Public health authorities fear that the increase in the number of covid patients will add to the pressure on hospitals already under pressure due to the effects of two other viral diseases, influenza and respiratory syncytial virus, widely known as RSV.
Nearly 20,000 Americans were hospitalized with the flu during Thanksgiving week, the most for this week in more than a decade and almost double the number of the previous week.
RSV, covid and flu are bringing hospitals to the brink – and it could get worse
Nancy Foster of the American Hospital Association said members still primarily raise concerns about RSV and influenza rather than covid.
“It could be in a week or two that we will see a lot more covid patients than we see RSV or flu, but the real concern is that we will see a large influx of all of them, which will really stress the ability of hospitals to caring for these very sick patients,” said Foster, the association’s vice president of quality and patient safety policy.
Experts warn that holiday gatherings are a prime time for the coronavirus to spread as millions of Americans travel and gather. The rise in hospitalizations likely reflects a combination of patients infected before the Thanksgiving holiday rush and those exposed during Thanksgiving week, health experts said.
Daily new hospital admissions for covid are now above 9,000 after hovering between 5,000 and 7,000 for much of the fall.
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Winter is usually hectic for hospitals, especially in cold states where people are more likely to congregate indoors, providing ample opportunity for respiratory viruses to grow.
In late 2020 and early 2021, before the widespread availability of coronavirus vaccines, covid patients were straining the country’s hospital services, with deaths peaking at more than 3,000 a day. And last winter, the explosion of cases fueled by the omicron variant of the coronavirus left hospitals struggling to provide basic care as they faced staffing shortages when the virus ripped through their workforces.
This winter, most people in the United States have some degree of immunity due to vaccination, previous infection, or both, which should reduce the severity of infections. And those who do get sick have a wider range of treatments to speed up their recovery and keep them from going to hospital.
“If we’re going to see a big surge, it’s going to start accelerating now, and it’s going to expand and probably peak in late December and early January,” said epidemiologist Jeffrey Shaman of Columbia University. “The hope will be that it will be somewhat mild, of course, and enough stimulation and prior exposure will prevent a large number of people from going to hospital.”
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At Banner Health, Arizona’s largest healthcare system, covid hospitalizations have doubled in the past month to nearly 600 patients. They represent less than 10% of all patients, compared to nearly 40% in the early stages of the pandemic. But the relatively lower number of covid cases is offset by an early spike in influenza and RSV cases exceeding five-year averages.
“What is already happening this winter and what we can continue to expect is that influenza and RSV will not be at unprecedented levels,” said Marjorie Bessel, Clinical Director of Banner. “We are going to have a high volume winter like we have had before in the pandemic. The high volume due to all this coming together is an unknown.
For hospitals already strained by other viruses, the coronavirus is an additional complication.
At Louisville’s Norton Healthcare system, coronavirus cases are stable, RSV is decreasing and influenza is increasing.
“Some winters are tougher than others, and I think we’re having a tougher winter this year,” said Steven Hester, senior vice president and chief clinical and strategic officer at Norton. “We’re going to see covid as part of the regular challenge that we have.”
Medicines for children are hard to find as respiratory viruses rise
Cases of RSV have slammed Orange County Children’s Hospital in California, prompting the county to declare and extend an emergency. The hospital’s emergency department saw a record influx of 12,000 patients in November and, at times, had to divert patients to other medical centers. Now the children’s hospital is also seeing an increase in covid hospitalizations, although nowhere near the number of RSV-related cases. Some children arrive infected with several viruses.
“It forces us to be organized and thoughtful, and we have to be innovative in the space. We still have to look for supplies,” said Sandip Godambe, the system’s chief medical officer.
Although children’s hospitals and pediatric wards have faced the most pressure from other respiratory viruses, older patients account for most new covid hospitalizations, according to data from the Department of Health and Human Services. social.
Experts say the trend highlights the importance of people 65 and older receiving updated booster shots tailored to the omicron variant. Less than a third of this age cohort received the latest vaccine, according to estimates from the Centers for Disease Control and Prevention.
“The main problem we face is declining immunity,” said Eric Topol, professor of molecular medicine at the Scripps Research Institute. “We are under-vaccinated and under-boosted, especially in old age.”
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To reduce the pressure on hospitals, the California state epidemiologist said it was essential to increase the use of recall in the elderly and to ensure that medically vulnerable patients receive antiviral treatments such as than Paxlovid shortly after testing positive.
“Even when you have mild or moderate symptoms, if you’re over 50, or have any medical conditions, you can probably benefit from treatment for a few days, so you don’t need to go to the hospital. ‘hospital,’ Erica Pan says.
Carmela Coyle, president and CEO of the California Hospital Association, said the public should still be concerned about hospitals’ ability to provide care even if there are fewer coronavirus patients this winter compared to earlier. of the pandemic. A shortage of healthcare workers has left hospitals understaffed, and hospitals are financially strapped nearly three years into the pandemic, she said.
“Covid for hospitals was like a flood,” Coyle said. “And although the floodwaters may have receded if you look at the past two winters compared to where we are now, the damage is still there.”
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