Super-cold or a silly headline?

Posted onAuthorIan M Mackay, PhD (EIC)

In Australia, there seem to be a bunch of articles talking about “super-colds”. Please stop calling them this. They are just colds caused by one or more of the many known respiratory viruses. Which now includes SARS-CoV-2.

As Australia opened up and we started sharing each others’ physical spaces and air spaces once again. So to did our viral overlord passengers begin to be transmitted in greater numbers. Apart from influenza viruses – it turns out these are highly dependent on the latest shiny version being introduced from overseas. It also turns out that the immunity we develop to the current flu virus after infection or via vaccination may be a lot better than we tend to hear each year in the winter flu stories.

SARS-CoV-2 was never the only virus in town

Those other endemic (always around, often peaking and troughing and causing a spectrum of outcomes) respiratory viruses had been ticking along all the time.

Although Australia had a number of lockdowns, there were still frontline workings out and about, there was grocery shopping to be done, and there were children in childcare. All those people came back to the safety of their unmasked, physically proximate households to share with those they lived with, what their airway cells had acquired while out.

Viruses were picked up because they were wearing inefficient masks or wearing them ineffectively, or maybe they were working too close to others or sharing stagnant air with an infected person – there are many ways other viruses could spread – but when you understand that they all have an airborne component to their transmission – then its easy to see that we create and maintain the problem, as humans usually do.

These airborne respiratory viruses cause a spectrum of outcomes after infection. They may not cause anything to happen – no signs or symptoms – an asymptomatic infection. They may cause colds or in some cases more severe respiratory diseases requiring hospitalization. They may also put so much stress on a system with underlying disease(s) that they trigger other problems in the heart or brain. Some of those with severe diseases will die. Heard this story before? Recently? Yeah. Most of the time these non-SARS-CoV-2 infections don’t lead to severe disease. And that is usually the case for SARS-CoV-2 as well. But sometimes they do. And when we have a lot of infections, that “sometimes” becomes a much bigger and badder number and becomes harder to overlook.

Pandemic and endemic viruses everywhere

Right now we have lots of acute respiratory tract infections going around – coughs, sneezes, runny noses, wheezing, asthma attacks, sniffles, tiredness, headaches (also gastro viruses).

You can see in the data from the eastern state of New South Wales (NSW) in Australia that at the moment (2022; Figure 1 green lines) there are rising numbers of influenza A virus cases, adenovirus cases, parainfluenza virus cases, RSV cases, human rhinovirus (HRVs) cases, human metapneumovirus (HMPV) cases and enterovirus cases.

Nothing in this signals a hugely dramatic difference from the average of 2016-2019 except for HMPV and perhaps the HRVs being more active earlier than usual (similar to a 2020 pattern). There are lots of viruses around.

Figure 1. The number of positive PCR test results for influenza and other respiratory viruses at sentinel New South Wales (NSW) laboratories, January 2020 to 3 April 2022. This graph is from the NSW COVID-19 weekly data overview for Epidemiological week 14, ending 9 April 2022.

And of course, there are a lot of SARS-CoV-2 around (Figure 2) compared to any other year since 2017 as well.

Figure 2. Weekly counts of unplanned Emergency Department presentations for coronaviruses and SARS, 2022, compared to the same week in the previous 5 years

For those of us with lots of COVID-19 vaccines +/- an infection, a new SARS-CoV-2 infection is likely to be much milder than it was. So with this virus also rampant everywhere, it’s not possible to say what we have without getting a sample collected and sent for a laboratory test. You could also get a rapid antigen test which tells you very little if negative, and something useful if positive. But we know that these tests can and do miss early infection. That matters if you want to catch the infection early for whatever reason. If you want to know if you are infectious – then a SARS-CoV-2 positive RAT result can tell you that. But it can also miss some of those cases.

What’s so super about these colds?

As far as we know, nothing. There are a lot of just normal old colds out in the community right now. Just how many will vary with where you are in the world, how and whether you locked down and so on.

From what I see in terms of colds around me, there are definitely a pretty sizable and significant number of distinct viruses co-circulating. But that’s not new.

How long is this thing gonna last?

You may end up with a cold that seems to “go on forever” rather than the 1-2 weeks most last for. The chances are that you are getting consecutive infections; one different virus after another after another. Because what they cause often feels indistinguishable, it all just seems like one long bout. This super-cold concept is really just about there being a high viral burden in the community.

This cold will be the death of me!

Different viruses can hit harder than others. More cell damage, more inflammation – a more general feeling of being under the weather. And viruses can be more active some years and quieter the next (presumably because lots of people were immune after infection). Some viruses change quickly or may have changed suddenly through sheer chance. Some of us don’t mix with others a lot, so we may not be infected by virusX for many years and our community to it will have waned so that when we do get it, it hits hard.

This year, you may have been hit with one of the bad ones and feel like you got a worse cold than ever before. It’s possible you may even feel worse with the next one. Or the first virus may set up some wheezing that the next one exacerbates. Or brings a cough that wasn’t; there with the virus infection. You get the picture. It can be a mixed bag.

But overall are these colds this year all worse than before? Probably not. In my opinion, it’s much more likely to be a simple mix of having lots of viruses around all at once, that the strength of our specific immunity to these critters has tapered off over the past two years but also perhaps just forgetting what colds feel like while we so successfully kept them at bay.

Super-colds? Nuh. Lots of colds? More than likely.

What can you do about it?

And while I know how y’all feel about masks, they do work. If you want to save yourself some illness and dodge one of two of what’s going around this year, get yourself a well-fitting P2/N95 face mask and wear it so that your mouth and nose are covered and the nose wire is fit snugly against your nose. You can test it by fit checking (can also see if you can taste or smell sprayed aerosols).

Masks keep you safer from the infections around you and they keep others safer from you if you are shedding a virus. So whether it’s a super-cold or a silly headline, there are things you can do to avoid the many viruses that are around in increasing numbers as we head into winter.

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