Covid, RSV and flu: the trifecta of respiratory viruses is straining hospitals across the country

Covid, RSV and flu: the trifecta of respiratory viruses is straining hospitals across the country


Across the country, overwhelmed healthcare workers are struggling to catch their breath as hospitals fill up with struggling sick patients trifecta of respiratory diseases – Covid-19, RSV and flu.

“We’ve seen a real uptick in cases … especially since Thanksgiving,” said Dr. Christopher Longhurst, chief medical officer at UC San Diego Health, who added that the hospital is dealing with a respiratory wave. “Covid is on the rise. Influenza is on the rise, and so are other respiratory viruses.”

The situation is so overwhelming at UC San Diego Health that the hospital has had to create space for patient triage by setting up tents in parking lots and using other unconventional spaces. The corridors of the emergency room are also full of temporary beds for patients who have been admitted but are waiting for hospital beds.

“We didn’t have to reconfigure the conference room space for patient care even during the Covid pandemic,” said Longhurst, who explained that UC San Diego Health has experienced an equal number of patients with Covid as patients with other respiratory viruses. “These are truly unprecedented times.”

Last week, hospitals across the country were at their busiest during the entire pandemic, reaching 80% capacity, a jump of 8 percentage points in two weeks. It’s also the highest level since Omicron’s rise in January. This week, the hospital’s capacity has improved a bit.

While RSV seems to have peaked in the US, both Covid and flu infections are on the rise.

All but seven states have high or very high respiratory virus activity, according to the Centers for Disease Control and Prevention. The CDC advises that people in areas with high levels of Covid-19 in the community wear a mask.

dr. Jeff Smith, executive vice president and chief operating officer for hospital operations at Cedars-Sinai Medical Center in Los Angeles, said the “extreme, rapid increase” in RSV from October to November is likely “the most RSV we’ve seen in the past decades.”

“And now we’ve seen a rapid decline (of RSV),” Smith said. “That overlapped this spike in Covid, which happened a little slower and a little later, and now it’s superimposed on this very rapid rise in influenza.”

However, the rise of this trio of viruses is still not as bad as Covid was during the peak of the pandemic.

“By far the most powerful factor is probably vaccines, but the other is the cumulative number of infections we’ve all had, which is now called natural immunity,” said Dr. Edward Jones-Lopez, an infectious disease specialist at Keck Medicine at the University of Southern California.

“Unfortunately, there is still about a third of the country … where, despite all the evidence of safety and effectiveness, people are still not getting vaccinated,” he said.

There are vaccines for both Covid and flu, but not for RSV. All three viruses show very similar symptoms – fever, cough and upper respiratory symptoms – so testing is needed to determine which illness it is and recommend treatment.

And just because a patient has one virus does not mean that he cannot get the other two.

“I saw one case of three infections that happened at the same time,” Jones-Lopez said. “These are independent viruses that can infect the same person and, obviously, the more viruses there are, the more infections you have … the greater the risk of one of them leading to a more serious illness.”

Mandatory masks have not yet been reinstated, but spikes in the virus in New York, Los Angeles and Seattle have prompted health officials to recommend that people wear masks indoors and in crowds.

But as friends and family gather this monthhealth officials are concerned.

“I would certainly recommend that you encourage wearing a mask now if you are elderly or have a medical condition that makes you immunocompromised or particularly susceptible to infection,” said Smith of Cedars-Sinai Medical Center. “It’s the best protection we have for everyone else who is concerned about transmission.”

Or, as Longhurst put it, “Wear a mask during the holidays and don’t kiss those sick babies.”

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