As COVID, flu and RSV cases make the rounds, where do things stand in Memphis?

Entering the new year, influenza and respiratory syncytial virus cases seem to be on a continual decline in the Memphis area, but COVID-19 cases are creeping up.

Local infectious disease specialists said in previous years, some viral illnesses have spiked around or after the winter holidays, with many people traveling and gathering indoors without masks. It’s too soon to tell if a spike in any or all of the three viruses ― being referred to by some as a “tripledemic” ― will occur in the Memphis area in January. Flu and RSV have seen earlier peaks than usual in the area, doctors said.

Here’s what three local experts had to say about COVID-19, flu and RSV in the Memphis area, as well as their thoughts on when to get vaccinations and if Mid-South residents should be concerned about the COVID-19 spike in China.

Flu, RSV declining in the Memphis area

The Centers for Disease Control and Prevention estimates so far this season there have been 18 million flu cases, 19,000 flu-related hospitalizations and 12,000 flu-related deaths across the U.S. There have also been 47 pediatric flu deaths reported, the agency said.

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A CDC weekly report issued before Christmas said flu activity remains high, but is declining in most places across the country. That has been the trend in the Memphis area too, said Dr. Shirin Mazumder, an infectious disease specialist with the Methodist Le Bonheur Healthcare System. As of the week of Dec. 19, 4.3% of all emergency room visits in Shelby County were related to influenza. While that’s up from the same time last year, it’s well down from the fall.

“It really looks like we peaked back in October, end of October and beginning of November. So at that time, it was nearly 12% of ER visits were for influenza-like illness,” Mazumder said.

She said hospitals in the Methodist network are seeing a decline in the number of inpatients testing positive for flu and that she is seeing the same thing in the outpatient population she works with.

Dr. Sandy Arnold, a pediatric infectious disease specialist at Le Bonheur Children’s Hospital and a professor at the University of Tennessee Health Science Center, said the hospital saw unusually high numbers of RSV cases early in the fall. However, those have fallen off in the past two months.

"There are still plenty of kids with respiratory viruses and complications of respiratory viruses, but we are not overwhelmed with patients with bronchitis anymore," she said.

On average each year, among kids 5 and younger, RSV results in 2.1 million outpatient visits, between 58,000 and 80,000 hospitalizations and 100-300 deaths, according to the CDC. The virus also results in hospitalizations and deaths among adults 65 and older, though it is more commonly associated with children.

Pediatric influenza cases have also been declining, Arnold said. From Dec. 1-29, there were about 250 children who came to Le Bonheur's emergency department with flu-like symptoms and tested positive for the virus. In November, there were more than 1,200 positives at the children's hospital.

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COVID-19 rising in the Memphis area

Nationally, COVID-19 numbers have been rising in the United States. According to the CDC, there were more than 487,000 new cases reported across the country the week of Christmas. The U.S. was also averaging about 5,000 new daily hospitalizations related to the virus.

In the most recent Shelby County Health Department update, which spans Dec. 25-31, there were 1,183 new cases reported. Cases have been rising slowly but steadily since May. Test positivity rates also spiked in December, a statistic impacted by both the spread of the virus and the number of tests reported.

Dr. Steve Threlkeld, an infectious disease expert with the Baptist Memorial Health Care system, said hospitals have been getting some relief as the volume of flu patients has declined.

“The real problem is that improvement is more than being filled in by a rampaging, kind of, return of COVID. And it's very disappointing and distressing,” he said.

At his hospital, Baptist Memorial Hospital-Memphis, there were 12 people in the hospital who were positive for COVID-19 on Nov. 15. On Dec. 29, that number was 99. While not all of those people were admitted to the hospital because of COVID-19, when they test positive for the virus they have to be isolated from other patients in specially outfitted rooms and healthcare workers have to put on extra layers of personal protective equipment.

“It gums up the works, if you will, for so many hospitals around the country,” Threlkeld said. “The biggest thing that I'm experiencing is that it's hard to get people transferred into your hospital from smaller and surrounding hospitals who need care at a tertiary center when, you know, so many of your beds are filled.”

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One of the few silver linings, Threlkeld said, is that most of the currently-admitted COVID-19 patients are much less sick than in previous waves. Still, some people who are unvaccinated or have significant underlying health conditions continue to get very sick and die.

Shelby County has seen more than 288,000 reported cases since the virus was first detected locally in March 2020. Experts believe the real total is higher, due to unreported cases, whether through people who never get tested when sick or do not report positive results on at-home tests.

As of Dec. 31, there were 3,551 reported and probable COVID-19 deaths in Shelby County, representing 1.2% of all reported cases in the county. The ages of those killed range from 10 to 107.

China sees massive COVID-19 spike

While the Chinese government continues to clamp down on information about the rapid spread of COVID-19 and the resultant hospitalizations and deaths, all reporting indicates cases are skyrocketing. Hospitals and crematoriums have become overwhelmed.

Both Mazumder and Threlkeld said the rapid transmission was concerning and something to keep an eye on.

“I think the concern in the medical community is that, you know, there may be a new variant that may emerge and be transmitted globally. So it's something that I think we do need to be concerned about,” Mazumder said.

Threlkeld said seeing a rapid increase in China is eye-catching because the virus originated there. But he said a rapid increase in the virus anywhere is something to be worried about.

“When you have a stark and protracted increase in the number of cases, you're suddenly going to increase the likelihood of generating those variants,” he said. “We just don't know yet how far we have immunologically boxed this virus into a corner.”

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Vaccinations remain essential

While influenza cases are declining, Threlkeld said there is still good reason to get a flu shot if you haven’t already, even if you’ve caught the flu this season. The early wave of flu in the Mid-South was Influenza A. Influenza B could increase in circulation as flu season drags on through the winter and into early spring. The flu shot protects against both.

“It's a very good and effective vaccine. Nothing is perfect preventing it all together. But it's quite good at preventing serious illness. So it's a good vaccine and a safe vaccine,” Threlkeld said. And with the Mid-South’s typical flu season peaking late, “there's no indication that flu is over.”

Mazumder echoed that sentiment.

“It's still not too late,” she said. “We started the flu season a little earlier than what's normal, but typically the flu season is significant until February and so it's not too late for people to get the flu shot.”

The same holds true for kids, Arnold said.

“It is never too late to get a flu shot. For young children who are under 9 they're supposed to get two doses the first time they get a flu shot. So get your kid that first flu shot if they've never had it before, and then their second dose and then next year, they'll be ready to just get one dose,” she said. “Yearly flu shots work really well to prevent severe influenza hospitalizations and death in children.”

All three doctors also encouraged people to get COVID-19 booster shots, especially if they are around people who are elderly or have underlying medical conditions.

Corinne S Kennedy covers healthcare, economic development and real estate for The Commercial Appeal. She can be reached via email at Corinne.Kennedy@CommercialAppeal.com

This article originally appeared on Memphis Commercial Appeal: Flu, RSV, COVID: Where do cases stand in Memphis?