This week on Nevada Week , the cost of Thanksgiving dinner reaches a record high.

How local food banks are adjusting amid increased demand.

Plus, a rise in respiratory viruses.

We explored strain on Valley hospitals and on Nevada's youngest citizens.

♪♪♪ Support for Nevada Week is provided by Senator William H. Hernstadt.

Welcome to Nevada Week .

I'm Amber Renee Dixon.

The Nevada Hospital Association says pediatric beds across the state are full and that the need for them continues to increase.

The reason?

Respiratory viruses like RSV, COVID-19, and influenza.

Here to explain further are Dr. Rebecca Meyers, a UNLV medicine pediatrician; and Brian Labus, infectious disease epidemiologist and assistant professor at UNLV School of Public Health.

Thank you both for joining us.

I have never heard of RSV before this year.

But according to the CDC, it's been around, at least recognized, since 1956 as one of the most common causes of childhood illness.

Why am I just hearing about it now, Dr. Meyers?

(Dr. Rebecca Meyers) So that's a really interesting question because RSV, as a pediatrician, RSV is something that we expect to see every winter.

It's nothing new for us.

It's really bread and butter of pediatrics.

That being said, I think because of COVID, there has been so much focus on respiratory viruses and so much interest in respiratory viruses from the public in general.

So that's why I think it's more of a news issue this year than it has been in the past.

That being said, we also have more risk this year than we've had in the past.

And I think the reason for that is this idea of multiple respiratory viruses circulating at once.

So we've always, or as long as I've been practicing, we've always expected to see RSV and flu.

They may come together in the winter.

Late fall, winter, we're gonna see those respiratory viruses.

But this year, now we're gonna see COVID plus the flu plus RSV, and that's a lot of respiratory illness going around all at once.

-Something interesting about this year, though, is that this has made a rise or an appearance in winter-- I mean, I'm sorry, in summer as opposed to starting around fall and then developing into the winter.

Why are we seeing it in the summer do you believe?

(Brian Labus) Well, we've changed the way that we act in trying to protect ourselves against respiratory viruses.

People are washing their hands more, wearing masks, social distancing, all those things that we did for COVID also work to reduce transmission of other viruses.

So when we do that, it kind of changes the natural cycle of those disease.

People get immunity at different times, and it kind of pushes the timeline around.

But RSV is something that we have seen in summer before.

It's not that we don't see it year round.

It's just that it's more common in the winter months just like flu.

We always think of flu as a winter disease, but we do see flu year round, just at very, very low levels.

-So then why the pediatric overload at this moment?

Why do you think?

-So I think it's like Brian was saying, it's that combination of factors.

So we typically expect to see these viruses surge in the winter months and the late fall and in the winter months, but we changed the way that we behave.

So when everyone was masking for COVID, we had very low transmission of respiratory viruses in general, and that included RSV and the flu.

We just weren't seeing very much of it when everyone was being very careful masking, washing their hands, social distancing.

But now we're all back together.

And we really saw this huge surge in the summer of 2021.

So that was kind of the moment when everyone took off their mask, kind of really relaxed a lot of their COVID precautions, and we did see exactly what you'd expect, which is a huge surge in respiratory viruses in the summer of 2021.

So these viruses are going to respond to how we behave.

-And I'm trying to figure out how big of a deal it actually is, because the American Academy of Pediatrics and the Children's Hospital Association have asked the President to declare a public health emergency to address the nationwide surge in RSV.

But it sounds like to me both of you think this is just a response to our behaviors.

-Well, it is response to behaviors, but that doesn't mean there isn't an emergency.

It doesn't mean there isn't extra pressure on the hospitals because the cases are increasing.

When we declare a public health emergency, either at the state or national level, it basically frees us up to do more things administratively.

It may make it easier with licensing or purchasing equipment or things like that.

So those are the reasons we declare emergencies: It allows us to respond to that surge.

So even if it's expected, we still have to deal with the fallout from that expected increase in disease.

-What do we need to know about RSV?

What are the important symptoms and actions to take?

-So as a pediatrician, what I tell my patients, what I tell my families is RSV is a common illness.

Most children will get RSV.

By the time they're about two years old, most of them will have had it at least once.

And people can continue to get RSV again and again, unfortunately.

So what I tell parents to watch out for once we've diagnosed RSV in their child is a few things.

The first is difficulty breathing.

So if your child is having any difficulty breathing, if they're huffing and puffing, they're breathing heavy, they're breathing fast, you need to call your doctor.

Related to that is if the child had any change in color.

So if they start to look bluer or dusky, if there's a change in color around their lips or their gums, doctor needs to know.

If your child is not drinking well, please call.

We expect the children aren't going to eat very well when they're sick.

Their appetite will come back when they're feeling better.

That's okay.

But if they're not drinking their milk, not taking their water, you can't get them to, that's a call to the doctor as well.

-When does an emergency room visit become necessary?

-Yeah, so that's a great question.

So again, a child who's not breathing well, if you feel like your child is in danger, you know, a little bit of huffing, puffing, maybe you aught to get to your pediatrician.

But if you really feel like your child is struggling to breathe, that's absolutely a medical emergency.

And again with the dehydration that we were just discussing, if your child stops making their normal number of wet diapers and you can't get them to take in their breast milk or their formula or their water that they normally take, that's a medical emergency as well.

-There is no RSV vaccine, but there has been an argument made to get vaccinated for COVID and the flu and that that may help decrease RSV numbers.

Will you help me explain how that works?

-It's not really about decreasing RSV; it's about our ability to respond to all those viruses.

COVID is enough to overwhelm or saturate our emergency rooms and hospitals by itself.

Flu, the same thing.

Every year, the hospitals are saturated with flu patients.

RSV can do that in the pediatric emergency rooms and pediatric beds.

If all those things happen at the same time, our system could become overwhelmed.

So if we can get people to not get flu and not get COVID, we have more capacity to deal with the RSV; and as people get sick, medical care will be available to them.

-You have mentioned this is a pediatrics-based issue.

I think it impacts the elderly as well, or it can.

What if you are around a baby this upcoming holiday season?

What should parents do?

And what about people around them?

-Right, so that's exactly right.

RSV affects-- Anyone can catch RSV.

But for most healthy people, RSV is really a cold.

That's how it's going to feel.

It's going to be congestion, runny nose, coughing, being uncomfortable, but a common cold, essentially.

But for the very young and the elderly in our population or people with chronic diseases, it can be very different, and it can be very dangerous.

So if you're going to be around a person who's in a high-risk group and you think you might be ill, then you really want to take precautions.

Ideally, you're just not going to be around a person who is at high risk if you are ill yourself.

But the same things that we know about: hand washing, masking if you can, and really trying to keep your distance from that person who is at risk.

-I mean, people want to hold babies.

-They do.

But if you're sick, it's really not worth the risk to the baby.

RSV really can be very dangerous, especially for infants and young children.

And the younger you are, the more at risk you are.

So we think about infants and especially our premature infants or any child with a chronic disease, we really need to be careful.

-So should a parent have like a barrier around a baby?

-Well, I think we also have to balance that with the joy of being with family and the benefit to all of us of being with our families.

And it's a huge benefit to children, too, to be held and loved by their families.

So we do have to balance the risk with the benefits.

-Okay, and take a take an honest assessment of how you are really feeling.

Because of the pediatric overcrowding, the Nevada Hospital Association says that crisis standards of care last enacted for COVID-19 surges may become necessary to allow some non pediatric hospitals to see older aged kids and for pediatric designated beds to be expanded onto adult floors.

Is that a big deal in your opinion?

-Absolutely.

It's something that we need to do to allow us to respond.

If you have more patients than you have beds, you have to find a way to be able to provide care to those patients.

And we have standards of care in place where we can change the way we do things.

Just in emergencies.

It isn't something we want to do all the time, but it gives us that flexibility to change our hospital systems to respond.

Just like we did with COVID, we were setting up all sorts of COVID beds and using different equipment for patients and using different rooms than we would normally use.

We can do that for RSV or for other problems as the hospitals get overwhelmed.

It's nothing that we're coming up with on the fly, though.

There is a well-described document that explains exactly what should and shouldn't be done and in what order: These are the first things that we're going to do.

This is what we do later.

These are the high priority things.

These are kind of the last resort things.

-How is this spread?

Is it similar to COVID?

-Yes, so it is similar in the sense that it's really any of those respiratory secretions, for lack of a better word.

So it's spread through coughing, through sneezing, through having those germs on our hands, not washing our hands, touching another person.

It can also be spread from surfaces as well.

So if there's a contaminated surface, you touch it, touch your eyes, touch your mouth, then you can become infected.

-Back to the behavior aspect of changing behaviors.

Some of the behaviors during COVID were that kids were kind of insulated or isolated, not going to daycares if daycare shut down.

Was there an issue with this in children not building immunity when they normally would have but COVID happened?

-Well, that's kind of an issue across all diseases.

If kids are not exposed to other kids when they're young, they're not going to be exposed to those diseases, they won't have that natural infection and develop that sort of immunity.

So there's been a lot of talk about the idea of an immunological debt.

Basically, you have kids that didn't get infected with these things, and they're getting infected with them now.

And that can lead to some of the surge as well.

You just have more susceptible kids out there than we have in previous seasons.

So basically taking kids that would have been infected the last couple years, they're getting it now instead.

And so that kind of just bunches everybody up together, which it's the same disease they're normally going to get but puts that strain on the hospital systems.

-I want to get reaction from both of you on this: UNLV Family Practitioner Dr. David Weismiller said that he believes the community is not defenseless against a possible tripledemic, which would be RSV, COVID, and the flu.

He acknowledged growing weary of trying to understand what stops people from getting a flu vaccine and COVID vaccine.

He also said his frustration is heightened by his concern for war-weary hospital personnel at the end of their ropes, and claimed to be reaching the point of simply saying to patients, quote, Get the damn vaccine, and be quiet.

Your response to that.

-So I do think that vaccination is the most important thing that we can do.

I will say that personally, I advise all of my patients to be fully vaccinated against the flu and against COVID with their booster for the applicable age groups.

I am fully vaccinated and boosted.

My young children at home are fully vaccinated and boosted.

Well, the one who is old enough to be boosted.

But they're fully vaccinated as well.

So I truly believe for my patients and for myself and for my own family that vaccination is the right thing to do.

-Brian?

-This has been a challenge for public health nationwide.

We have lower vaccination rates than we want to have for every disease.

For Nevada, it's even worse.

We have some of the worst vaccination rates in the country.

And this continues through COVID, through flu, through anything that we deal with.

So all of us on the side of public health get really frustrated dealing with it.

And it's easy to try and just yell at everybody and tell them to get vaccinated.

It's also not a very effective approach, unfortunately.

If we're trying to change people's behaviors, just yelling at them and telling them to change isn't going to do it.

We really have to think through how we want to get people vaccinated.

-Thank you both for sharing your time.

-Thank you.

-Thanks for having me.

-The latest data from the US Census Bureau's Household Pulse Survey shows Nevada has the second highest rate of food scarcity in the country, with 16.7% of adults living in households where there was either sometimes or often not enough to eat in the last seven days.

Joining us now to talk about what's behind that number and how it's being addressed are Regis Whaley, Director of Advocacy and Research at Three Square Food Bank; and Deacon Tom Roberts, President and CEO of Catholic Charities of Southern Nevada.

Gentlemen, thank you so much for being here.

According to the state's annual report on food security at the height of the pandemic, food security partners like your organization saw an unprecedented increase in need for food and nutrition services.

Now there are reports across the country that that need is even higher now than at the height of the pandemic.

What are each of you seeing?

Deacon?

(Deacon Tom Roberts) Thank you for having us on to talk about this really important issue in our community.

Sadly, yes, the information is correct.

We're seeing higher trends of new clients and additional food insecurity, even greater numbers than during the pandemic.

We serve about 150 families a day in our food pantry.

And these are mostly folks that are working poor that are on the edge of the poverty line.

Many of those are almost ready to fall into homelessness if they can't get enough food to be able to pay the rent and utilities and provide food for their families.

So the cost of food and the cost of fuel and the availability of food that we're all very familiar with is often a bit of a headache or an aggravation for us.

It doesn't really change the way we live our lives.

But for the people that we serve, it does.

It makes a difference in how they're able to care for themselves.

And that's one of the reasons why the demand is really unprecedented in my 10 years at Catholic Charities.

-Regis, what about Three Square?

(Regis Whaley) Like other food banks across the country, Three Square has seen pretty stark increase in the percentage of people that are coming to seek services.

Food banks on the whole across the country are seeing somewhere around a 20% increase in the number of people that are seeking service.

And so for us to be two years, almost three years now into this pandemic, and to see this incredible rise in the amount of demand for charitable food, it's something we didn't see coming.

-And you had mentioned, Deacon, inflation, global food crisis, the cost of fuel as being reasons that people are suffering at the moment.

So what adjustments have each of your organizations made as a result of these factors?

Regis?

-For Three Square, it's been really trying to be as strategic as we can with the need that we see in the community.

We knew that going into COVID, it was going to-- We were going to see a much greater demand for food during that time.

We knew from the Great Recession that the recovery period was going to be a long one.

And so right now it's really trying to think through, you know, if this is going to be a long-term recovery process for all of Southern Nevada, how do we at Three Square be as strategic as possible in trying to make the adjustments that we need to make with just the resources that we have, the resources that we expect to be coming in for us to be able to serve the community with this heightened level of need.

So we've gone through everything from beginning to end as far as the food supply chain goes, thinking about how we're bringing in food, how we're getting it distributed back out into the community, trying to work through some of the supply chain issues that we've seen with changes in, you know, things like food packaging, things that used to be in cans and jars and now coming in bags, things like avian flu that took place earlier on in the year that have reduced the amount of animal-based proteins that are available for us to be able to purchase and then to distribute in the community.

So thinking through how do we continue to meet the nutrition needs of the community also.

So being able to just diversify the foods that we're purchasing and then thinking through the partners that we're working with.

How do we work better with partners like Catholic Charities that we knew were doing a lot of work for a lot of different important communities here in Southern Nevada?

How do we identify those who might not be getting served currently?

And how do we ensure that we're reaching them?

So it's really taking a look at all of our operations from beginning to end and making sure that we're doing the very best for Southern Nevada.

-Deacon, what kind of adjustments have you made?

-You know, our Food For Life program, it has three pillars: The first one is senior food through our Meals on Wheels program; the second one is the food pantry that I mentioned earlier; and the third one is the community meal, which serves about 500 families a day.

On Thanksgiving Day, we'll serve probably up to 1,000.

We'll probably distribute up to 3,500 turkeys and all the fixins by the end of the Thanksgiving holiday which, again, is unprecedented.

For us, it's being able to ensure that we can find resources, focus on our menus.

The Meals on Wheels clients that we see have nutrition and dietary needs, and we meet those.

So our chefs and our team have had to be resourceful and imaginative in our menu engineering and making changes on the fly when product isn't available.

-Something with turkeys you specifically did ahead of Thanksgiving?

-Yeah, we did a few things.

One is we had to ensure that we purchased turkeys far in advance.

Thanks be to God, in February, we placed our turkey order; otherwise, I'm not sure we would have had enough, given the supply issues to support the demand.

So that's the waterfall of ensuring that if there's product available, then the chefs have the food to be able to prepare enough.

And in the case of Meals on Wheels, 2,500 seniors are getting food every day from that program, and there are still 500 on a waiting list.

We probably have more food consumed in Southern Nevada per capita than any other city in the country, and yet we have food insecurity.

So I think we're making a big dent in that, but we have more work to do.

-What kind of policies could be implemented at the federal or local level to help your mission?

-So one of the most important policies that we look at, at the food bank is the Supplemental Nutrition Assistance Program, SNAP program.

It used to be known as food stamps.

That has been far and away the most effective antihunger program in the United States.

For every meal that's served through Feeding America Food Bank across the country, one meal served by Feeding America, SNAP is serving nine meals.

So SNAP is such an important part of the social safety net for all of the United States with respect to food security.

So whatever we can do to strengthen SNAP, that's really I think the key.

So making sure that those benefit amounts are adequate, making sure that more people are able to get access to SNAP, and that we aren't putting barriers in the way for people to be able to get access to SNAP.

So some of the bans that might be in place for specific populations, the time limits that are in place for people to have to work a certain amount to be able to continue receiving SNAP benefits.

That's one big thing that needs to be changed is ensuring that the SNAP program is as accessible to as many people as possible.

From there, I think there's a lot of other things that can happen just across the lifespan.

So thinking about babies, even before they're born, making sure that families have access to the WIC program that provides for Women, Infants, and Children; making sure that the benefit amounts they're adequate; that the education opportunities that are available through WIC are things that can be accessed online.

Going into childhood, thinking about access to school meals, and just making school meals accessible to all children, regardless of ability to pay.

Like I said, strengthening the SNAP program.

But also thinking about our seniors too, especially here in Southern Nevada.

We know we've got a growing senior population.

We've got to make sure that those programs that are available for seniors, those nutrition programs, food delivery, things available through health insurance, all of those programs need to be strengthened to ensure that we're able to provide food across the lifespan.

So increasing access to these government programs, government funding is one part, but you're going to have people saying, Gosh, our government is already spending so much money.

And then that makes me think of the private donations.

How real is compassion burnout at this point, the compassion that you saw during COVID compared to now?

-It is the "both/and."

It is continuing to focus on government funding, and we also work very closely with the State, the Governor's office, the legislature.

We have an upcoming legislative session.

And so one thing that the listeners can do and the watchers can do is to let their elected officials know that food insecurity is important to them.

It's on their priority list.

I'll be up in Carson City to address that directly with our legislators and with our new Governor.

People have been so generous in this community for so long, and they stepped up in a big way during the pandemic.

And there's always the factor of fatigue with givers, or not going back to the same people.

We also try to focus on education.

In Catholic Charities' case, 90 cents of every dollar that we raise goes directly to the clients.

So that's a good, effective, efficient way to give.

So it's important to me as a donor and as the CEO of Catholic Charities for our folks to know that what we're doing is efficient, it is effective, and it's delivered with dignity because it cannot just be about the food, it must also be about the hope.

That also is the both/and of what's really important to the people that we serve.

And thank God for our volunteers and our team that deliver that to thousands of people every day.

-I want to circle back to the progress that was made following the Great Recession in food insecurity in Nevada.

That was according to that state report.

There was progress made, but COVID changed everything.

How long do you anticipate until we can return to those prepandemic levels?

-We're hoping that the Great Recession is not a good indicator of that because the recovery from the Great Recession took a decade.

On paper, the Great Recession ended in 2009.

We didn't see food insecurity rates returned to prerecession levels until 2019.

And then the image that always comes to mind for me when I think about the impact of COVID on food insecurity is going back to Charlie Brown going to go kick that football and then Lucy pulls it out of the way right as he goes to kick.

And that's really what it felt like with food insecurity.

We were getting back to where we were prerecession and then COVID took away all that progress.

And so now we're seeing food insecurity being elevated, similar to the way that it was during the recession with it, you know, peaking after the recession had started.

It's the same thing we're seeing with food insecurity now, where it's really starting to peak, you know, after a couple years after COVID started.

And so we're hoping that it's not a decade of recovery, but we'll see.

We're right now, we're following the same trajectory as we were during the recession.

So it could be awhile.

-There may be people watching this who have full bellies following Thanksgiving, and they're thinking, You know what?

I struggled to afford my Thanksgiving meal this year.

Why should I care about food insecurity for others when I'm having my own problems?

What would you tell them?

-I don't expect that we're going to see any reduction in food costs or demand.

I think we all realize that we're in an increase in trajectory of cost and inflation.

That's going to mean more people are going to have greater needs.

So again, there's the dignity, compassion component of saying, When we give of ourselves with thanksgiving-- The context of giving to others who are struggling I think helps us realize that despite the fact that all of us have issues and many are really struggling, sadly there are people that are likely struggling even more.

And so being aware of that and helping them I also think makes more room in our heart for gratitude.

It also, by helping others, ensures that we're doing our part.

Sometimes I like to remind people that sometimes the work seems overwhelming.

And we can't always do everything, but we can do something.

And everyone can do something.

They can volunteer their time, their talents, they can support us financially.

And I really think that does make a difference in this community.

-Anything can happen to anyone at anytime.

We need to support each other.

We've seen it at Three Square where we've been able to come together and support this community.

So let's just continue doing it.

-Gentlemen, thank you so much for your time.

And thank you for watching Nevada Week .

For any of the resources discussed on this show, go to vegaspbs.org/nevadaweek.

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