It is going to be a sniffly Christmas for many in Cayman amid a ‘viral siege’ that is leaving doctors’ offices full and pharmacy aisles empty.
The combination of COVID-19 and a significant resurgence of traditional winter cold and flu viruses has been described as a ‘tripledemic’, with many Cayman residents, particularly children, facing an onslaught of different illnesses over the winter season.
It is the first Christmas since the end of the COVID-era lockdowns. And while the dreaded virus has not gone away, it is the return of virulent strains of more traditional cold and flu viruses that is causing the majority of illnesses over the festive season.
Dr. Heidi Fahy, of Cayman Clinic in George Town, said the facility was seeing an unusually large number of non-COVID related viral illnesses.
She said the restart of travel in the latter half of the year, building towards record arrival numbers in the past few months, had brought back the germs that Cayman had been sheltered from during the COVID border closure. Schools have been particularly badly hit, with the impact spreading to siblings and parents ahead of the holidays.
“People are generally reporting being unwell for longer than what’s usual for them and I think part of the problem is our immune systems hibernated a bit during the lockdown,” she said.
“We rarely saw colds and coughs during that period so now that we are fully open with unrestricted travel, germs are moving around and being quite successful.”
COVID remains a concern, she said, but currently colds, coughs and traditional flu are causing more problems for patients.
Dr. Sara Watkin, paediatrician at Integra Healthcare on West Bay Road, said the amount of colds, coughs and general illness was much higher than in the past few years. She said young children particularly were getting much sicker than pre-COVID.
“It is not just in Cayman, it is happening all over the world,” she said.
“We are absolutely putting it down to the fact that people were locked down, wearing masks, sanitising their hands all the time and, of course, in Cayman there was no travel. We had very little exposure to infectious diseases.
The bubble has burst
Those viruses appear to have come back stronger, with people getting worse symptoms for longer periods and children suffering particularly severe effects.
Young children, especially, have grown up in a bubble in Cayman, without exposure to the usual colds and coughs that help toughen the immune system.
“In their first year in childcare or school, the average child picks up 8-10 viruses. During COVID many children didn’t get that exposure so this is effectively their first true year in school.”
Triple threat
Public health officials are reporting exponential growth in flu-like illnesses over the past months.
From a reported 111 cases per week in September, the amount of cases has risen to an average of 244 each week in December. The total number of cases for the season for the calendar year is expected to be more than 7,000, making it now of the most active flu seasons on record.
Timothy McLaughlin, Cayman’s senior public health surveillance officer, said there had been a slight increase in hospitalisations, with 3-7 admissions per week for flu-like illnesses.
While COVID remains a factor, particularly for elderly people, it is the more traditional cold viruses that are impacting children.
“Many of these cases were the result of there being three different viral illness circulating simultaneously, namely the Flu (Influenza), Covid 19 (Corona Virus) and Respiratory Syncytial Virus (RSV) detected in children admitted to the paediatric unit,” he said.
COVID-19 weekly cases dropped from 126 cases in September and have stayed consistent at just over 60 per week through the rest of the winter, according to Public Health.
Medicine shortages
The effect is being seen in supermarket aisles and at pharmacy counters too.
Michael Anderson, head pharmacist at the Foster’s chain of stores, said there had been a steady increase in prescriptions, as well as rising demand for over-the-counter cold and flu remedies.
Cold medication has been in short supply in Canada, in particular, during an especially virulent cold and flu season. And while Cayman pharmacies are facing some challenges, they are able to keep up.
Anderson said some of the popular brands were “depleted on the shelves” but the store holds back supplies behind the pharmacy counter and is able to meet demand.
“We are facing a bit of pressure, but because of the diversity of our suppliers we are keeping it steady. I think this year is unique because of what is happening the US and Canada. That puts pressure on out sales as well.”
Mental impact
There’s a psychological element, too, says Dr. Fahy.
We’ve forgotten that we get colds and coughs in the winter months and are feeling the pain a little more acutely than we might otherwise.
To stay healthy, she advises all the basic tips that kept people safe during COVID – wearing masks, washing hands, staying away from large gatherings.
But she cautions that having a cold or cough is a normal part of life and, in the long term, it is good for the immune system.
“Trying to remain germ free sounds appealing but leaves our immune systems vulnerable so a happy balance would be ideal. Being a germaphobe is not a good idea either.”
Dr. Watkin agrees.
“Children need these viruses to keep them healthy in the long term. We don’t want to go back to masks and isolation but sensible hygiene to avoid spreading is something that we should all be doing.”
International phenomenon
While flu and now COVID are the most common illness people think they have when the sniffles start, it is most likely to be a respiratory syncytial virus.
Data out of the US shows that COVID remains the biggest threat in terms of hospitilisations.
But RSV illnesses are among the highest on record and are impacting younger people, especially children at a higher rate.
Weekly hospitalisations for RSV among children are the highest they have been since the Centers for Disease Control and Prevention began its surveillance in the 2018-19 season, the New York Times reported.
“Roughly one in every 70 babies 6 months and younger have been hospitalized since the beginning of October, according to preliminary estimates.”
Cayman’s virus profile typically reflects the countries that fly into the island, with the US being the primary supplier of tourists. The island is also exposed to viruses from the UK and the Caribbean. With more than 20 gateway cities now flying into Grand Cayman, we are particularly exposed to a wide range of viruses.
