Erie County battles respiratory virus triple threat from RSV, COVID-19 and flu

A triple whammy of respiratory viruses has sent scores of patients to Erie County physician offices and emergency rooms over the past few weeks.

Flu season has arrived in Erie County as 31 cases have been reported since Oct. 2, including 23 last week, according to the Erie County Department of Health. This comes as the county continues to deal with an early outbreak of the respiratory syncytial virus and the continuing COVID-19 pandemic.

"There is a lot of respiratory illness out in the community," said Dr. Christopher Clark, Saint Vincent Hospital president. "You walk through our emergency department and there are a lot of patients getting tested for COVID/flu/RSV. It's not just one illness."

More: Coughing, congestion and sore throats: Do Erie residents have COVID-19, RSV or the flu?

The concern is that simultaneous outbreaks of RSV, flu and COVID-19 could overwhelm Erie hospitals that typically operate with few open patient beds. Though Erie County saw outbreaks of all three viruses in 2021-22, there was little overlap.

That might not be the case this fall and winter as flu season has already started, RSV is peaking and medical experts predict another rise in COVID-19 cases over the holidays.

"We would be concerned about a large number of COVID, flu and RSV patients, but the COVID pandemic has taught us a lot," said Emily Shears, vice president of quality for UPMC in northwestern Pennsylvania and New York. "It taught us how to handle large patient populations with different strategies."

UPMC Hamot and Saint Vincent have increased their number of patient rooms where negative air pressure inside the room prevents viruses from spreading outside when the door is opened.

The hospitals have also become more flexible in converting medical/surgical units into COVID units based on the number of patients.

"We are as prepared as we can be, based on what we have experienced with COVID during the pandemic," Clark said.

Flu season arrives in Erie County

The 2022-23 flu season unofficially arrived last week as 23 cases were reported in the county Oct. 16-22, increasing the season's total to 31 cases, the county health department reported. Three of those 23 county residents with flu needed to be hospitalized.

It appears to be an earlier flu season than last year, when flu cases started to rise in November and didn't peak until late March/early April.

"We know the Southern Hemisphere (whose flu season usually runs June-September) had their busiest flu season since before the COVID pandemic," said Charlotte Berringer, R.N., director of community health services for the county health department. "The good news is that the flu vaccine is based on the history of flu cases they saw in the Southern Hemisphere, though it's too early to know for sure if it's a good match."

Flu vaccine is available at most physician offices and chain pharmacies. It is also available, along with COVID-19 vaccine, at the LECOM Center for Health & Aging, 3910 Schaper Ave.

More: Erie County's highest COVID vaccination rate by ZIP code is nearly double its lowest

COVID cases rise as new variant arrives

The county's weekly number of confirmed COVID-19 cases has increased each of the past two weeks as it appears a new strain has arrived in northwestern Pennsylvania.

A total of 345 cases were reported in the county Oct. 17-23, compared to 288 Oct. 10-16 and 268 Oct. 3-9, according to the county health department.

Sampling done at the Erie Wastewater Treatment Plant earlier in October showed a sharp increase in the amount of coronavirus. Tests performed on samples taken Oct. 3 showed a majority of them (57%) were the variant BA.2, which hasn't been detected since late spring.

"I think this BA.2 is not the older BA.2 or BA.2.12 that caused outbreaks here in March and April, but might be BA.2.75, a much newer and more immune evasive strain," Dr. Howard Nadworny, a Saint Vincent infectious diseases specialist and county health department adviser, said in an email. "(T)he sharp surge over the past two weeks, which now appears to be starting to decline (in wastewater sampling), is almost certainly due to yet another variant."

The BA.2.75 variants represented 2.6% of all variants sampled Oct. 16-22 from a section of the country that includes Pennsylvania, the Centers for Disease Control & Prevention reported.

Nadworny said rapid variant changes could lead to short surges in cases through the winter.

The number of county residents hospitalized with COVID-19 has increased slightly in recent days, with the 14-day moving average increasing to 34.2 on Tuesday, according to the Pennsylvania Department of Health. It has remained between 24.7 and 35 since mid-August.

"Our daily number of COVID patients has remained pretty steady since May," Clark said. "Our average daily census for October is 12, and most are admitted for other reasons."

No COVID-19 deaths have been reported in the county in October, compared to 11 deaths in September and 10 in August.

RSV cases decline after early peak in Erie County

The county's RSV outbreak might have already peaked as the weekly number of cases dropped from 176 last week to 97 this week, according to the county health department.

RSV usually arrives around the holidays but this season started in late summer. About 71% of cases involve children younger than 5, which is typical since babies are most at risk of serious RSV complications due to their tiny airways.

More: RSV season strikes early again as Erie hospitals see sick babies. Here are the symptoms

The county health department reported 415 cases in October and 16 hospitalizations. No deaths have been reported due to RSV.

"We're not seeing a lot of hospitalizations with RSV, maybe one or two," Shears said.

Berringer cautioned, however, that parents should continue to be aware of the virus, especially if they have infants or children with breathing or immune system problems.

"If you or someone in your family is at risk for poor outcomes with any of these viruses, it makes sense to wear a face mask in any crowded situation," Berringer said. "And it should be a surgical mask at least."

Contact David Bruce at dbruce@timesnews.com. Follow him on Twitter @ETNBruce.

This article originally appeared on Erie Times-News: Erie County battling RSV, COVID-19 and flu at the same time