Scenario Projections for SARS-CoV-2, Influenza, and RSV Burden in the US (2023-2024)

Abstract Following the relaxation of COVID-19 non-pharmaceutical interventions, the concurrent spread of SARS-CoV-2, influenza and respiratory syncytial virus (RSV) from September 2022 to March 2023 taxed healthcare resources globally. The unpredictable nature of future tripledemics challenges public health planning, as these viruses have not settled into post-pandemic seasonal cycles and the future uptake of medical countermeasures is uncertain. This study employs mathematical models to project hospitalizations due to COVID-19, influenza, and RSV in the United States during the 2023-2024 respiratory virus season under plausible scenarios for viral transmission rates and the impacts of influenza vaccines, SARS-CoV-2 boosters, and newly-approved RSV vaccines and monoclonal antibodies. Projections suggest that, comparing the most optimistic to the most pessimistic scenarios, cumulative hospitalizations could decrease by 38% (95% CI: 21%, 54%) or increase by 45% (95% CI: 10%, 82%) relative to the 2022-23 season.