Covid, RSV and flu: A trifecta of respiratory viruses is plaguing hospitals across the country


Covid, RSV and flu: A trifecta of respiratory viruses is plaguing hospitals across the country

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Across the country, overcrowded healthcare workers are struggling to catch their breath as hospitals fill with ailing patients battling a trifecta of respiratory illnesses — Covid-19, RSV and the flu.

“We’ve seen a real spike in cases…especially since Thanksgiving,” said Dr. UC San Diego Health chief medical officer Christopher Longhurst, who added that the hospital was facing a surge in breathing. “Covid is up. The flu is on the rise and other respiratory viruses are on the rise as well.”

The situation at UC San Diego Health is so overwhelming that the hospital has had to make room for patient triage by erecting tents in parking lots and using other unconventional spaces. The emergency room corridors are also lined with makeshift beds for patients who have been admitted but are waiting for hospital beds.

“We didn’t have to reconfigure the conference room to accommodate patients, even during the Covid pandemic,” said Longhurst, who explained that UC San Diego Health has experienced an equal number of Covid patients as patients with other respiratory viruses. “These are truly unprecedented times.”

Last week, hospitals across the country were at their fullest levels during the pandemic, hitting 80% capacity, up 8 percentage points in two weeks. This is also the highest level since the Omicron surge in January. Hospital capacity has improved slightly this week.

While RSV appears to have peaked in the US, both Covid and flu infections are on the rise.

All but seven states have high or very high respiratory virus activity, according to the Centers for Disease Control and Prevention. The CDC advises that people in areas with high levels of Covid-19 community wear a mask.

dr Jeff Smith, executive vice president and chief operating officer for hospital operations at Cedars-Sinai Medical Center in Los Angeles, said the “extreme, rapid spike” in RSV from October through November was probably “the strongest RSV we’ve seen.” last decade.”

“And now we’ve seen a rapid decline (in RSV),” Smith said. “That has been superimposed on this Covid surge, which happened a little slower and a little later, and then is now being superimposed on this very rapid surge in influenza.”

dr  Christopher Longhurst, chief medical officer at UC San Diego Health, said they've seen a significant increase in cases, especially since Thanksgiving.

Still, the surge in this virus trio isn’t as bad as Covid was during the peak of the pandemic.

“By far the most powerful factor is probably the vaccines, but the other is the cumulative number of infections we’ve all had, which is now called natural immunity,” said Dr. Edward Jones-Lopez, an infectious disease specialist at Keck Medicine of the University of Southern California.

“Unfortunately, there’s still about a third of the country … where, despite all the evidence of safety and effectiveness, people are still not getting vaccinated,” he said.

There are vaccines for both Covid and flu but not for RSV. All three viruses share very similar symptoms – fever, cough and upper respiratory symptoms – so testing is needed to determine which disease is involved and recommend treatment.

And just because a patient has one virus doesn’t mean they can’t get the other two, too.

“I saw a case of three infections occurring at the same time,” Jones-Lopez said. “These are independent viruses that can infect the same individual, and obviously the more viruses you have, the more infections you have… the higher the risk that one of them will lead to a more serious illness.”

Mask mandates have yet to return, but virus spikes in New York, Los Angeles and Seattle have prompted health officials to recommend people dress up indoors and in crowds.

But as friends and family gather this month, health officials are concerned.

“I would definitely recommend that you wear a mask now if you are elderly or have a medical condition that makes you immunocompromised or particularly susceptible to infection,” said Smith of Cedars-Sinai Medical Center. “It’s the best protection we have for anyone else who is concerned about transmission.”

Or, as Longhurst put it, “Wear a mask during the holiday season and don’t kiss those sick babies.”

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