'Tripledemic' came home for the holidays, continues to circulate, strain Oregon hospitals

COVID-19 has loosened its grip on much of the world. But as masking and social distancing vigilance has decreased, other viruses have made vengeful returns.

Over the holiday season, households and health care providers dealt with the impacts of ongoing COVID-19 cases, influenza and respiratory syncytial virus, known as RSV.

"It has been a rough season," Dr. Melissa Sutton, medical director for Respiratory Viral Pathogens for the Oregon Health Authority, said. "We are seeing our hospitals just overwhelmed. We are seeing our friends and our family members get sick, and often quite sick."

Other viruses are also infecting people, but they can be harder to track.

This season has had an especially high rate of illness and the viruses hit people earlier than in years past.

"We've seen that shift since the pandemic began, that when these viruses come back, they seem to be coming back earlier and earlier," Sutton said. "The timing of this season is unusual."

A full picture of holiday season impacts won't be completed for a few weeks, but experts are certain of a few trends.

Flu, mostly infuenza A

Sutton said this year has been notably severe for RSV and influenza compared to past seasons. During the last week of the year, the state reported 2,585 positive influenza tests. The Willamette Valley accounted for 199 of those.

Flu, mostly influenza A, is running rampant this year.

People are gathering more than in years past, but some pre-pandemic flu seasons were similarly severe, so experts can't say for sure if it's driven by post-pandemic gathering.

"It's hard to say if this is just a wild influenza season or if this is a post-pandemic wild influenza season," Sutton said.

The percentage of people in the emergency department for influenza-like illnesses was much higher over the holiday season than in years past, peaking in early December at about 5%, nearly five times what it had been the past few years.

That number is coming down now, at 2.6% during the last week of the year. However, it’s typical to see flu peak again after the holidays, Lane County Public Health spokesperson Jason Davis cautioned.

“Our flu numbers are coming down but you shouldn't be drawing any conclusions,” he said. “Most likely, the final peak will happen the third or fourth week of January. (There’s) no crystal ball, but if we pay attention to the history, that's what typically happens.”

The severity of the flu isn’t as bad as in previous years, but more people are catching it, Davis said.

COVID-19 variants

While the variants of COVID-19 currently circulating are less severe than previous ones, the virus is trudging on.

On Jan. 4, the Oregon Health Authority announced 2,876 new cases over the previous week and 62 newly identified deaths with the virus, pushing the state to 9,024 total.

In Lane County, there were 348 cases and two deaths. Marion saw 220 cases and identified five people who died with the virus. Polk saw 62 cases, but no new deaths.

Sutton, with Oregon Health Authority, said cases have plateaued and national forecasts are predicting that they'll remain at their current level for at least the next few weeks.

As was the case throughout the pandemic, those with underlying conditions are faring worse.

“The severity of COVID is less than what it was in the beginning. We're not seeing the ICU patients, the deaths. It is closer to the flu,” Dr. James McGovern, chief medical officer of PeaceHealth Oregon, said. “We're definitely seeing people who have underlying COPD, emphysema, asthma, those underlying lung conditions.”

RSV hits kids, infants

RSV has plagued families and especially kids this winter.

"This is the most severe pediatric season we have on record, with the caveat that we've only been collecting hospitalization data on children for the last five years," Sutton said. "It has been really, really severe. We have surpassed all previous peaks by quite a bit."

In Oregon, RSV is not a mandatory reporting disease, so data is limited to test results reported by participating laboratories. Participating laboratories reported 516 positive RSV tests during the last week of the year.

Providers are seeing a decrease in RSV, experts said. The virus typically has sharp increases and sharp decreases. While it may be trending downward, the virus is continuing to circulate, experts warn.

Available data doesn’t capture the full picture of what most people are facing. Most people who are sick are not going to the hospital or getting tested.

Strain on health care continues

Flu, COVID-19 and RSV are hitting with such a force that the situation has been dubbed a “tripledemic,” but they’re not the only viruses circulating.

“You're thinking everybody is sick, and they are, it's just that it’s not all those three,” Davis said. “There's a lot going around and it's hitting all at once.”

Health officials said hospitals and health care facilities continue to be strained by a season of sickness.

“It’s been busy,” McGovern, with PeaceHealth Oregon, said. “RSV, flu and COVID-19 all remained pretty consistent through the holidays.”

He said there have been about 40 patients in the hospital with flu, RSV or COVID-19 each day for the past three weeks. In early December, the average was closer to 50.

Ongoing staffing issues and the fact that health care workers are not immune from the viruses circulating in the community compound the issues. McGovern said this means wait times for elective surgeries are longer than usual.

“Cancer surgeries and other types of surgeries are being delayed right now due to everything that's going on across the state and country,” McGovern said. “We're not in crisis. But we're definitely working every day to make sure that things keep moving and we create the access that we need.”

Salem Hospital has treated a large number of kids needing hospitalization due to the unprecedented early RSV surge starting in the fall, said Lisa Wood, a spokesperson for Salem Health, in an email. As the holidays neared, hospitalization numbers due to the different viruses continued to climb.

"The three respiratory illness have resulted in the hospital being near or above capacity for much of December," Wood said. "The community clinics have increased the number of open appointments with many primary care providers extending their hours and weekend coverage to treat the large number of illnesses."

What can you do?

Experts are singing the same tune they have over the past couple of years: Mask in public, get up-to-date vaccines, wash hands and stay home when sick.

“I will always say get vaccinated. Even now, in the midst of this, it's still helpful,” McGovern said. “It reduces the severity of the disease; you won't get as sick if you do get it.”

Wood, with Salem Health, also advised keeping up with a healthy lifestyle to prevent illness. Tips include avoiding smoking, eating healthy foods, regular exercise and getting adequate sleep.

Experts said to call 911 in an emergency and to go to the hospital if they are experiencing severe symptoms. However, most people will experience typical symptoms of the viruses circulating currently such as fever, phlegm, body aches and fatigue.

Davis, with public health, advised people to pay attention to symptoms such as belabored breathing and changes in skin color.

He also encouraged people who can afford to stay home when sick to do so, not just for their own benefit, but to protect those who can’t.

Contact reporter Tatiana Parafiniuk-Talesnick at Tatiana@registerguard.com or 541-521-7512, and follow her on Twitter @TatianaSophiaPT.

This article originally appeared on Register-Guard: 'Tripledemic' of COVID-19, flu, RSV strains Oregon hospitals