- Surge in RSV, Influenza, Covid
- Tripledemic Strains Hospitals
- Children’s Hospitals Face Strain
As hospitals are simultaneously besieged by RSV, influenza, and Covid, the United States is in the midst of a tripledemic.
Already, physicians in some children’s facilities are declaring this the most severe year ever for RSV infections, with children being more ill than ever before.
Additionally, Centres for Disease Control and Prevention (CDC) officials have issued a warning regarding children’s hospitals, stating that facilities are “nearly as full as they were at this time last year” and may become “strained” in the near future.
A combination of an earlier-than-usual winter virus season and the immaturity of children’s immune systems due to lockdowns may account for the increase, according to experts.
The incidence of influenza has tripled in the past month, and nearly half of the states are now reporting extremely high or high levels of influenza-like illness. A mere twenty-four states, or slightly more than a quarter, were at this level two weeks ago.
Additionally, according to CDC estimates, 5.3 million individuals are afflicted with influenza at this time, a 40 percent increase from this time in 2019, the year preceding the pandemic.
Concerns Rise as Covid and RSV Surge Puts Strain on Children’s Hospitals
In the most recent week for which data is available, wastewater surveillance revealed a ten percent increase in the quantity of Covid detected, which is further evidence that the virus is on the rise. Preliminary experiments indicate that a new variant, denoted as JN.1, may possess a higher degree of infectiousness.
Whitney Marvin, a paediatric intensive care specialist at the Medical University of South Carolina’s hospital, has expressed concern. She states that this RSV season is the most severe she can recall.
The season started earlier and kids were hospitalised longer than normal, she told the Washington Post.
She stated, “We are still ensuring that patients are receiving the necessary care.” They might not always be able to reach the nearest facility.
“Everyone in the intensive care unit who sees the sickest children is hopeful that next year’s RSV season will be different due to the greater availability of the vaccine.”
A CDC spokesperson stated, “In certain regions of the country, paediatric hospital beds are nearly as full as they were at this time last year.”
By the end of the month, similar patterns may overburden emergency departments and hospitals again.
Growing Concerns as Diseases Surge
Children’s hospitals experienced operational strain in the previous year due to a surge in patient admissions.
As infections spread rapidly following the epidemic, experts worry that the same pattern is repeating this year.
The most recent data indicates that RSV cases have reached their highest point, as the positivity rate (the percentage of PCR tests that detect the virus) decreased to 11 percent in the week ending December 16, from 12 percent in the week prior.
Experts, however, predict that hospitalisations will remain elevated for an extended period of time. It takes a long time for a virus-infected person to grow sick enough to seek medical assistance.
Dr. Mandy Cohen, director of the CDC, estimates that RSV has already reached its apex for the year. Whereas neither influenza nor Covid have shown any indication of this.
She stated last week, “We are observing RSV peaks a bit earlier. But we do not believe the flu or Covid epidemics are nearing their peaks.”
The latest data indicates that twenty-four states reported high or very high levels of influenza-like illness in the week ending December 16, up from nineteen in the previous seven-day period.
In the past week, Arkansas, Indiana, Kentucky, Maryland, and Massachusetts reported elevated or extremely elevated levels.
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Influenza Surges in Southern States
Louisiana and South Carolina, along with most southern states, are hardest hit with “extremely high” influenza-like sickness.
The CDC states that 5.3 million individuals have contracted influenza this year, with 54,000 hospitalised and 3,200 dead.
This is a 40% rise over the 3.7 million illnesses documented in 2019, the year before the pandemic.
However, it is lower than this time last year, when 15 million people were sick.
Additionally, there were 1,800 fatalities and 32,000 hospitalisations at this period in 2019.
Dr. Bill Schaffner, an expert in infectious diseases at Vanderbilt University in Tennessee, expressed optimism. He believes that “normal” disease trends would return to the United States in the near future.
Previously, he stated, “I believed things had returned to normal for the most part this year, but it appears otherwise.”
Regarding this season, I am hopeful that we can return to our previous state of affairs a little faster.
More people are monitoring virus propagation, therefore outbreaks may be recognised more often.
According to the most recent data available from the CDC, the percentage of samples detecting the virus increased to nearly 13 percent in the week leading up to December 16, which was the peak of flu cases.
In contrast, during the preceding seven-day period, 9.9% of samples exhibited the presence of the virus.
Influenza’s Tragic Toll on Children
A minimum of fourteen paediatric fatalities attributed to influenza have been documented thus far this year, encompassing children.
On December 18, Wilson, North Carolina resident Jasmyne Kite, nine, died from the virus.
Fourteen fatalities have been attributed to influenza in the state thus far in 2023.
After five days of illness, Jasmyne was hospitalised last Wednesday after spells of unconsciousness.
Doctors reported that the influenza virus had infected Jasmyne’s heart, resulting in a cardiac arrest.
Influenza had caused viral myocarditis, which is an inflammation of the myocardium.
Jasmyne was treated at ECU health in Greenville, where pediatrician-in-chief Matthew Ledoux stated that influenza can be fatal for children.
He told Cleveland19, “Their systems are relatively young, and they have not been exposed to the majority of those things.”
According to data from the CDC, daily hospitalisations attributable to Covid increased by 3% during the initial week of December.
In the week ending December 9, there were over 23,000 new Covid hospital admissions, marking the highest level since February. It also marked the fifth consecutive week that the number of admissions has increased.
Cautious Optimism Amidst Covid Trends
It remains, nonetheless, 33 percent below the 34,932 hospitalisations that occurred during this period last year.
Weekly Covid death rates remain 36 times lower on a national scale compared to the apex of 2021 and 24 times lower than the peak of 2020; however, it is anticipated that they will continue to rise through the winter.
The new variant JN.1 was initially found in the US in September and accounts for 20% of cases.
Director of the National Centre for Immunisation and Respiratory Diseases Dr. Manisha Patel, the agency’s principal medical officer, stated that the CDC anticipates it to reach fifty percent within the next two weeks.
More than half of states, especially in the South, reported high or very high influenza activity in the week ending December 16.
At least two of the following must be in the highest percentiles on a national scale to qualify as high: the proportion of flu-related hospitalisations, the percentage of flu-related fatalities, or the percentage of outpatient clinic visits by patients presenting with flu symptoms.
American elderly may face a “significant risk of serious illness” due to low immunisation rates.
Health officials emphasised the critical nature of safeguarding the susceptible population against a potential respiratory virus outbreak.
Today, the Centres for Disease Control and Prevention reported that as of December 10, only one-third of residents had received their RSV vaccine and one-third were current on their Covid vaccination.
A greater proportion, 72%, have been administered the influenza vaccine.
The elderly residing in nursing homes face an increased susceptibility to severe illness and mortality. This vulnerability is due to their compromised immune systems.
Amidst the influenza season of 2021-2022, the mortality rate among individuals aged 65 years and above was approximately 7.4 per 100,000 inhabitants, while that of those aged 18 to 49 years was 0.1 per 100,000 people.
Health experts have issued a warning that the United States is currently experiencing one of the most severe winter cold seasons in their history, due to the increasing incidence of Covid, influenza, and RSV, which is straining hospital resources.
