The work begins now that the treatments are here
The danger of RSV for older adults and health-compromised adults: An old doctor’s experience in New York, and a recent study of the U.S.
RSV is one of the viruses that cause common colds, as well as bronchitis and pneumonia, in older people and health-compromised adults. Falsey asserts that, even among physicians, there is still a constant perception ofRSV as a mainly paediatric pathogen. The University of Edinburgh, UK’s Harish Nair, an epidemiologist with expertise in the virus, says that more and more people get older and have larger airways so this is usually the reason for the decline in the number of infections. We get a nose bleed and some sniffles.
When a retired doctor in his 80s checked into the Rochester General Hospital in New York complaining of difficulty breathing, his doctors suspected he had pre-existing heart failure. They gave him diuretic drugs to try to lower his blood pressure, and started him on antibiotics. The medications, however, made no difference. His doctors were stumped.
The risk of serious illness from RSV also begins to climb as people age. Each year, RSV causes about 159,000 hospitalizations, 119,000 emergency-department visits and 1.4 million outpatient appointments in older adults in the United States2. Fatality rates hover at around 6–8% in those who are hospitalized, meaning that somewhere between 9,500 and 12,700 older adults in the United States die from RSV every year. A 2005 study3 of both older and high-risk adult patients in the United States — the largest and most comprehensive study of its kind, according to Falsey — evaluated a total of 2,514 illnesses and put the RSV mortality estimate higher, at around 14,000 annual deaths.
In people with underlying conditions such as Diabetes or heart or lung disease, it is possible to be at a high risk for RSV. In a 2022 meta-analysis2 of 14 studies of RSV occurrence in US adults over the age of 65, for example, researchers found that people with chronic medical conditions were 1.2 to 28 times more likely to be hospitalized than were adults without an underlying condition.
It doesn’t help, either, that there’s no effective antiviral treatment for RSV for adults, Falsey adds. Hospitals and doctors don’t want to spend $50 on healthcare if there is nothing they can do.
The good news is that some tests now automatically include flu, respiratory syncytialviruses and coronaviruses. Hospitals and physicians have increased their testing for viral infections since the swine flu epidemic. “It’s funny, people will come to me now like, ‘My goodness! What is going on with the vehicle? It’s in all my old people!’” Falsey says. “I’m like, ‘Nothing is going on — it’s just that you’re testing.’”
The two phase III trials for the vaccine could be completed by the end of the year. The first vaccine is made by the UK’s GSK. The vaccine showed efficacy of nearly 83% in preventing RSV infection in all adults over 60 years old, and of nearly 95% in those with at least one underlying medical condition. The second vaccine, developed by the pharmaceutical firm Pfizer, based in New York City, demonstrated similar levels of efficacy, at nearly 86% for adults over 60.
The Age of Innovation: The Challenges of Keeping Low-Income Poverty People Away from the High-Surface
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Yet, even as these developments engender optimism, substantial hurdles remain. Many people in low-income countries are vulnerable due to the difference in access to existing interventions. Without policies in place to ensure equity, these communities could be left exposed despite the recent progress.
Efforts to keep vulnerable people out of the hospital are starting to pay off, but new challenges arise from using these strategies.
A study found that older adults over the age of 65 with underlying health conditions were between 1.2 to 28 times more likely to be hospitalised than adults without an underlying condition. It also found that those with at least one underlying medical condition were nearly 95% less likely to be hospitalised than those without an underlying condition.