Hospitals overwhelmed with cases of flu COVID and RSV : Consider This from NPR Hospitals around the country are overwhelmed, but this time it's not just with COVID.

Cases of the flu and RSV are also spiking earlier this year.

We hear from a pediatrician in Seattle who says it is the worst season she's seen in her 16-year career.

And NPR's Rob Stein reports on what infectious disease specialists recommend to stay healthy this season.

In participating regions, you'll also hear a local news segment to help you make sense of what's going on in your community.

Email us at considerthis@npr.org.

A Triple Serving Of Flu, COVID And RSV Hits Hospitals Ahead Of Thanksgiving

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MARY LOUISE KELLY, HOST:

Dr. Syra Madad is an epidemiologist in Boston. Recently, her 2-year old daughter, Laila, started showing signs that she was getting sick.

SYRA MADAD: She started being irritable, very clingy. And to me as a parent, when she starts to wanting to be held more often, I know she's probably coming down with something.

KELLY: Madad says her daughter had contracted RSV, a virus that can cause severe respiratory illness in infants and young children.

MADAD: She progressed to nasal congestion and coughing, and then she started to spike high fevers, about 103. And she had those fevers for a few days.

KELLY: Laila was treated at an urgent care clinic for the fever, then again at a pediatrician's office.

MADAD: She started to feel much better, still less coughing, less congestion. She was eating well. She was alert and kind of being playful and active, you know, normally, as she normally is,

KELLY: But then a day and a half later, she developed a rash.

MADAD: I noticed that those rashes were not only on her legs, but it was also on her chest, her abdomen, her trunk, her limbs and a little bit on her back. It was just like, you know what? I need to get her evaluated and see what's going on. She was feeling better. Did she pick something else up?

KELLY: This time, they went to the emergency department, and it was packed.

MADAD: I saw a lot of children coughing, sneezing, congestion and runny nose. And the parents and caregivers just - you know, just trying to console their child.

KELLY: Laila was evaluated, and doctors said the rash was her body's response to the virus. She was prescribed Benadryl, but because the hospital was so busy, hospital staff asked them to move out to the hallway to receive the medication.

MADAD: And I completely understand. You know, again, I'm coming from a health care background, so I know, you know, so many patients in the ED, they need to have - they need to evaluate, you know, additional patients. And so we very quickly put our belongings together, and they were able to go in and clean and disinfect the room quite quickly, turn it over for the next patient.

KELLY: This scenario is playing out all across the country right now. Many hospitals have been overwhelmed by RSV patients on top of the COVID and flu cases already coming through their emergency departments. The American Academy of Pediatrics has asked President Biden to declare a pediatric health emergency because of the strain these illnesses are putting on the health care system. Now, RSV, it's not new. In normal years, it sends thousands of children to the hospital during the fall and winter. But Madad says this spike is different.

MADAD: Now this year, what is even more unusual is that COVID-19 is a little bit steady. It seems as if it's almost taking a backseat, if you will. And again, that can change any time. But RSV and flu are just taking a front seat and really running with it. They didn't have a chance to spread in the last couple of years. And so what's unusual and challenging in this particular season is that RSV started earlier than usual. And we're seeing a peak earlier than we normally would.

KELLY: CONSIDER THIS - a triple serving of flu, COVID and RSV is overwhelming hospitals and emergency departments just in time for Thanksgiving. What should you do to keep your family safe before gathering this holiday season?

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KELLY: From NPR, I'm Mary Louise Kelly. It is Wednesday, November 23.

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KELLY: It's CONSIDER THIS FROM NPR. Children's hospitals around the country are overwhelmed with cases of respiratory infections, including RSV. For adults, that usually means mild, cold-like symptoms, but it can cause much more serious conditions, such as pneumonia, when it's contracted by infants and children. One city that is seeing a big rise in pediatric cases of RSV is Seattle.

SHAQUITA BELL: Unfortunately, at 16 years of practicing medicine in pediatrics, this is the worst season I have seen. Our hospitals are very busy. Our clinics are very busy. Our average phone call intake is about 30 calls a day at our clinic. And right now, we're getting 100 a day.

KELLY: That is Dr. Shaquita Bell. She's a pediatrician and senior medical director of Seattle Children's Odessa Brown Children's Clinic. She spoke with my colleague, Juana Summers, this week about what's happening there. Here's Dr. Bell again.

BELL: It's definitely really bad. And we are absolutely seeing a lot of sick children in our community right now.

JUANA SUMMERS, BYLINE: So given that influx, that begs the question here, do y'all have enough beds and staff to care for these children?

BELL: It's such a great question. I think it's a complex one. We all know that the health care system has been taxed by the COVID pandemic for the last two years. And to have this outbreak and this severe season of RSV has been very, very hard. All of our hospitals in our region are having maximum capacities. Some of our adult hospitals are taking some cases so that our children's hospital can focus on the respiratory illnesses.

SUMMERS: You know, I can't help but think that there's concern about RSV potentially spreading right as we're heading into the start of the holiday season, Thanksgiving just a few days away. What is your concern there, given that backdrop?

BELL: I think that we should treat it a lot like we have treated all respiratory illnesses in the last two years. We should be very cautious. If people are sick, they should stay home, or they should find ways to mitigate risk, like wearing masks and frequent hand-washing. The unique thing about RSV is that adults generally are not very sick because most of us - the vast majority of the population has had an RSV infection by the time they're 2 years old. And while we don't become immune to RSV, we usually don't become as sick the older we get. Therefore, you're less likely to know that you have RSV and could give it to somebody else. So even if you just have a light cold, I would absolutely stay at home or wear a mask and make sure you're trying to keep everybody safe.

SUMMERS: You mentioned masking. And in many parts of the country, masks are not recommended in group settings like daycares and schools. So would it be your recommendation, given what you're seeing, that those kinds of places - daycares, schools - perhaps should start having kids mask up again?

BELL: We know that RSV is spread through droplets, which means somebody coughing or sneezing or breathing on somebody else. But we also know that those droplets can drop and land on surfaces and last for hours. So not only would masking help with the risks of spreading RSV, but so does hand-washing and washing countertops. Now, the caveat to all of this is that the most at-risk children are children under 1 year of age, and unfortunately, they're not old enough to wear masks. So my advice is, if you have a child or if you are a person who can wear a mask, that it would absolutely be helpful to do so in group settings, especially as we get together for the holidays.

KELLY: That was Dr. Shaquita Bell, a pediatrician in Seattle. Now, as we noted earlier, RSV is not the only virus looming over the Thanksgiving table. Infectious disease specialists are bracing for the possibility that the holidays will trigger a tripledemic of RSV, flu and COVID. NPR health correspondent Rob Stein spoke to some of those specialists who also offered some tips to stay healthy this season.

ROB STEIN, BYLINE: For two years, Thanksgiving ushered in very unwelcome guests - devastating waves of COVID. No one thinks this year will be anything like those dark pandemic winters, but the country is facing something entirely new - an unpredictable mashup of old and new respiratory pathogens.

WILLIAM SCHAFFNER: We're facing an onslaught of three viruses - COVID, RSV and influenza, all simultaneously.

STEIN: Dr. William Schaffner is an infectious disease expert at Vanderbilt University.

SCHAFFNER: We're calling this a tripledemic.

STEIN: RSV crept back first, infecting lockdown babies and their older brothers and sisters with little immunity, overwhelming pediatric emergency rooms and intensive care units from coast to coast. The first big flu season in three years started early, too, sickening more kids with a strain that looks like it could be bad for their grandparents, too. That's swamping more already under-staffed, pandemic-spent hospitals. Here's Lynnette Brammer from the CDC.

LYNNETTE BRAMMER: Flu hospitalization rates right now are the highest we've seen for this time of year in the past decade.

STEIN: And now Thanksgiving is coming. Dr. William Schaffner again, from Vanderbilt.

SCHAFFNER: These holiday celebrations, with all their travel and their close contact, usually function as virus accelerators. We're spending a lot of time with each other, laughing and breathing deeply. And that's an ideal environment for these respiratory viruses to spread to others.

STEIN: And of course there's COVID, still sickening tens of thousands and killing hundreds every day as new omicron subvariants are taking over that are even better at getting people even if they've been vaxxed (ph), boosted or previously infected.

DAVID RUBIN: The real question that we have is, what is this all going to mean for COVID?

STEIN: Dr. David Rubin has been tracking COVID at the PolicyLab in Philadelphia.

RUBIN: Are we going to see a January-February resurgence of COVID that's going to be fairly significant? That may yet still be coming.

STEIN: Immunity from all the COVID vaccinations and infections should blunt a new surge of serious illness, especially, Dr. Ashish Jha at the White House says, if people get one of the new bivalent omicron boosters.

ASHISH JHA: I'm hopeful, given where we are, that we're not looking at something like last winter. But look, at the end of the day, Mother Nature gets the final word on these things.

STEIN: And the new boosters aren't finding a lot of takers - same for flu shots.

JENNIFER NUZZO: Yeah, I think it's a really worrisome situation looking to the weeks coming ahead.

STEIN: Jennifer Nuzzo at Brown University's Pandemic Center knows how done everyone is going into a third pandemic winter.

NUZZO: We can't just resign ourselves to assuming that it's going to happen no matter what. We can very much take action to prevent a rise in hospitalizations and deaths.

STEIN: Like, sorry, Zooming for Thanksgiving if you're sick, doing one of those rapid tests the morning before hugging grandma and grandpa and, says Dr. Tina Tan from Northwestern, keeping that mask handy.

TINA TAN: If you're not eating or drinking, it's probably a smart idea to protect the immunocompromised, the infants, as well as the older individuals in the household.

STEIN: Now, here's the good news. RSV may already be peaking. And the flu could peak early, too, before colliding with a new COVID surge. There's even a theory RSV and the flu could help stifle COVID like COVID crowded out those viruses the last two years. Fingers crossed for one of those scenarios to be thankful for this year.

KELLY: That was NPR's Rob Stein.

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KELLY: It's CONSIDER THIS FROM NPR. I'm Mary Louise Kelly.

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