A dangerous mix of COVID-19, RSV, flu and other respiratory illnesses has led to a crisis in hospitals across the United States after the holiday season. Cases are spiking to the highest levels in years, filling up pediatric units and intensive care beds. Health officials warn this “tripledemic” could last for weeks or months longer.
Holiday Gatherings Fuel Surge
The holidays brought families and friends back together after years of COVID restrictions. While long-awaited reunions were celebrated, infectious disease experts worried these gatherings would cause respiratory viruses to spread rapidly.
Their warnings have proven accurate, as 38 states now show “very high” or “extreme” flu activity, according to the latest CDC data. RSV cases are soaring among children and seniors. And new Omicron subvariants are evading immunity to drive up COVID hospitalizations once again.
“”We saw more social mixing and traveling around Thanksgiving and Christmas,” said Dr. José R. Romero, director of the National Center for Immunization and Respiratory Diseases. “This has contributed to one of the worst surges of respiratory illnesses we have seen in years.”
| State | Flu Level | RSV Trend | COVID Trend |
|---|---|---|---|
| Ohio | Very High | Rising steeply | Rising steeply |
| Colorado | Very High | Rising steeply | Rising |
| Indiana | Very High | Rising steeply | Rising |
| Virginia | Very High | Rising | Rising |
CDC flu map as of Jan. 7, 2023. RSV and COVID trends from state health department data.
With so many viruses circulating at once, co-infections are becoming more common. Doctors are seeing patients test positive for flu and COVID, or RSV and flu, at the same time. This can lead to much more severe illness.
“These viruses on their own can make you quite sick,” said Dr. Erica Shenoy of Massachusetts General Hospital. “Having two viruses at the same time can be really dangerous.”
Hospitals Overwhelmed With Youngest and Oldest Patients
Pediatric hospital beds and ICUs are filled to capacity in many states. The wave of RSV has hit infants and young children especially hard.
“I have been doing this a long time, and I have never seen this level of surge specifically for RSV,” said Dr. Amy Edwards, a pediatric infectious disease specialist at UH Rainbow Babies and Children’s Hospital in Cleveland.
At the other end of the age spectrum, flu and COVID are proving deadly for seniors again. With limited ICU space, doctors report having to make difficult decisions about rationing care.
“To have simultaneous surges of all three of these viruses is quite unprecedented,” said Dr. Andrew Badley, head of Mayo Clinic’s COVID Task Force. He urged high-risk individuals to take precautions and get vaccinated if eligible.
Experts say the pressure on hospitals could get even worse in the coming weeks and months. There is often a lag between when cases first start rising in the community and when the sickest patients end up needing hospital care.
“January and February are typically very difficult months for us,” said Dr. James Kennedy of MetroHealth Medical Center in Ohio. He implored the public to do their part to help slow the spread of illness.
Calls for More Funding, Coordination
Many hospitals entered this tripledemic surge already understaffed and lacking resources. Now healthcare workers find themselves overburdened, putting in extra shifts to keep up with the high patient volume.
“Our healthcare heroes need reinforcements,” said AHA President and CEO Stacey Hughes. She called on Congress to provide more emergency funding for hospitals to pay nurses overtime and hire temporary staff.
Better coordination between healthcare facilities has also been proposed. In hard-hit regions, some hospitals with available beds could take transfers from other hospitals that have run out of space. But funding and liability issues often prevent such coordination.
The AHA urged government action now to get through this crisis and prepare for future surges that may emerge.
“This is a nationwide emergency we need to address collectively before it’s too late,” said Hughes.
Prevention Still Key as Viruses Rage
Masking, good hand hygiene and staying home when sick remain vitally important to slow the spread, doctors emphasize. Getting an updated COVID booster and annual flu shot also provides protection – though it appears too many people skipped vaccination this year.
The CDC estimates only 15% of Americans have gotten the new Omicron booster. While flu shot rates started out strong, delays in vaccine delivery caused many to miss early opportunities. Still, experts say it’s not too late to get protected.
Vaccines alone won’t fend off this tripledemic surge, however. Multiple health officials said individuals should rethink travel plans, avoid large gatherings when possible, and wear high-quality, well-fitting masks in public indoor spaces amid ongoing high transmission.
Though Americans are understandably exhausted of COVID precautions, doctors plead for a renewed public health response until this viral tsunami starts to recede. Only then may hospitals find some relief from the crushing influx of respiratory illness cases in ERs and ICUs nationwide.
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