that the response continues.

Ideally, they add, kids should get their flu shot by the end of October.

This story comes to Reporter Newspapers / Atlanta Intown through a reporting partnership with GPB News, a non-profit newsroom covering the state of Georgia.

Ellen Eldridge | GPB

Ellen Eldridge is a health care reporter for Georgia Public Broadcasting.