Respiratory illnesses soar, putting hospitals under strain

Next week marks National Influenza Vaccination Week -- a time to remind Americans it’s not too late to get a flu shot.

In fact, the CDC’s Flu Tracker map would suggest there’s no time to waste. In the last two weeks, the number of states with ‘high’ or ‘very high’ flu activity went from 20 to 32. That’s a 60 percent increase. Massachusetts remains in the ‘moderate’ activity bracket, for now. Local hospitals can only hope it stays that way -- given how slammed they’ve been with various respiratory illnesses for weeks.

“What’s new this year is that they’re happening a lot more often, people are getting sicker and it seems to be clustering in a smaller period of time, in the context of a healthcare system that is overwhelmed with everything from Covid,” said Andrew Eyre, MD, an Emergency Department physician at Brigham and Women’s Hospital. “It’s not necessarily that they’re new viruses. But that people are getting sicker, we’re seeing more of them altogether in the context of a tough time.”

Aside from Covid and influenza, doctors are dealing with widespread RSV -- plus the usual stew of pathogens that normally cause everything from the common cold to bronchitis to pneumonia. These would include adenoviruses, rhinoviruses, parainfluenza and other coronaviruses.

Eyre said infections are proliferating, in part, because of the anti-infective measures taken against Covid in recent years.

“People were washing their hands, they were wearing their masks, they were staying away from other people,” he said. “But now people haven’t been exposed for a few years, so all of a sudden people’s immune systems aren’t used to seeing this virus and it’s coming on stronger and worse -- and the doctor’s offices and hospitals are already super busy.”

Eyre said that’s why it’s more important than ever to prevent what illnesses you can prevent by getting vaccinated.

Adrienne Randolph, MD, couldn’t agree more -- especially when it comes to kids and the flu. Randolph, a pediatric critical care doctor at Boston Children’s Hospital, has been studying cases of severe influenza in kids for some 20 years.

“Some children do die of influenza,” she said. “This year, already, there’ve been 12 deaths.”

In rare cases, children will develop severe flu infections because of their genetic makeup, Randolph said.

“Although it’s uncommon, some children do have a rare presentation where they might have an immune deficiency that the influenza infection kind of reveals,” Randolph said. “And they get really, really sick with the influenza infection.”

Subsequent genetic testing sometimes reveals the children may be missing something in the ability to fight off the influenza virus, Randolph said.

But fighting off influenza is more difficult for kids, period -- especially young ones.

“Especially children under four years of age,” Randolph said. “Because their immune systems are just developing.” Children six months and under, who are not eligible for flu shots, can also become extremely ill from influenza.

Already, this year, Randolph has seen cases of children with influenza who have needed mechanical ventilation to recover. This is why she is urging all eligible children to get flu shots -- and as soon as possible.

“It takes about two weeks to get protection from that vaccine and it will really help protect against severe disease,” she said.

As for milder respiratory illnesses -- they usually can be managed at home. Eyre said some of the symptoms that might suggest it’s time to get medical attention include extreme shortness of breath, chest pain, uncontrollable coughing and high fever.

“And the other times are if you have really high fevers or you just really feel sick,” he added. “You’re getting weak, you don’t have energy to do the things you need to do, you have a poor appetite and can’t keep up with your fluids.”

Doctors hope influenza season, severe as it is already, will also be short-lived. But there’s no guarantee things won’t get worse.

“People are spending more time indoors where it’s a lot easier for these viruses to transmit,” said Eyre. “So my concern is these viruses will spread and some percentage of people who get them will get quite sick.”

This is a developing story. Check back for updates as more information becomes available.

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