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Flu and RSV in spotlight with Covid remaining at lower levels locally

Empty room at Virginia Hospital Center (photo courtesy Virginia Hospital Center)

The rate of reported Covid cases in Arlington has not changed much in the past two weeks, while there are new worries about kids getting sick with other diseases.

Across the country childhood respiratory illnesses are surging, putting a strain on hospitals.

Here in Arlington, Virginia Hospital Center is seeing RSV and flu cases among kids, in addition to Covid, according to emergency department chief Mike Silverman.

From Silverman’s weekly public Facebook post on Friday.

During my last shift, I had kids infected with COVID, influenza, and RSV. By far, the sickest of the three was the one with RSV. Respiratory syncytial virus (RSV) is a fairly common virus that causes something called bronchiolitis. This is a respiratory tract infection that can cause coughing, shortness of breath, and a low oxygen level. It impacts kids less than 2 much harder than the kids who are older. It is also possible to get as an adult though we typically stop testing for long before a child is a teenager. We’re seeing a lot more cases of RSV then we typically see this time of year. While only a fraction of kids who have RSV require hospitalization, we are already seeing pediatric intensive care units (PICU) in the area reach critical occupancy levels.

Unfortunately, this means that some kids who would normally be placed in a PICU may spend additional time in the emergency department waiting for a bed to become available. Additionally, there may be additional time a patient spends in another hospital’s ER waiting to be transferred to one of the handful of hospitals in the DMV that have PICU beds, from whichever emergency department the patient was initially seen in. It also means that some patients who are borderline and might often get a PICU bed versus a hospital floor bed, may not get the PICU bed because beds are prioritized to sicker patients. (We saw all of this with COVID during our big surges, just in the adult population). […]

Of course, there is a trickle-down effect to this as well. Anytime we have patients boarding in the emergency department, (boarders are broadly defined as patients who require hospitalization but the hospital doesn’t have space for them at the moment so they stay in the ER and get their care), we then have beds that are not available to be used for the new patients that are arriving to the emergency department.

Covid and flu are continuing to infect kids and adults in Arlington, though not at surge-level rates.

Covid cases in Arlington as of 10/25/22 (via Virginia Dept. of Health)

The county is seeing a seven-day moving average of about 32 reported Covid cases per day, according to the Virginia Dept. of Health, a figure that hasn’t fluctuated much over the past couple of weeks.

VDH this week stopped reporting Covid test positivity rates, but the U.S. Centers for Disease Control and Prevention website puts Arlington’s current positivity rate at 7.5% and falling. Arlington is still well within the CDC’s “low” Covid level guidelines, with fewer than 100 weekly cases per 100,000 in population (the “medium” level threshold is 200 weekly cases per 100,000 people).

Covid test positivity rate in Arlington as of 10/25/22 (via CDC)

Arlington County’s health department last week announced that the new, bivalent Covid booster shots are now available from the county for kids ages 5 and up.

From a press release:

Appointments are now available for a free bivalent (updated) COVID-19 booster for children ages 5 and older through Arlington County Public Health. Boosters are available as of Wednesday, Oct. 19, 2022, by appointment only. No walk-ins will be allowed.

The Centers for Disease Control and Prevention (CDC) recommends that everyone ages 5 and older gets one updated booster if it has been at least two months since they completed their primary series or booster vaccination.

Make an appointment online with Arlington County Public Health though the Vaccine Administration Management System (VAMS). If you need ADA accommodations or require assistance scheduling your appointment with Arlington County Public Health, call 703-228-7999.

Additional opportunities to get COVID-19 vaccines and boosters are available in and around Arlington through pharmacies and other medical providers–visit vaccines.gov to find a location near you.

Flu cases statewide are on the rise at last check, meanwhile, with the CDC reporting that Virginia is has “moderate” level of flu infections.

In a press release Monday, VDH said that there are “concerning, early signs” of a tough flu season.

Today, the Virginia Department of Health (VDH) announced that this year’s flu season is already showing concerning, early signs that it may be worse than in recent years. More people are seeking care in hospitals and urgent care centers for influenza-like illness than at this point in previous years, particularly young children aged 0-4 years. Virginia health officials encourage everyone aged six months and older to get a flu vaccine this fall, with rare exception.

“The best way to reduce the risk of flu and its potentially serious complications is to get vaccinated each year” said State Health Commissioner Colin M. Greene, MD, MPH. “This is why I am encouraging Virginians to receive their annual flu shot and practice preventive healthy habits. These include staying home when sick, using your elbow to cover your mouth and nose when you cough or sneeze, and frequently washing your hands. Parents should help their children learn healthy habits and discuss vaccination with their children’s pediatric caregiver.”

The 2022-2023 seasonal flu vaccine is designed to protect against the influenza viruses that research indicates will be most common. For most people, September and October are generally good times to be vaccinated against flu. However, even if you are not able to get vaccinated until November or later, vaccination is still valuable because flu most commonly peaks in February and significant activity can continue into May.

The federal Centers for Disease Control and Prevention reports it is safe to get both a COVID-19 vaccine and a flu vaccine at the same time, if you are eligible and the timing coincides. The updated COVID-19 bivalent boosters provide targeted protection against the original virus strain and the circulating Omicron sub variants (BA.4 and BA.5).

Another respiratory illness circulating in Virginia is the Respiratory Syncytial Virus (RSV). Emergency department and urgent care visits with diagnosed RSV have quadrupled and have been rapidly increasing in Virginia’s syndromic surveillance system since early September. RSV is common and usually causes mild to moderate symptoms in most people but can be very dangerous for young infants or those who are immunocompromised. Practice preventive health habits to reduce chance of infection and call your healthcare provider if you or your child is having difficulty breathing, not drinking enough fluids, or experiencing worsening symptoms.

Both the flu shot and COVID-19 vaccines are widely available in Virginia at many different locations, including pharmacies and health departments. To learn more and to get help finding vaccines, contact the Call Center at 877-VAX-IN-VA (877-829-4682, TTY users call 7-1-1). Assistance is available in English, Spanish, and more than 100 other languages. Visit www.vaccinate.virginia.gov or www.vaccines.gov to find a vaccine near you.

Contact your healthcare provider or your local health department for additional information on how to prevent fluCOVID-19 and RSV. Weekly reports on influenza activity in Virginia are posted on the VDH influenza surveillance webpage.

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