A conversation with Wellstar infectious disease specialist Dr. Danny Branstetter about the flu season, COVID and RSV

Dr Danny Branstetter headshot photoDr. Danny Branstetter (photo courtesy of Dr. Branstetter)

According to the CDC, flu season commences in about October, and peaks between December and February. During this particular flu season, we also have COVID and the recent national surge in RSV cases to contend with.

The Courier spoke with Dr. Danny Branstetter, a leading infectious disease specialist at Wellstar Health System.

Dr. Branstetter began by giving an overview of recent developments with COVID.

“We’ve talked about COVID A lot.


“It’s now endemic, meaning that it’s here to stay. And we’re seeing waxing and waning numbers, but it’s kind of overall on a pretty steady pace.

“As anticipated, we’re seeing a couple of new variants. These are called B as in boy, Q as in Queen, one and 1.1. (BQ.1 and BQ.1.1)

“So those are the newest variants circulating.

“From that standpoint, the number of hospitalizations and deaths seem to be flat. So we’re not seeing a big rise or lowering based on this variant from what we normally are seeing month over month, with the most recent variants of Omicron.

“For example, the biggest changes that I see is that we now have the bivalent vaccine available for a booster, and we no longer have monoclonal antibody therapy for people infected.

“So for these most recent variants, the monoclonals we had available are not effective for that anymore. But the oral antiviral medications, two of those are still very much effective against the current strains, the BQs that I mentioned.”

Branstetter then talked about RSV in our area.

The CDC describes RSV as follows:

Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults. RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States.

Branstetter said the recent trajectory of transmisstion for the disease has been encouraging.

“It’s actually improving. It was a big, big problem.

“CHOA (Children’s Healthcare of Atlanta) and some of our children’s hospitals in the area were having a significant crowding and capacity problem, primarily driven by the number of cases of RSV is my understanding.

“So yes, we were seeing a lot of that, but the numbers actually are waning from RSV for right now, as well as the the capacities at our children’s hospital. So I think we’re in a much better spot than say, three, four weeks ago.”

Asked about COVID vaccination, Branstetter said it is still important to get vaccinated and boosted.

“All respiratory virus protections, whether from natural infections or from vaccine protection wanes over time.

“So to keep us at our best level to respond to those viruses as we interact with those that are likely exposed, to protect ourselves the most, and the others we love, we’ve got to maintain the highest level of protection possible and that requires repeating vaccinations.

“Flu, for example, we do that every fall for that because that’s the best window to protect.”

“Same thing about COVID as we see new strains and develop these vaccines to boost us. We’re trying to keep everybody as healthy as possible. So it’s then important to get that re-boosting and up to date on the vaccines.”

Dr. Branstetter then described the latest masking recommendations. He said that if you’re at high risk, or are around others at high risk, you should mask. You should also mask if you can’t take the vaccine for some reason, have a weakened immune system or chronic respiratory condition, or are recovering from COVID (in that case for a five-day period to reduce the likelihood of community spread)”

He then talked about the current flu season we’re in.

“We typically start seeing the increased numbers right around the Thanksgiving holidays, as people gather this year.

“Like our partners in the southern hemisphere we saw an early flu season with increased numbers and an early what we consider transmission and illness requiring hospitalization.

“But right now we’re seeing a slight decrease in our communities, particularly Georgia. So that’s good.

“The worry, though, is that we’re entering another holiday travel gathering season. And while we had an early start to our flu season, my concern is that we may have a more robust flu season as the holidays approach. And so right now in a better spot than we were a couple of weeks ago, but I am a little bit leery that we may see more of an outbreak or more flu transmission in our communities over the next coming weeks.”

The Courier asked Dr. Branstetter if there were other things he thought the public should know.

He said that for COVID and the flu, staying up to date with vaccinations is the most important thing.

He said if you have a young child with a chronic illness, there is a prophylactic monoclonal antibiotic that you may be able to get for your child, so you should ask your pediatrician if it’s available for your child to give added protection against RSV.

He said the things talked about during the COVID pandemic: wearing a mask, hand-washing, watching our distance, are other good protective measures.

Early testing and isolating ourselves if we feel sick to prevent transmission are other things we can do.

“But I think the other things to do as we go on the holiday season, there’s a lot of things we do that may not be your healthiest to fight infections,” he said.

“Number one, we get stressed we get busy and our holiday season. We know stress weakens the immune system, just try to stay in and reduce our amount of stress is important.

“Getting good amounts of sleep and restful sleep is always important in fighting viral infections and preventing viral infections.

“Maintaining our health otherwise:

“If you have chronic illnesses, such as heart disease, making sure you’re maximized on your treatment therapy, working with your physicians.

“Regular exercise also reduces the likelihood of illness for respiratory viral illnesses.

“Those are really good and hard to do during a holiday season as we get really busy.

“So I want to remind people that that is crucial to enjoying the holiday season staying as healthy as possible.”