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Health officials address triple whammy of COVID-19, RSV and flu KENNETH SONG/NEWS-PRESS FILEDr. Kenneth Waxman, right, delivers the booster Moderna COVID-19 vaccine dose to Maria Cortez in February 2021 at the Sansum Diabetes Research Institute in Santa Barbara. Physicians recommend people get the COVID vaccines and the boosters, as well as the flu vaccine.
Local health officials are discussing what residents could be facing this winter concerning COVID-19, respiratory syncytial virus and influenza, all of which are being seen in a significant number of cases.
Is a tridemic looming on the horizon?
“Well, that depends on what you mean by ‘tridemic,’” said Dr. David Fisk, medical director of Infection Prevention and Control at Cottage Health.
“You can already say as of today, that the community has experienced high rates of RSV and influenza and increasing rates of COVID-19 over the last several weeks,” said Dr. Fisk, who, in addition to his Cottage Health duties, is chief medical officer of the Public Health Company.
“Most striking is the RSV impact on children,” Dr. Fisk told the News-Press. “This is one of the worst RSV seasons in years. Influenza is on the upswing and has arrived much earlier than most years. Community test positive rates for influenza are much higher than most years.
“Much of the U.S. is experiencing the worst influenza season in years,” he said.
COURTESY PHOTODr. David Fisk“It’s fair to say we are seeing high rates of all three infections (flu, COVID-19 and RSV) putting a significant strain on the health system,” Dr. Fisk said. “Any one of three viruses is not dominant at this time.”
Dr. Fisk said great progress has not been made in fighting COVID-19 in recent months.
“In fact, the reverse is true on many fronts because of less masking and less social distancing,” Dr. Fisk told the News-Press.
“Where we are seeing progress is with the bivalent mRNA booster, which offers good protection against hospitalization and death and some protection against (COVID variants) BQ1 and BQ1.1, but not as strong protection as we had hoped, depending on the age group,” he said.
“The protection against acquiring COVID is between 30-56%,” Dr. Fisk said. “The further out from the last vaccine, the more beneficial the booster has become.
“The greatest chances of death remain in senior citizens, with over 90% of deaths in the last month in senior citizens, according to the CDC. The uptake of the bivalent vaccine has been very low.
“Only one-fifth of senior citizens are bivalent-boosted (the most effective booster),” Dr. Fisk said. “We are seeing signs of local increase in COVID-19 cases in terms of case counts, hospital admissions and positive COVID-19 tests at Cottage Health.”
Jackeline Ruiz, public information officer for the Santa Barbara County Public Health Department, said increased activity is being seen for respiratory illnesses during the fall and winter.
“When certain respiratory illnesses are having elevated activity earlier in the season, it is an important reminder of the many prevention strategies we have available to us — including getting vaccinated against COVID-19 and the flu, wearing a high-quality mask in crowded spaces, regular hand washing, covering coughs and sneezes, and staying home if you’re sick,” Ms. Ruiz told the News-Press.
“Masks, particularly high-quality masks, offer protection against contracting and spreading respiratory illnesses,” she said. “Wearing a mask this year, particularly in crowded spaces, is advisable.”’
She also recommends monitoring vulnerable family members.
The News-Press asked Dr. Fisk how society can keep up with the ever-evolving COVID-19 virus.
“Given that so much of the world population does not have ready, rapid access to the bivalent booster or current mRNA booster, we will keep seeing variants arise,” he said. “There is no sign of variant production slowing down. What we have to do is figure out on an individual, community and societal level how to manage the variants.
“How will we manage it, and what steps are we willing to take to manage it? Our most effective tool available is vaccination,” Dr. Fisk said. “The other thing changing over time is the natural immunity that we have developed. However. variants could come forth that our immunity offers little protection against. Similar to influenza, COVID-19 fluctuates in its ability to cause severe disease. It will remain exceptionally contagious.
“COVID-19 is one of the most contagious organisms we know of.”
Dr. Fisk recommends reducing the chance of acquiring COVID-19, the flu and RSV by interacting with people outdoors as much as possible and masking indoors. He also said handwashing offers protection against the flu and RSV and, to a lesser degree, against COVID-19.
“Also, get an influenza vaccine,” Dr. Fisk said. “The influenza vaccine does a great job of reducing risk of death or hospitalization. Pretty much anyone over six months is eligible for an influenza vaccine. It is also completely safe to get a COVID-19 vaccine and an influenza vaccine at the same time.”
Dr. Fisk said it is unclear whether mask wearing in recent years has reduced immunity.
“What is clear and relevant is that children under the age of 2 are most susceptible to RSV. There has been less RSV in the last few seasons due to less interaction,” Dr. Fisk said. “Almost everyone is exposed to RSV by the age of 2. It is unclear how much of a role the quarantine and masks are playing in the transmission of RSV in adults.”
“The main message is that there are a lot of sick people of all ages with respiratory infections,” Dr. Fisk said. “Just because you’re healthy and not of advanced age you shouldn’t assume you aren’t at risk. There are measures you can take to protect yourselves. There are measures families can take to protect each other and their colleagues.
“I would also like to emphasize the importance of improving ventilation and improving filtration of air,” he said. “The more we look into it, the more we find the benefits of in-room HEPA filters, which are widely available commercially.”
email: kzehnder@newspress.com
FYIThe California Department of Public Health provides the following guidance concerning respiratory illnesses, particularly for children who become sick.
According to the state health department, most childhood respiratory illnesses are mild and resolve on their own without the need for emergency care or hospitalization. But the department recommends calling to get medical advice and seeing what you can do at home and when it is best to come in to be examined. Seek evaluation right away, the state public health department says, if your child has:
— Symptoms of lung disease: fast breathing, flaring nostrils, head bobbing, grunting, or wheezing while breathing; belly breathing; pauses in breathing.
— Symptoms of dehydration: www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/dehydration.aspx.
— Gray or blue color to tongue, lips or skin.
— Significantly decreased activity and alertness.
— Symptoms that worsen or do not improve after seven days.
— Fever in those under 3 months of age (12 weeks).
— Fever above 104°F repeatedly for a child of any age.
— Poor sleep or fussiness, chest pain, ear tugging or ear drainage.
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