Winter’s accompaniments — mixed in with increasingly cold weather and a festive Christmas holiday season — include three respiratory illnesses: the flu, RSV and COVID.
“This can strain healthcare resources, particularly hospital capacity, while being a threat especially to the most vulnerable,” said Mike Zelek, the director of the Chatham County Public Health Department. “We have already been seeing some of this. We continue to promote vaccination, both COVID boosters and flu shots. Our clinic in Siler City offers both free of charge, including to those without insurance.”
Johnsie Hubble, the infection preventionist at Chatham Hospital, said the hospital has seen admissions for all three — and that the most recent numbers from tests done in the hospital’s lab “shows a very high prevalence of Influenza and RSV in our local communities, compared to most normal years at this time, and even higher than we usually see during peak flu season prior to COVID-19.”
COVID-19 is still being spread in our communities, she said, but at lower levels than this past summer and last January. But seasonal flu activity is elevated across the country, she added.
“Now is a good time to get a flu vaccine if you have not already had one this fall,” Hubble said. “There are also COVID bivalent booster vaccines. There are no vaccines for RSV at this time, although a new vaccine may become available for adults next year.”
RSV and the flu — not as prevalent in the last two years, thanks in part to COVID-19 health practices — are now straining pediatricians’ offices and children’s hospitals around the nation. The Centers for Disease Control says hospitalizations for RSV among children under 5 are outpacing those for COVID, and public-health experts have been quoted as saying increasing RSV and flu numbers are partly due to a larger pool of susceptible children this year.
CDC data says there have been nearly 9 million flu cases and more than 4,500 flu-related deaths already this flu season, with flu-related hospitalizations at the highest rate for this time of year in a decade.
Here’s a rundown of the three illnesses and how you might prevent them from running you down:
COVID
Zachary Horner, the public information specialist for the department, said past trends and the “ever-present concern” of emerging variants means his department is anticipating an increase in COVID cases as winter progresses in Chatham County. Both Chatham and the state saw higher numbers of COVID cases in the winters of 2020 and 2021 after a relatively tame fall.
“While our COVID-19 community transmission level per the CDC is ‘low’ as we move from November to December, there’s a decent chance that might change soon,” he said.
Horner said that over the last three months, 97% of COVID deaths in North Carolina were among individuals ages 50 and older.
“But 59% of the cases were in individuals ages 49 and younger,” he said. “I think we’re reaching the point where we can say everyone is vulnerable of being affected by COVID in some way.”
Thankfully, he said, there’s a way to combat that.
“Around 80% of patients currently hospitalized or in the ICU due to COVID were either unvaccinated (the majority of that group) or were vaccinated but had not gotten a booster shot,” he said. “And, has been the case since the early days of vaccination, those without vaccination are more likely to die of COVID-19. The data speaks for itself, to me. That’s why I’m vaccinated and boosted, and I encourage everyone else to do the same.”
Ultimately, like the flu and RSV — respiratory syncytial virus — Horner said the department’s advice to the public “is about being safe and healthy, especially during the holidays.”
“We’d give this same advice during flu season, or in any other disease outbreak: do what you can to stay healthy and keep those around you healthy,” he said. “It’s good advice all the time.”
FLU
Sadly, more than three dozen North Carolinians have already died from the flu this season. Additionally, for the week ending Nov. 26, 4.6% of all emergency department visits across the state were for flu-like illness, compared to 1.8% in 2021 and 1.2% in 2020.
“I think it’s safe to say, the flu is back,” Horner said. “I would simply encourage folks to take similar precautions to COVID.”
The public health department has been focusing its messaging on “Do Two to Stop the Flu.”
First, get a flu shot. Recent studies show that flu vaccination can reduce the risk of flu illness by between 40% and 60% among the general population, Horner said. Vaccination reduced flu-related hospitalizations by an estimated 105,000 in the 2019-20 flu season.
“Everyone six months and older should get a flu shot,” he said. “We are offering the flu shot free of charge at our clinic to everyone, including those without health insurance, for the first time this year, which we are very excited about.”
Flu shot locations can be found at myspot.nc.gov/flu.
Second, practice cleanliness.
“There’s these things in public health we call non-pharmaceutical interventions, or NPIs,” Horner said. “These are things we can do to protect ourselves and prevent the spread of illness: staying home when you’re sick, covering coughs and sneezes with a tissue, and washing our hands thoroughly with soap and water for at least 20 seconds, or using hand sanitizer when soap and water is not available. These NPIs are things you can do every day at home, at work, at a restaurant, at the grocery store, just about anywhere, that don’t require a prescription. Just good common sense.”
The public health department continues recommending wearing a snug-fitting mask in public and crowded spaces if you’d like.
Meanwhile, the Optum Health testing site in Pittsboro will remain open for the foreseeable future. This site, located at the old Ag building across from the Justice Center, offers free testing for both COVID and the flu, including a rapid test that screens for both.
“We encourage folks to take advantage of it,” Horner said.
RSV
RSV is a common respiratory virus that usually causes mild, cold-like symptoms. While most infected recover in a week or two, RSV can be serious in infants and older adults.
RSV is particularly more dangerous for children 5 and under and for adults 65 and older, and levels of RSV in our community is high at this time, Hubble said.
The public health department continues to receive reports of cases in young children across the county, according to Horner.
The best ways to prevent RSV from spreading, he said, are similar to both COVID and the flu because all three are respiratory viruses that are spread the same way.
“Keep your surfaces clean, wash your hands frequently, and stay home from work or school if you or your child are sick,” he said. “I’d encourage folks to wear a mask in crowded spaces to both lower the risk of spreading or catching it from others.”
And one more thing, he said: “It may sound like we’re singing the same song, fourth verse. We are doing that because it works. Every year, the flu pops up and we give the same advice because it gives you the best chance to stay healthy and enjoy the holidays. That’s all we’re here to do, provide health guidance to the public for their flourishing.”
Zelek said as a parent of newborn — he and his wife just welcomed the arrival of their second child, a daughter — following his department’s advice is particularly important to him.
“I had a respiratory bug soon after she was born and was careful to wash my hands and wear a mask while holding her,” he said. “We also increased air flow in our house by opening windows and turned on the air purifiers. Thankfully, she has avoided respiratory illness so far.”
Precautions you can take
Chatham Hospital’s Johnsie Hubble said everyone can take “everyday preventative actions to stop the spread of germs, including flu, RSV and COVID-19.” Her advice:
• Avoid close contact with people who are sick.
• If you are sick, limit contact with others as much as possible to keep from infecting them.
• Cover coughs and sneezes.
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• You can wear a mask around others if you are sick, especially if there are vulnerable persons close by.
• Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
• Avoid touching your eyes, nose, and mouth. Germs spread this way.
• Clean and disinfect surfaces and objects that may be contaminated with viruses that cause flu and RSV.
• For flu, CDC recommends that people stay home for at least 24 hours after their fever is gone except to get medical care or other necessities. Fever should be gone without the need to use a fever-reducing medicine.
• Take any medication prescribed by your doctor, such as antivirals for flu.
• For COVID-19, stay home for at least 5 days and away from others, and if you must go out on days 6-10, wear a good fitting, high quality mask.