Covid, flu, RSV down in hospitals as ‘tripledemic’ threat fades

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So much RSV patients had flooded the Connecticut Children’s Medical Center that they had to be cared for in hallways and playrooms. Facing their busiest season in memory last fall, hospital leaders launched a plan to enlist the National Guard to set up tents outside. Doctors braced for a terrible winter — a looming disaster that some have dubbed a “triple epidemic” — with flu season gathering pace, coronavirus returning and the holidays providing fuel for the spread of viruses.

But no such a push materialized. The RSV wave has receded in Connecticut and across the country. Flu cases declined rapidly. Covid hospitalizations rose briefly after Christmas, only to fall again.

“We’re seeing the normal busy ones, but not the very busy ones that I thought we were seeing,” said Juan Salazar, chief medical officer at Connecticut Children’s in Hartford. “I am so happy that we can now return to a normal squad. Busy staff, but nothing close to what we saw in the fall.

It turns out that the first waves of respiratory syncytial virus and influenza peaked before the new year, according to new data from the Centers for Disease Control and Prevention. And the expected rise of the coronavirus in winter is far from overwhelming hospitals, as was the case in 2021 when covid wards were filled with unvaccinated people struggling to breathe and last winter when the highly transmissible variant of the omicron unleashed a massive wave of disease.

The national seven-day average of hospital patients testing positive for the coronavirus fell to 39,000 on Friday, after peaking at 47,000 around January 10. Covid-19 patients occupy 5% of hospital beds, up from 21% so far last year, CDC data shows.

Weekly ER visits for all three viruses combined peaked in early December — with no resurgence after the holidays, according to a new CDC dashboard. For seniors, covid and flu emergency room visits peaked in late December.

“It’s possible the decline was even greater without the holiday mix,” said Barbara Mahon, a CDC official who oversees the response to the coronavirus and other respiratory viruses. “Things don’t look as bad as they did a few weeks or months ago, but we’re still in the middle of winter.”

Experts warn the country could see further increases in the flu, which sometimes has two peaks, and another RSV season in the spring. The highly transmissible and immunocompromised XBB.1.5 subvariant of the coronavirus that accounts for half of all new infections in the United States and has been dominant in the Northeast could spread elsewhere.

Despite the declines, it’s still a busy winter for hospitals grappling with an unpredictable new rhythm of infectious diseases. Viral attacks have taken a heavy toll on exhausted healthcare staff and compromised their ability to care for patients with non-respiratory emergencies, hospital leaders say.

Covid winters make long hospital waits the new normal

As the third anniversary of the arrival of the coronavirus in the United States approaches, many hospitals are resigned that it will never go away.

“We have almost three full years of going nonstop, surges, peaks, downslopes, coming to a valley,” said Cathy Bennett, president and CEO of the New Jersey Hospital Association. “It’s rinse, wash, repeat.”

Comparisons with the devastation of the first two pandemic winters may obscure the continuing toll of the elderly and severely immunocompromised. Covid deaths are rising and averaging around 670 a day, well below the peak of 3,300 a day in the middleJanuary 2021.

The United States is better equipped now than it was at the start of the pandemic to deal with coronavirus outbreaks, as most people have some degree of immunity and early treatment maintains the most vulnerable people from falling seriously ill.

“As horrible as omicron was, it left a tremendous amount of immunity in its wake,” said Jennifer Nuzzo, an epidemiologist at Brown University School of Public Health.

Even if the subvariants of omicron which are currently in circulation raise concerns due to their ability to evade antibodies, the immune system of those who have been vaccinated or previously infected is still effective in maintaining mild cases, especially if they have recently received booster shots, say the doctors.

At Our Lady of the Lake Regional Medical Center in Baton Rouge, covid cases peaked the first week of January, with 170 patients testing positive compared to 1,338 at the same time last year. Doctors there believe covid is still rampant in the community, but fewer people need hospital care.

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Even after XBB.1.5 quickly became the dominant coronavirus strain in Massachusetts in December, the temporary The increase in the number of patients testing positive in the state’s largest hospital system has been modest and did not exceed the last winter surge. The Mass General Brigham system, headquartered in Boston, now has an average of about 400 patients a day testing positive for coronavirus, up from about 2,100 patients a day this time last year.

Almost three-quarters of patients admitted with covid during the most recent spike were ‘secondary’ diagnoses, meaning the patient tested positive while being admitted for other causes. While such cases still create complications for hospitals to isolate the patient and prevent the spread, they don’t drain as many clinical resources, doctors say.

“This is good news overall,” said Erica Shenoy, medical director of infection control for the system. “A question we all have is, ‘Where are you going? Are we going to settle into a typical respiratory season where things will work out? »

The flu is notoriously unpredictable in public health, but experts monitoring its trajectory say it appears to be in line with previous flu seasons and started to decline early because it started early. The share of respiratory illness outpatient visits has fallen below baseline levels in some parts of the country, including the Upper Midwest, Great Plains and South-Central United States, the CDC said Friday.

“Now the question is, are we going to have a typical influenza B outbreak in the spring or at the end of the season?” said Scott Hensley, a microbiologist who tracks influenza viruses at the University of Pennsylvania’s Perelman School of Medicine. He urges people who haven’t had the flu shot to do so because Americans have less immunity, given the low number of influenza B cases in recent years.

It is important for public health experts and the media to be transparent but not alarmist in their messaging and reporting, said David Rubin, a pediatrician who tracks national respiratory virus trends as director of the PolicyLab at Children’s Hospital of Philadelphia. Public fixation on a “triple epidemic” has always been a misnomer, he said, because viruses do not soar simultaneously, but ebb and flow as they compete for hosts.

“It can become like a crying wolf,” he said, “What if there really is another public health emergency, like a new pandemic, will people listen?”

Jacqueline Dupree and Dan Keating contributed to this report.

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