‘In the thick of it’: Flu, COVID-19, RSV spread misery across Michigan yet again

The big three respiratory viruses — influenza, coronavirus and respiratory syncytial virus, better known as RSV — are spreading misery across Michigan yet again, as people flood doctor's offices, urgent care sites and emergency departments seeking treatment and many fill hospital beds.

"At the moment, I would say we are in the thick of it," said Dr. Natasha Bagdasarian, the state's chief medical executive. "We've got lots of COVID circulating, lots of flu, and RSV as well."

Though real-time case tracking for these viruses isn't precise and has become harder since the COVID-19 public health emergency ended in May, Bagdasarian and other health leaders are able to evaluate viral activity by watching hospital admissions, reports of positive flu and COVID-19 tests, through wastewater testing and other data.

"With RSV, it's possible that we have plateaued," Bagdasarian told the Free Press. "The rates are not as high for RSV hospitalizations as they were last year. And for influenza and COVID, those numbers still look like they're on an upward trajectory. ... I think we have yet to see the worst for COVID and flu."

High flu activity, COVID-19 hospitalizations

The U.S. Centers for Disease Control and Prevention now lists Michigan among states with high flu activity. The majority of cases spreading through the last week of December were types of influenza A.

The flu surge comes as 1,200 Michiganders were hospitalized with COVID-19 as of Monday, according to data from the state health department. That compares with 884 one month earlier — a 35.7% increase.

"Our COVID hospitalization rates look a little bit higher than they were in last winter and our flu rates are not quite as high as they were at the peak of last winter," Bagdasarian said. "If I had to say which one is really the dominant virus right now, it does look like it's COVID again."

This time, the JN.1 subvariant is dominant across the U.S. and in the Midwest region, according to the U.S. Centers for Disease Control and Prevention. JN.1 was classified in December by the World Health Organization as a variant of interest because of its rapid spread globally. However, the WHO reported: "available limited evidence does not suggest that the associated disease severity is higher as compared to other circulating variants."

Though we're once again seeing a COVID-19 spike, it's nowhere near the level of previous pandemic peaks. In early January 2022, when the omicron variant became the dominant strain circulating, more than 4,600 Michiganders were being treated in hospitals statewide with the virus.

Hospitals stretched thin

Even though Michigan's COVID-19 hospitalizations haven't hit levels seen during pandemic peaks, hospitals statewide still are strained because they're also filled with flu and RSV patients along with others in need of care, said Dr. Charles Gibson, vice president for medical affairs for Corewell Health in western Michigan.

"That's the real bugaboo," Gibson said. "It makes it quite tight around here because you have got to have a bed for every patient, a physical bed. And then, more importantly, you have to have appropriate staffing to be able to take care of all those patients.

"That also backs up all of the other stuff that tends to come in — the broken legs and the car crash injuries and the person that's having chest pain or shortness of breath not related to a respiratory illness. ... We still have to be able to take care of all those types of patients, too."

Hospital leaders have to consider how many surgeries and other procedures they can accommodate at times like these "so that we can maintain our day-to-day operations but also accommodate the influx," said Gibson of Corewell's 21 hospitals, which span the Lower Peninsula. "It's a really big deal when our capacity gets hit.

"We're seeing an influx into our care spaces — whether it's the inpatients in hospitals that are a little bit sicker and need to be admitted coming to the ED, our walk-in clinics, our primary care offices. They are all at higher volumes across the board. We're certainly feeling the impact of these respiratory illnesses."

It's not too late to get vaccinated

To keep people out of hospitals as infections with these viruses climb in Michigan, Bagdasarian and Gibson said it's key to use the tools that are available — vaccines for all three viruses, monoclonal antibody treatments to protect infants and toddlers from RSV, and antiviral medications for flu and COVID-19.

"It's not a secret that the vaccines can save lives," Gibson said. "We learned that in past pandemics going back to the early 1900s as well as during the COVID pandemic. These things have a real impact."

Yet fewer than 10% of Michiganders are up-to-date on COVID-19 vaccines, Bagdasarian said. And roughly one quarter of Michigan residents — about 2.6 million people — have gotten a flu shot this season.

That's the lowest rate of flu vaccine uptake in four years, she said.

More: Vaccines deployed against triple viral threat from COVID-19, RSV, flu

"I think that for a lot of people, not only was COVID very politicized during the pandemic, but vaccines became politicized, respiratory viruses became politicized," Bagdasarian said. "And so I think that that's part of it. I think that the other part of it is that people ... got out of the habit of going to see their health care provider for routine things and that may have impacted some of these vaccination rates."

It's not too late to get vaccinated now, Bagdasarian said.

Other precautions to consider

Gibson reiterated other advice echoed throughout the COVID-19 pandemic.

"If you don't have to be out and about and you're not feeling well, by all means stay home and rest for a couple of days," he said. "Don't go to the party if you're not feeling great. Don't go into the office if you can reasonably work from home. Wash your hands more than you think you should. ... If you're feeling kind of cruddy but still need to go out, then a mask is a good idea."

If you do find yourself sniffling and sneezing, Bagdasarian urged people to get tested to find out which virus is causing the symptoms.

"Take a test for COVID and influenza because if you test positive you can talk to your health care provider to see if you qualify for one of those antiviral medications," Bagdasarian said, such as Paxlovid or Tamiflu.

And if you're in need of medical care, Gibson urged one last bit of advice: pack your patience.

"We all went into this to help patients and help take care of people and get them better and get them back home. And so when things get busy, sometimes you have to wait," he said. "Things take a long time. We hear of people spending several hours in the emergency department, waiting to get into the walk-in clinic, waiting to get in to see their PCP (primary care provider), and that causes some frustration.

"People can sometimes exhibit that frustration and in ways that wouldn't make us proud in our better moments. And so I just ask for ... respectful treatment of our staff that are trying to take care of you at your worst moment."

Contact Kristen Shamus: kshamus@freepress.com. Subscribe to the Free Press.

This article originally appeared on Detroit Free Press: Rising cases of flu, COVID-19, RSV put pressure on Michigan hospitals