The Decibel - This year’s hottest viral trends: norovirus, flu, COVID and RSV

Episode Date: January 31, 2025

If it seems like everyone you know is sick right now, that’s because respiratory virus season is in full swing. On top of influenza, COVID-19 and RSV, this year, medical professionals are seeing a surge of norovirus cases – also known as ‘winter vomiting disease.’Alanna Smith is a health reporter with the Globe. Every week, she’s publishing data on respiratory virus season across the country, including links to resources about where you can get vaccinated. Today, she’s on the show to talk about what the spread of illnesses looks like in Canada, how hospitals are affected, how to best prevent illness, and what you need to know about avian flu.Questions? Comments? Ideas? Email us at [e-mail]

It's that time of year again. So many people are sick right now. The 2025 flu is insane. I've been sick for the last like two weeks. Whatever it is has hit my house so bad. More and more people you know are probably sick. Or maybe you yourself have caught something. And the mix of viruses looks different this year. It includes a surge of norovirus alongside the usual

respiratory illnesses. So today, Alana Smith is on the show. She's a health reporter with The Globe. She'll tell us what else we can expect from cold and flu season, how hospitals are dealing with it, and what you need to know to protect yourself and your family. I'm Maynika Ramen-Wilms and this is The Decibel from The Globe and Mail. Alana, it's so great to have you here.

Thanks for having me. Let's just start with the basics. What respiratory viruses are we seeing right now? So all the usual suspects, I'm talking influenza, RSV, COVID, the common cold of course, and you know data from the most recent Public Health Agency of Canada dashboard update shows flu is really the major contributor right now. Last I checked it was about 13.6% of tests coming back positive for flu. You can compare that to 8.7% for

RSV, which is holding quite stable, and then declining 6.8% for COVID. Okay. And I think we're all fairly familiar with all three of those, but can you just kind of remind us the differences between those three viruses? I mean, the symptoms are super similar. so it can be really difficult to tell without testing the difference between them or which one you might have, but there is some distinguishing features. So for flu, for example, symptoms appear rather quickly. I'm talking like, you know, anywhere from one to four days you're going to get it after exposure. RSV is a little bit longer. You're looking at two to eight days. COVID is kind of a big old question mark to some extent.

You know, it's one to 14 days, but sometimes there's no symptoms at all, which we learned obviously during the height of the pandemic. Some people may be asymptomatic, of course, but maybe if I can take you through some of the common symptoms associated with each one. Yeah, please. So flu, for example, you're gonna see fever, cough, muscle aches, chills, headaches, maybe even a sore throat. RSV, a little bit similar, but a little different. Gonna get runny nose, coughing, wheezing, sneezing.

A good thing for parents to know is that infants may appear irritable or they may have a decrease in appetite. And then for COVID, of course, it varies person by person. So common symptoms, you could see a sore throat, runny nose, shortness of breath, fatigue. And then of course, which we learned only a couple years ago, of course, sometimes that also comes with the loss of smell and taste. Right. Okay. And you gave us some numbers for what we're seeing across the country in terms of flu, COVID, and RSV. Do we know yet, Elena, have we hit our peaks for the

season for those viruses? So it's going to depend where you're looking in Canada. Typically speaking, you're going to see things start in the West and then move their way East. So hospitals in Alberta, for example, in December were just packed to the brim. They were double-bunking pediatric patients. That seems to have calmed down a little bit, but we're still seeing pretty aggressive flu numbers. So the hospitals are still double-bunking in some cases. Some provinces, like further east, for example,

may just be moving up to their spike now. I think I had mentioned that the overall national average for flu is 13.6%, but there also are some provinces where they're seeing a higher prevalence of flu. So for example, it's 15.4% in Ontario. In BC, it's 15.3%. COVID also relatively tame kind of across the country, but Ontario is recording an 11% positivity rate. Of course, Canada's average is 6.8%. So that's pretty significant. There was even some emails from some Toronto schools

this week that just said, please keep your kids at home if they're sick. So clearly the viruses are making their rounds. Yeah, that gives us kind of a good breakdown of where in the country we're seeing the most prevalent viruses then. And of course, one of the ways that we can help protect ourselves and those around us is through vaccination.

We had a few years of really major vaccination campaigns with COVID, right? But I guess I wonder, are people still getting COVID and flu shots at similar rates? I wish I had a better answer for you. The problem is, provinces, the country as a whole, it's just not tracking this data like it used to. It's not as robust in some ways. Some provinces you can still get certain figures, but I'll just say that across the board, we are getting different things from different provinces.

Some are tracking, some maybe sorta tracking, and some it seems like not at all. So, anecdotally, I'll say that I am hearing more and more people that are saying that they just didn't get the flu shot this year or the COVID booster this year that could be due to you know, fatigue, vaccination fatigue, which is something we hear about often. But I did get some data from BC recently, which might put things into a little bit of perspective. And so when it comes to the flu shot in 2023-24, by about early January, January 9 or so, there was 1.5 million influenza doses provided.

In 2024-25, that's only 1.3 million. And then when it comes to COVID in 2023-24, there were nearly 1.4 million doses. In 2024-25, we're seeing almost 1.1 million. Okay, so that gives us some idea then that maybe those rates are down a little bit here. I wonder, is the messaging around vaccines changing right now? I mean, it depends on the province for sure, but something that I will say across the country is we have lost this sense of urgency that we saw during the height of the pandemic. Obviously, that's kind of minimized to some extent because you know we're not right in the heart of it anymore. It's kind of seen as this virus that's gonna come around every year. People are gonna get sick. Yes they should get their shots much like flu. But

I will give you a specific example and that's Alberta where I'm based. So during the 23-24 immunization campaign we found through freedom of information documents that Alberta, the government of Alberta had directed the removal of keywords, so influenza and COVID, from advertisements during that campaign. They had also limited the amount of information that could be included in the campaign and even made it to where it came out later than it was supposed to start for the public. I would suggest based on what I've seen so far in Alberta that the campaign this year is quite similar.

So I'll give you a specific example. So Alberta Health Services was running ads last year that said something like, seasonal immunizations still available, but lacked any specific details. And so that's still a very similar ad that's going around this year. But in 2018, just to show the difference, there was an ad that read, influenza could be one less thing your child brings home this

winter. Influenza is serious. Immunization works. Protect your family. So we got a totally different messaging between those two. Yeah. This is a really interesting example that you're telling us from Alberta. Do we have an idea of what is behind that change in messaging? That's not as clear. We know that it happened. Of course, we have Premier idea of what is behind that change in messaging? That's not as clear. We know that it happened. Of course, we have Premier Daniel Smith here who has been an opponent to many of the measures taken during the height of the COVID-19 pandemic.

So related to things such as lockdowns or vaccines. There's also a report in Alberta that was recently published and it looked into Alberta's COVID response. And in that report, there were a lot of things that were counter to the mainstream scientific consensus around things like masking, vaccination, of course pandemic public health restrictions again such as lockdowns. So there is a bit of the I don't want to say a mentality in all of Alberta but that there is some stuff happening politically here that that you could argue may have something to do with the

vaccine messaging. Let me ask you about hospitals too, because we've heard, especially over the last few years, about how hospitals can get very overwhelmed, right, when illnesses are surging this time of year. Do we know how hospitals are dealing with this respiratory virus season? Hospitals are not doing well, to put it really bluntly. I mean, hospitals never really bounced back, so to say, from everything that happened during, you know, the height of the COVID-19 pandemic. They were already strained. Now they're further strained. So we're seeing hospitals add staff, we're seeing hospitals add beds. This is to just ensure that they can keep care of the, you know, load of people that are coming in, obviously for different types of things, but respiratory illnesses is one

of them. I'll just give you an example. It happened in early January in Manitoba. They were facing a huge increase based on doctors that talked to us with flu and with RSV. And of course, this increases backlogs in hospitals. During that same time, there was a middle-aged man who actually died waiting for care in a Winnipeg ER. Now, we're still waiting for details of a report that will go over what exactly happened. But one of the doctors I talked to said, you know,

just because there was such a huge patient load with viruses, it could have been a factor that increased hospital pressure and ultimately didn't give him the care that he needed. We'll be right back. Okay so Alana, so far we focused on respiratory viruses but another illness that we are hearing a lot about this season is norovirus. If we look at the numbers is there actually a surge in this illness this year? So based on doctors that have talked to us, and I don't have any data to provide you, but they're saying that we're seeing higher than normal case counts for this time of year. Do we know what's behind that? Like, why are we seeing the surge all of a sudden in norovirus?

I think we're seeing a surge in a whole bunch of things. I mean, in December, we heard about walking pneumonia cases doing a huge spike in Atlantic Canada. We're seeing norovirus. There was actually a message that was released by a Toronto school yesterday about fifths disease. I mean, everywhere you look, it seems like, you gotta stay on your toes. Who knows what's gonna happen next, which is unfortunate.

I think part of it is just, we've lost some of the measures that were in place during COVID, such as, as social distancing. Those sort of things helped decrease the prevalence of other viruses. Think like flu, for example. People just aren't doing that obviously to the same extent anymore. So that's why we're kind of seeing this reemergence or you know back to basics emergence of other illnesses. Can I just take a second and go back?

You mentioned a disease that was spreading in schools that you're hearing about. What is this? I don't think I've heard of it. I won't go so far as to say it's spreading, but there was a case in a Toronto school, so it's called fifth disease. It's a really mild illness.

It's rarely serious. It happens a lot among children, but one of the kind of significant symptoms or one that you'll recognize, it's a bright red rash on the face. All right, that's good to know as well. Let's go back to norovirus because there's a little bit more to talk about here. People have been hearing about this a lot. What are the typical symptoms to look out for? Well, norovirus is often referred to as the winter vomiting disease. So you can take from that name exactly what happens. People are vomiting.

They, it also causes diarrhea and it is super duper contagious. How contagious like compared to other viruses, how contagious are we talking? Well, I was talking to an infectious disease specialist earlier this week and they told me that just a trace of it can make you ill. But then in the perspective, they were explaining me that just a trace of it can make you ill. To put that into perspective, they were explaining to me 15 particles of the virus can cause infection. Other viruses require thousands.

Wow. And to make it even worse, vomit has millions of particles. So you can imagine that if you're caring for somebody who's sick, for example, you know, contaminated food and drinks, contaminated surfaces, all of those things might put you in the line of fire, so to say. Wow. Are there specific precautions, I guess,

that people should take to prevent norovirus, especially if they're living with someone who has it? Like, what do they need to, I guess, watch for? I mean, this may sound really basic, but wash those hands. And don't use hand sanitizer. I was explained to me earlier this week that hand sanitizer, the virus is actually resistant

to some of the chemicals inside of it. So the best way to protect yourself is just washing those hands. I'm talking in between the fingers, back of your palms, under the nails, you know, get two minutes, lather it in. That is your best protection against getting norovirus. And of course the usual stuff, you know, stay home if you're sick. Don't cough on people. Okay, good. Back to basics. Let me ask you about bird flu as well. We spoke to Andre Picard, our health columnist, back in December about the potential for avian flu to be the next pandemic. And we

have seen it spread through domesticated birds and wild bird populations and now it has jumped to other species including cows in the US. So Alana, how concerned do we need to be about avian flu in Canada? I will say that public health officials across Canada are stressing that the risks to humans, just like the general public, remains low. There's no evidence yet of sustained human-to-human transmission. But there is some worries just in the way that as the virus mutates, it may become more susceptible to humans. So we did have that case in BC.

It was a 13-year-old girl. She was the first human case acquired in Canada of avian flu. We've also recently had the case in Louisiana in the States where that patient died and that was the first US death attributed to H5N1. And do we know how many cases of avian flu there are in humans so far? So we know in the US there are 67 cases in humans based on data from the Centers for Disease Control and Prevention, but of course it's widespread in birds and also some mammals. Okay and just to be clear there we have not seen evidence that it is spreading between humans at this point it sounds like. No. Okay. No.

Yeah. Okay you did mention though of course spreading in in animals. So do we know how people contract avian flu from animals? Like I've heard concerns about people getting it from cattle in the states. Is that also a concern in Canada? So direct contact with infected birds and then direct contact with highly contaminated environments, those are the main two ways of which you could become ill with avian flu. There are no cases of avian flu in dairy cows in Canada and one of the health precautions that we do take in Canada is that any milk that's sold is pasteurized. And what this does is that it kills any viruses or bacteria.

Helena, we've talked about a lot of different things today. I guess just lastly, before I let you go, with all of these viruses going around, just remind us, how can people best protect themselves from getting sick? Well, I don't want to sound like a broken record, but wash your hands. That is a big one. That's going to help you protect yourself. Stay home when you're sick, of course. Sanitizing any sort of high touch areas. Cover your mouth if you're coughing or sneezing. You can also get vaccinated. It is safe to get

the COVID and flu vaccines at the same time. And if you go to the Globe website, we do have a list there. You can click by province to see where exactly you can book your flu or COVID immunization. Elena, thank you so much for being here. Thanks for having me. That's it for today. I'm Maynika Ramon-Wilms. This episode was mixed by Ali Graham.

Our producers are Madeleine White, Bihal Stein, and Ali Graham. David Crosby edits the show. Adrian Chung is our senior producer, and Matt Frainer is our managing editor. Thanks so much for listening, and I'll talk to you soon.