'Tripledemic' of COVID, RSV and flu in Florida this winter? 'Do not panic,' doctors say

A respiratory virus is on the rise in Florida as winter flu season looms, and at least one major urban area in the state is seeing signs of a steady rise in COVID-19, but doctors say not to panic yet.

Hospitals across the state are seeing a growing number of patients with RSV, a respiratory illness that most often causes mild cold-like symptoms and spreads mostly among children in the fall or winter each year. It can be serious, however, for some older adults and infants, according to the Centers for Disease Control and Prevention.

Headlines from national news outlets have warned of a “tripledemic” of COVID, RSV and flu. But, doctors such as pediatrician Celina Moore of West Boca Medical Center have this message for anyone concerned: “Do not panic.”

More on RSV: What to know about this ‘extremely contagious’ virus and its effects on babies

More on the flu: Bird flu, first detected in Palm Beach County, spreads through Florida

Senior COVID deaths: Florida's seniors lead nation in COVID deaths since April 2021; population can't explain it

Sewage tests from Palm Beach County, the third-most populous in the state, have found an increasing number of coronavirus particles in wastewater since early October, reversing a months-long decline.

About 6% of child patients in emergency rooms statewide tested positive for RSV the week of Sept. 11-24, which the Florida Department of Health notes is higher than the same period two years ago, when it was between 1% and 3%.

“We are kind of seeing a whole bunch of typical childhood viruses that are typically spread out over the season all happening at the same time,” Moore said.

Hospitals seeing increase in adults with RSV

That’s because of the COVID pandemic, she said. During normal times, children would be exposed to pathogens such as RSV as they grew. But quarantines and isolation kept kids from infection. Now, as children have returned to in-person schooling, Moore said, they’re getting the germs all at once.

And although RSV mostly infects children, “we have a noted increase in the number of RSV cases in the adult population in the hospitals,” said Boynton Beach infectious disease specialist Dr. Kitonga Kiminyo, vice president of the T. Leroy Jefferson Medical Society. “We are definitely seeing more cases than we are used to.”

But, Kiminyo noted, few RSV cases in adults are severe. Like COVID, though, people with underlying health conditions are more susceptible to the worst effects of RSV, he said.

Both RSV and the coronavirus appear to be on the rise in Palm Beach County, sewage readings from the Jupiter-area Loxahatchee River District show.

There were about 18,000 RSV genetic fragments in the district samples tested Monday by WastewaterSCAN, a nationwide initiative that includes Stanford University. That’s more than double the amount found Sept. 14, when the district started sending wastewater samples for testing.

Testing on Wednesday revealed about 1,062 coronavirus fragments per milliliter of sewage, up from about 268 per milliliter Oct. 3. Wastewater testing from other Florida counties have yet to show a consistent increase of viral molecules.

Slight increase in COVID in sewage across Florida

The district is testing for monkeypox, too, but has so far turned up nothing.

About 8.5% of COVID tests from Palm Beach County conducted over the past week came back positive for the respiratory disease, the Florida Department of Health said Friday in its biweekly pandemic report. That's down from 9.9% during the week ending Oct. 21.

Statewide, the latest ratio is 7.8%, up from 7.1% two weeks ago.

“There are vaccines for COVID, and there are vaccines for flu,” she said. The latest coronavirus boosters by Moderna and Pfizer, federally approved in late August, were built for offshoots of the coronavirus’ omicron variant. Virtually all COVID infections this year have been caused by omicron and its subvariants.

And while there is no vaccine yet for RSV, monoclonal treatments can be administered to children most threatened by the pathogen: infants and toddlers with heart or lung diseases from birth.

And although infectious disease specialists may find use out of tracking RSV through sewage testing and other data, Moore said, for most people, it shouldn’t be cause for alarm.

Vaccines have made COVID infections less severe. And the newest versions of the virus are milder than previous ones. When examining patients recently infected with COVID, Palm Beach County infectious disease specialist Dr. Larry Bush said, "It's hard to distinguish them from other upper respiratory diseases."

"I haven't seen anybody very sick from COVID In a very long time," said Bush, former president of the Palm Beach County Medical Society.

People who see an uptick in the numbers, Moore said, should make sure to wash their hands more — RSV is spread through the air and on surfaces — and mask up around those most vulnerable to the pathogen — sick children and the elderly. “It doesn't mean we need to hunker down and go back into lockdown.”

COVID by the numbers in Florida

Florida logged an average of 11,579 infections each week between Oct. 21 and Friday, the state Health Department's biweekly pandemic report shows. That's slightly higher than the previous two weeks, but still 85% lower than the summer peak in July.

Hospitals statewide tended to 1,110 COVID-positive patients Friday, the U.S. Health and Human Services Department said, the lowest number since the first week of May. Hospitalizations have hovered just above 1,000 since early October.

Florida's COVID death toll climbed an average of 183 residents each week since Oct. 21. That's the lowest weekly rate since mid-June.

At least 82,541 Floridians have been killed by COVID. The death toll leaves out more than 3,000 victims found in 2020 by state auditors that the Health Department did not include.

More elderly residents ages 65 and older have died of COVID in Florida than in any other state since vaccines became widely available to adults in April 2021, a recent Palm Beach Post analysis shows.

At least 29% of Florida residents have gotten COVID boosters beyond the first two Moderna and Pfizer shots or the single-dose Johnson & Johnson formula, a Post comparison of state data and U.S. Census Bureau population estimates shows.

Chris Persaud is The Palm Beach Post's data reporter. Email him at cpersaud@pbpost.com. Click @ChrisMPersaud and follow him on Twitter.

This article originally appeared on Palm Beach Post: COVID, RSV, flu: Triple threat for Florida this winter?