Cases of three respiratory illnesses are starting to creep up in Kansas City and hospitals are wary of another “tripledemic” as the weather gets colder and people travel for the holidays.
Last year, following an unusually early surge in Respiratory Syncytial Virus, or RSV, doctors were left to grapple with the rising case numbers and spikes of COVID-19 and influenza at the same time. The illnesses left hospital emergency rooms bogged down, with few beds available to patients, and led to an increased workload for staff.
Todd Shaffer, family physician and professor of medicine at University Health Truman Medical Center, said pandemic protocols like masking and social distancing may played a role. They may have delayed RSV and flu season, so when people returned to a more normal schedule last year, it caused a sharp and earlier-than-expected increase.
This year, RSV and influenza case numbers are trending back toward previous baselines, and COVID-19 numbers have held relatively steady. But Shaffer said this is also the time of year when those numbers start to creep up.
“As people travel for the holidays, kids come back from college, there is a lot more spreading from different corners of the country,” Shaffer said. “As we go into December and then through Christmas and after the new year, this time of year usually is the worst time of year for any kind of illness, whether it's bacterial or viral.”
Right now, Shaffer said there are a little more than a dozen COVID-19 cases in his hospital. Since the public health emergency ended earlier this year, hospitals are no longer reporting this data to local health departments.
According to the CDC, only Wyandotte and Leavenworth counties are reporting moderate levels of COVID-19 community spread. That means there were between 10 and 20 new hospital admissions per 100,000 people in the past week. All other metro counties are reporting low spread.
Shaffer said despite the low numbers, he still regularly sees patients coming in with COVID-19 and is aware many are using at-home tests. He suspects there is a lot of what he calls “casual COVID” going around — people who have symptoms but aren't testing.
Dana Hawkinson, Medical Director of Infection Prevention and Control at the University of Kansas Health System, said COVID-19 may be becoming seasonal in much the same way as the flu and RSV.
Hawkinson said COVID-19 numbers have fluctuated at the health system. Last week it had 22 hospitalizations, but this week only 19. But the number of people coming in for COVID testing increased from 600 last week to 800 this week.
Influenza testing also jumped from 440 to 664 and the number of influenza inpatients increased from two to 14.
According to the CDC, both Missouri and Kansas have minimal influenza activity as of November 25, but surrounding states are reporting gradually increasing activity, which could indicate an incoming surge following Thanksgiving travel.
“I do expect those numbers to elevate,” Hawkinson said. “By how much, it's always hard to say, but that's why it's so vitally important to protect yourself by vaccination, especially with the influenza vaccination, which, by all estimates, looks like there is a good match of the vaccine and the circulating viruses currently.”
There are currently eight inpatient RSV cases at KU Health System, up from six last week and one just over a month ago.
This year is the first when there are vaccines available for all three of these illnesses. But an RSV vaccine intended for infants younger than 8 months old – who are among those most at risk of infection — has been in short supply.
KU Health System currently does not have a supply of the vaccine. University Health reports they sometimes have supply but it varies. Children’s Mercy Kansas City does have the vaccine, but with limited supply has to make some tough choices.
“The federal bodies that recommend this immunization along with the American Academy of Pediatrics have kind of created guidelines around how to prioritize highest risk infants during this time of the shortage,” said Angela Myers, division director of Infectious Diseases at Children's Mercy Kansas City. “We are following those guidelines to try to target the infants that are at highest risk of having severe RSV infection.”
Myers doesn’t expect a sufficient supply of this vaccine during the 2023-24 respiratory illness season, but is optimistic there will be enough next year. There is also an RSV vaccine that's available for pregnant people between 32 and 36 weeks of pregnancy, which can help prevent severe cases, and one for adults over 60 years old.
Sarah Boyd, an infectious disease physician at Saint Luke's Health System, urged those planning to travel or gather with friends and family this winter to take appropriate precautions.
“If they are sick, think about staying home, and reaching out to their medical provider to get tested, so that potentially if they are a candidate for treatment with antivirals for influenza or COVID,” she said. “And in general, good hand washing, covering coughs, and all of those things can go a long way to prevent spread within the community.”
