Respiratory virus season is ramping up in California, prompting health officials to renew their calls for residents to be vaccinated in hopes of reducing potential pressure on health systems across the state.
Although conditions so far are not as dire as last autumn – when hospitals labored under “tribledemic” stress spawned by the simultaneous widespread circulation of COVID-19, influenza and respiratory syncytial virus – it’s r transferable trio on the rise.
Data shows new COVID and flu hospital admissions are increasing in California, and Fresno County was forced to take steps last month to stem a flood of patients arriving at its emergency rooms, instructing ambulances not to transport patients to hospitals if they are stable and do not suffer. from an emergency.
Nationally, “RSV season is in full swing. The flu season has just started across most of the country, although it is gathering pace. And while we’re seeing relatively low levels of COVID, COVID remains the leading cause of new respiratory admissions and deaths, with about 15,000 hospitalizations and about 1,000 deaths each week,” Dr. Mandy Cohen, director of the US Centers for Disease Control and Prevention Atal, to a sub-committee of the House of Representatives last week.
Of the three viruses, RSV is the most concerning in California in terms of community transmission, said Dr. Peter Chin-Hong, an infectious disease expert at UC San Francisco. In Los Angeles County, for data released Thursday, 13% of specimens tested for RSV came back positive, up from 9% two weeks earlier.
“It’s quite high [and] haven’t started going down yet,” Chin-Hong said.
But despite recent progress, health officials say they have yet to see the kind of widespread issues that made the previous respiratory virus season so challenging. Last year at this time, children’s hospitals across California were under strain, with extremely high RSV-related hospitalization rates — including in Orange County, which declared a health emergency related to the virus.
“The interesting thing with RSV is that the hospitalization levels are not the same levels of crisis in pediatric hospitals as a year ago, when it peaked in November,” Chin-Hong said.
One possible reason is that since RSV was quite severe last fall, there may be some carry-over immunity. Chin-Hong said UC San Francisco’s pediatric hospitals are now about 90% full — “average for this time of year” — rather than being over capacity last year.
The availability of RSV vaccines for infants and young children, the elderly and those who are pregnant may also help, he added.
On 18 November, levels of coronavirus in LA County’s wastewater were 24% of last winter’s peak, up from 13% the previous week.
That level, although still considered relatively low, is the highest seen since late September, when the county was recovering from the late summer surge of COVID-19.
And for the week ending Nov. 25, about 8% of specimens tested for the flu at LA County labs were positive for the virus, up from about 7% the previous week.
“We believe the flu season has begun,” the county Public Health Leavement said in a statement to The Times. “Flu is circulating in the community and on the rise.”
Doctors are also keeping a close eye on the latest upstart coronavirus sub-variant – nicknamed “Pirola” but officially designated as BA.2.86.
The CDC estimates that BA.2.86 accounted for 8.8% of coronavirus cases over the two-week period ending November 25, up from 3% for the previous two-week period.
The CDC has been concerned that the strain’s unusually high number of mutations could empower it to more easily infect those who had previously caught the coronavirus or received an older vaccine formulation. However, emerging evidence shows that the latest COVID-19 vaccine formula appears to provide strong protection against Pirola.
The progress of BA.2.86 should further encourage people, especially older individuals, to get the new vaccine this fall, doctors say, because relying on old booster shots or natural immunity from past infection may not be protective enough.
“If someone is at risk of becoming seriously ill, especially those older than 65, you can’t really rely on having the old shot from last year to really carry you through this winter,” Chin said. -Hong. “You really need some replenishment of the antibodies, and that’s what the new vaccine will do.”
In LA County, only 21% of seniors have received the updated COVID-19 vaccine this fall. Orange County reports that about 25% of its seniors received the updated shot, as did 27% of seniors in San Diego and Ventura counties. In Riverside County, about 20% of seniors have received the latest shot, along with 17% of seniors in San Bernardino County.
Ancienter vaccination rates are much higher in the San Francisco Bay Area. Santa Clara County, the most populous in the region, has a higher vaccination rate of 36%; while San Francisco and Alameda County report a rate of 38%. Contra Costa and San Mateo counties report a rate of 40%, while Sonoma, Marin and Napa counties report even higher figures.
Statewide, 27% of California seniors have received the latest COVID-19 vaccination.
Cruelwhile, global health officials are monitoring a significant increase in respiratory illnesses among children in northern China. Chin-Hong characterized the situation there as “an unprecedented number of children and young people who are getting sick; a proportion of those go to hospital in very large numbers” – serious enough to prompt the World Health Organization to inquire what was going on.
Cohen, the CDC director, told House lawmakers last week that “we don’t believe this is a new or novel pathogen,” but a combination of diseases like COVID-19, influenza, RSV, as well as a bacterium from the name mycoplasma pneumoniae which can infect the respiratory system and trigger bronchitis or pneumonia.
“Chinese authorities advised that no unusual or new pathogens or unusual clinical presentations were detected, including in Beijing and Liaoning, but only the aforementioned general increase in respiratory illnesses due to multiple known pathogens,” WHO said in a statement last month. “They further said that the rise in respiratory illness has not resulted in patient loads exceeding hospital capacity.”
Other areas of the world reporting reports of mycoplasma or pneumonia affecting children include Denmark and the Netherlands, Chin-Hong said.
Stateside, Warren County, Ohio, has also reported what local officials called “a very high number of pediatric pneumonia cases being reported this fall season.” No deaths have been reported, however, and most of the sick children are recovering at home and have been given antibiotics.
“The increase in reported pneumonia cases is not suspected to be a new/novel respiratory virus but rather a large increase in typical pediatric pneumonia cases,” the Warren County Health District said in a statement . “There has been no evidence that this case is connected to other cases, either statewide, nationally or internationally.”
Some health officials have taken note of reports from China. A statement posted on Taiwan’s government website on Sunday said officials there have not seen a “rapid surge in respiratory infections similar to China,” but rather a drop in flu-like cases in recent weeks.
Taiwan’s prime minister, Chen Chien-jen, who is also an epidemiologist, was quoted in the government statement as saying that the surge in respiratory illness in China was mainly related to flu, but also rhinovirus – the most common cause of the common cold – mycoplasma pneumoniae, adenoviruses and coronaviruses. Still, “the government has increased surveillance measures for related infectious pathogens,” the statement said.
There are several potential, competing explanations for why China is seeing such an increase in respiratory illness among children. One is that this is the first fall and winter season after the end of the COVID lockdown periods there, and children are going to see a surge in illness after years of not being exposed to viruses, Chin-Hong said.
Mycoplasma is a possible culprit, as the bacterium resurfaces every few years, but it can be treated with antibiotics.
The third explanation, says Chin-Hong, is that “there’s something we don’t know about yet that’s causing this illness. And I guess part of that logic is that we are also seeing ‘children’s pneumonias’ in other parts of the world at the same time, [places that] reopened much earlier than China. “
One encouraging data point is that there have been no reports of more children dying from this wave of pediatric pneumonia, or overtaxing hospitals. “But again, it’s something to watch as the season goes on,” Chin-Hong said.
For children with respiratory illnesses, a warning sign to take them to the hospital is if they have trouble breathing, Chin-Hong said. A warning sign for young children is if they have difficulty feeding or become lethargic.
