COVID-19 and Cold Season Preparedness

If less than one year ago we were talking about pandemic preparedness in general terms, we are now in the midst of a real-life pandemic, and much of our focus has shifted, at least temporarily, to cold season preparedness.

As clinicians, we strive for the best available evidence for managing our patients. As researchers, we understand that even the most accurate of estimates comes with its own margins of imprecision.

With the emergence of SARS-CoV-2 and the gradual understanding of its transmission routes, one of the first questions that we asked ourselves was: what circulation pattern will we see? Will the initial outbreak die out on its own? Will the containment measures manage to stop transmission? Or will the novel coronavirus join the ranks of other circulating respiratory pathogens?

As containment increasingly became less likely with the establishment of community transmission of SARS-CoV-2 in most countries throughout the world, we are now asking the same question, albeit expecting somewhat different responses.

The medical and scientific community now focus on preparing for the cold season, when increased circulation is normally expected for seasonal pathogens such as common-cold coronaviruses, rhinoviruses and influenza viruses, to name only a few. And this increased circulation may very well come amid an upsurge in COVID-19 cases, which has already started to be seen in most European countries.

Will we see increased circulation of both influenza viruses and SARS-CoV-2? Will we see SARS-CoV-2 taking a leading role among cold season pathogens this year? Or will we see influenza viruses taking the spotlight again? With COVID-19 starting to circulate endemically in the Northern hemisphere at the end of this year’s cold season, we have only seen a glimpse of what the future may hold, with some concurrent respiratory coinfections, but gradual reduction in influenza activity, as reasonably expected for that time of the year. However, we are yet to see what viral circulation patterns the next cold season will bring.

The three corona golden rules of hand washing, mask wearing and social distancing could reasonably be expected to also impact the circulation of other respiratory pathogens. However, in order for any public health or personal health measure to be efficient, it needs to be constantly and consistently applied.

With more than a century having passed since the Spanish influenza pandemic, we still do not fully understand all factors that drive the intensity of the seasonal recurrence of influenza viruses. It will most likely be a while until SARS-CoV-2 settles into a predictable pattern, and regardless of what the future waves of COVID-19 will look like, it is only with shared responsibility that we will be able to navigate to a safe course.