PITTSFIELD — As the Berkshires heads into its first post-pandemic winter, local health experts are recommending vaccination and vigilance for COVID-19, influenza and respiratory syncytial virus (RSV).
The winter months generally mean an uptick in cases of flu, RSV and COVID-19 due to people staying inside more often and cold, dry air making disease transmission more prevalent, according to Dr. James Lederer, chief medical officer of Berkshire Health Systems. And he said the relaxation of precautions taken during the pandemic will likely lead to higher rates of RSV and flu.
Dr. James Lederer, the chief medical officer at Berkshire Medical Center in Pittsfield.
“There’s always been a background of RSV,” Lederer said. “There’s always been a background influenza. Some of these, to some extent, were prevented in the early days of COVID because we masked and social distanced ... now we’re in more of a ‘back to normal’ community belief.”
Lederer said that about a month ago, health care professionals were monitoring what seemed to be an uptick for COVID-19 hospitalizations, to the tune of between 12 to 16 patients at a time. Recently, however, that number has dropped — and RSV has become a larger concern.
That’s not to say that COVID concerns have gone away. Mitigation measures such as masking, social distancing and vaccination are still recommended to help slow the spread of the coronavirus. Dr. Jonna Gaberman, director of adult medicine for Community Health Programs said sticking to areas with good airflow and avoiding crowds may help too.
The Centers for Disease Control and Prevention estimates that RSV results in over 2 million outpatient visits for children 5 or younger. Between 58,000 and 80,000 children in this age group will be hospitalized, and on average, between 100 and 300 children could die from the disease in a given year.
People aged 65 and over are the other primary group of concern: in a given year, between 60,000 and 160,000 people will be hospitalized, and between 6,000 and 10,000 will die from the disease.
Lederer said that a recently approved vaccine for RSV should help prevent severe illness in people in the over-65 age group. The RSV vaccine, approved by the Food and Drug Administration earlier this year, is approved for use in individuals 60 and over.
Gaberman recommended that people who are interested in the RSV vaccine consult their doctors first to engage in “shared decision-making.” Gaberman noted that the vaccine is recommended for people with underlying cardiac and pulmonary disease, but does have some side effects.
The Centers for Disease Control and Prevention also recommend people over 60 get the shot after discussing the vaccine with their health provider.
Lederer said that there was a concerted effort to get mothers who were about 32 to 36 weeks pregnant vaccinated for RSV to pass on the protection to the infant. There are also antibodies available to help children who get RSV have milder symptoms.
Treating and preventing the disease in children is a priority, Lederer said.
“The airways of little kids are much smaller in diameter,” Lederer said. “So a little bit of infection and a little bit of swelling and edema goes a long way. That’s why little kids are so compromised.”
'ARE YOU OK TO LEARN?'
At the school level, runny noses and lingering coughs are back for the season, too. Cristina Lenfest, school nurse at Richmond Consolidated School, said that this time of the year makes it important for families to pay close attention to how their children are feeling.
Cristina Lenfest, school nurse at Richmond Consolidated School, suggests using the "Are you OK to learn?" metric when deciding on sending children to school who have minor symptoms.
Lenfest said that informing families of best practices to keep them from getting sick can be critical in the winter months. Reminding children to wash their hands and cover their cough help in the classroom; getting good rest and eating healthy at home are precautions that families can help with.
Mild symptoms can make it tricky to determine if a student should go to school, Lenfest said, but there are ways to determine if a child can attend class.
“It’s kind of using the metric of, 'Are you OK to learn?’” Lenfest said. “If you’re in class and it’s coughing nonstop, blowing your nose nonstop where you’re interfering with your learning or others’ learning, that’s kind of like a gauge to stay home. Other than the obvious ones, like a 100-degree temperature.”
Gaberman also recommended that people get vaccinated for influenza; convincing people isn’t always easy, as many have the mistaken impression that “the flu” is milder than it really is. The use of “flu” as a colloquial catchall term for illness can lead people to think they don’t need to be vaccinated.
“We talk about it as if it’s a common, mild infection," she said, "but people can get severely ill from influenza.”
Lederer said that getting the flu vaccine could be critical to helping prevent severe symptoms in people. Community vaccination rates are usually below 40 percent, he said, showcasing the difficulty that health care providers have in getting people to take it seriously.
As of Nov. 25, about 32 percent of residents in the commonwealth were vaccinated for influenza, according to the Department of Public Health.
“It seems as if the symptomatology and the presentation of COVID is much more mild than it once was,” Lederer said. “That will not be the case for influenza.”
Symptoms between the three diseases are very similar, and the main concern should be monitoring the severity of symptoms, Lederer said. Gaberman said that anyone struggling with shortness of breath should be seen urgently, for instance, and said that people should call their doctor if they have other concerns.
Lederer echoed that, and said that vaccination for all three diseases remains a key way to prevent severe illness.
“I wouldn’t try to roll the dice and play the odds game,” Lederer said. “If you’re sick and you feel like you need support: go to urgent care, go to your primary care and get seen.”
