Winter surge in infections from RSV, flu, and COVID straining U.S. hospitals

The White House is warning of a surge of illness this holiday season, as the country deals with the simultaneous uptick of three, highly contagious respiratory viruses. Hospitals across the country are filling up with patients suffering from flu, RSV and COVID. William Brangham reports.

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  • Judy Woodruff:

    The White House is warning of a surge of illness this holiday season, as the country deals with a simultaneous uptick of three highly contagious respiratory viruses. Hospitals across the country are filling to near capacity and stressing health care workers.

    William Brangham has our report on this alarming rise.

  • William Brangham:

    Just before Thanksgiving, Elly Rivera's 2-month-old daughter, Sloane, got sick. She was congested, started coughing. After a few days, it got worse. Sloane was really struggling to breathe, so Rivera rushed her to a nearby hospital in Las Vegas. So, you go to the emergency room, and then what happens?

  • Elly Rivera, Mother:

    As soon as that nurse was able to look at Sloane, it was like a blur. And they start tearing off her onesie, trying to find a vein for an I.V. There was an oxygen mask. They're probing and doing all the things that they need to do to make to get her vitals and check her temperature and all that. It was — I feel like there was probably six or seven people working on her at once.

  • William Brangham:

    Oh, my Gosh. That's a horrible feeling to sit there watching your kid go through that.

  • Elly Rivera:

    You try as a parent to hold it together, but I lost it.

  • William Brangham:

    Doctors said Sloane had a common cold, but she also had respiratory syncytial virus, known as RSV. And while most people recover from RSV in a week or so, it can be more severe for the elderly and for infants.

  • Elly Rivera:

    So, once that was determined, they went from a just standard kind of oxygen mask to something called a high-flow, which, from my understanding, is the step before CPAP or intubation.

  • William Brangham:

    Across the country, hospitals are grappling with an earlier-than-usual peak in RSV infections. It's a common virus most people are exposed to by the time they are 2 years old, but, due to the isolation of the pandemic, many kids have had no normal exposure, and so cases are now surging.So, you take RSV, add on a particularly bad flu season, plus COVID, it's creating what some public health experts are calling a tridemic. This season, the CDC has recorded more than 13 million cases of influenza. An estimated 7,300 people have already died and 120,000 hospitalized from the flu, the highest numbers in a decade. And, in the last two weeks, COVID cases and hospitalizations have risen 25 percent nationwide, all of which is leaving hospitals once again overwhelmed.

  • Dr. Per Gesteland, Intermountain Primary Children’s Hospital:

    Various layers of backup that we typically have in place during our normal respiratory season months, which is usually kind of January or February, we're having to kind of roll that all out a couple of months early.

  • William Brangham:

    Dr. Per Gesteland is a pediatric hospitalist at Intermountain Primary Children's Hospital in Salt Lake City, Utah. The majority of his patients have RSV, but flu is taking a heavy toll as well.

  • Dr. Per Gesteland:

    Our hospital is designed to have about 287 beds. We have been bumping up around 95 percent, 105 percent of occupancy of those beds. That means that, at times, we have to double-bunk patients. So, we create beds out of nowhere. We take one smallish room, put a curtain in the middle, roll in some portable monitors. The next thing you know, you have got two beds.

  • William Brangham:

    Right now, nearly 80 percent of hospital beds across the U.S. are occupied. So to ease the flow of new patients, some areas are urging people to mask back up. In New York, the city's health commissioner has advised mask-wearing in all indoor and crowded settings. In California, rates of RSV are the highest they have been in years, and an uptick in COVID and influenza is pushing front-line workers to the brink.

  • Dr. Tami Hendriksz, Pediatrician:

    Pediatricians, we're talking about this as kind of our summer of 2020, when COVID was really hitting and all of the adult hospitalists were asking the pediatricians to come in and work in the ICUs.

  • William Brangham:

    Dr. Tami Hendriksz is a pediatrician in Vallejo, California.

  • Dr. Tami Hendriksz:

    And it's not like you just get one virus and you're done. You can stack them. And we see that. We see kids who have RSV and flu and COVID, plus strep on top of it. There's — it's just — yes, it's really scary.

  • William Brangham:

    Unlike COVID and flu, there is no vaccine for RSV, and these decade-high hospitalizations have led to an increased demand for the medication that helps treat respiratory illnesses. The FDA has warned of an urgent need to increase the supply of the antibiotic amoxicillin. And some pharmacies are reporting shortages of over-the-counter fever and pain medications for kids, like liquid acetaminophen and ibuprofen.Sally Chia owns a pharmacy in Las Vegas.

    Sally Chia, Pharmacist and Owner: We are getting patients who are calling in for — are looking for flu medication, which is not available.

  • William Brangham:

    For Rivera, a mother of three, it is a lot to manage. After a week spent in the pediatric ICU, Sloane was released. How is Sloane doing now?

  • Elly Rivera:

    As soon as we left the hospital, she was pretty much 100 percent better. We are very, very lucky and very fortunate. But, when you're in those settings, you see every other situation, because there are so many patients in the hospital that you kind of — that are around. And it's very tough. I can understand how people can really suffer a lot of traumatic stress from an experience like this.

  • William Brangham:

    So, let's take a moment to focus on what people can do to protect themselves during this surge.For that, I am joined again by Katelyn Jetelina. She's an epidemiologist with the University of Texas. And she writes the Your Local Epidemiologist newsletter on Substack. Katelyn Jetelina, great to have you back on the "NewsHour." So we have got these three highly contagious viruses, respiratory viruses, circulating in the world right now. I know that they are on different trajectories. But when you look at the data, what does your crystal ball tell you about the winter? Is it going to get worse? Is it going to plateau? What do you see?

    Katelyn Jetelina, University of Texas Health Science Center: Yes you know, that's really the billion-dollar question is, what's going to happen? And the reason we don't really know is because flu and RSV are incredibly early this season. Typically, they peak in around January. And for them to peak during Thanksgiving and Christmas and Hanukkah is perplexing, because, during all of those holidays, we're opening up our social networks. So, in fact, this respiratory season, we may see several humps, instead of one big, large hump. So we don't know. And we're really approaching this with a lot of humility, and we hope that it's over soon.

  • William Brangham:

    Always a fan of humility. Who — when you look out in our society, who is most at risk from these three viruses?

  • Katelyn Jetelina:

    There's really three groups I'm really concerned about. One is those over 65. They are at risk for severe disease from all three, from flu, RSV, COVID-19, also very concerned about our immunocompromised. I'm also very concerned about those under 5. RSV is incredibly dangerous for them. Flu can be as well, as COVID-19 can be as well. And so all three of those groups really need to take extra precautions, and not only them, but the people around those groups have to do that as well.

  • William Brangham:

    Tell me a little bit more about those precautions. What should people be doing to best protect themselves?

  • Katelyn Jetelina:

    I think people may be sick of what I'm about to say. I mean, it's masks. Masks work. They work, you guys .They work against COVID. They work against flu. We think that they work against RSV, they work just even if you're the only one wearing them, especially if it's fitted and tight fit. The next down line is antigen testing. We got great news today that the USPS program is offering free antigen tests again, and so highly recommend doing that a few days and the morning of an event. And I think one of the most important things is, yes, filtration and ventilation, but stay home if you're sick. I know it's not fun during the holidays. It's super lonely, but it's, honestly, the best thing that you can do for your family, as well as your community, so these hospitalization numbers go down.

  • William Brangham:

    What about the issue of vaccines? We know there's not one for RSV, but there is a very good flu shot out there. And the COVID bivalent booster that is out there, we have just recently got some data about how effective that is. So, someone comes to you and says, should I get the flu shot, should I get that bivalent booster, should I do both, what do you counsel people?

  • Katelyn Jetelina:

    I say yes.

    (LAUGHTER)

  • Katelyn Jetelina:

    The best time to have gotten…

  • William Brangham:

    Yes to all?

    (LAUGHTER)

  • Katelyn Jetelina:

    The best time to have gotten those is about two or three weeks ago, but today is the second best time. The flu vaccine, we're getting great data from the Southern Hemisphere that it's actually a good match this year. We're super happy about it. And, like you say, we're getting real-world data almost in real time about our fall boosters, and I really couldn't be any happier about the data we're seeing.The fall boosters increase our protection against infection and hospitalization. They broaden our protection, so they — our antibodies are more able to see different parts of the virus because Omicron is changing. And we also hope that there's a longer duration. Unfortunately, with that third, we are at the mercy of time. But, yes, go get that booster shot. Go get that flu shot. It will help this winter.

  • William Brangham:

    All right, Katelyn Jetelina. Your Local Epidemiologist, it's a great newsletter. I recommend everyone read it. Thank you so much for being here again. Good to see you.

  • Katelyn Jetelina:

    Thanks. Thanks for having me.

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