Winter virus season is just getting underway as millions of travelers prepare to pack into jetliners and squeeze into SUVs for that Thanksgiving trip to Grandma’s, and Bay Area health officials are urging people to take precautions as they see RSV, influenza and COVID-19 cases rise.
“The bottom line is we do have a lot of respiratory virus activity out there,” said Dr. Monika Roy, assistant health officer and communicable disease controller for the Santa Clara County Health Department.
Santa Clara and San Francisco county health officials both report increased signs of Respiratory Syncytial Virus — or RSV — leading to this year’s triple threat of illnesses. The highly contagious respiratory virus that usually causes mild, cold-like symptoms can require a week or two of recovery but may be serious for infants and older adults who are more likely to develop severe infections requiring hospitalization.
“We are seeing a rise in our wastewater data, a sharp increase in RSV, in all our watersheds,” Roy said of Santa Clara County. “Visits to emergency rooms for influenza-like illnesses, that’s been increasing since the beginning of November. And COVID hospitalizations, while they had been declining, we are beginning to see a slight rise.”
COVID-19 also is being detected at high wastewater levels in San Jose and Palo Alto and medium levels in Sunnyvale and Gilroy.
And influenza is starting to rise again after a small surge in late September had subsided slightly, though flu levels remain just a tenth of last year’s peak in late November.
Throughout California, since Oct. 1 there have been 14 deaths from flu and RSV, with 5 of those just reported the week ending Nov. 11, the most recent week for which data is available.
One of those RSV deaths was a child, between 5 and 18 years old. Deaths can take weeks to be reported, so additional deaths are likely to have already occurred. Last year’s virus season saw nearly 300 RSV deaths and 700 flu deaths statewide.
Around the Bay Area, San Francisco Department of Public Health officials also reported RSV activity has been increasing over the last two months while flu and COVID-19 activity are relatively low but have begun to rise.
San Mateo County health officials said they are not seeing unexpected levels of respiratory disease and that COVID-19 levels are stable, unlike previous years at this time. Contra Costa County health services also said they don’t have any unusual respiratory illness activity to report.
So what can you do to avoid catching the crud or passing it on to a vulnerable baby or other family member?
Simply put, wash your hands frequently, consider masking around people of compromised health, and get vaccinated, experts say.
In the past, there wasn’t much you could do about RSV, which for most is a mere annoyance but which can cause life-threatening pneumonia or swelling of the small airway passages in the lungs in older adults and infants.
But the Food and Drug Administration in May approved the first RSV vaccine for use in the U.S. It is approved for adults age 60 and older, and for pregnant women in the last months of pregnancy, 32 to 36 weeks.
“This is the first year ever we have vaccine protection for infants and the elderly, because they are most at risk,” Roy said.
Dr. Iris Colon, a maternal fetal medicine specialist at Santa Clara County’s health department, said the RSV vaccine given to mothers in the final weeks of pregnancy allows them to build up and pass along immunity to their developing baby, providing the infants protection in their vulnerable first year.
“We want to put word out for those older than 60 but also it’s approved for pregnant patients,” Colon said. “We’re really trying to vaccinate all pregnant moms so that by the time their babies are born, they are considered protected.”
Another immunization, an antibody shot, also is available for newborn infants, Roy said. But it’s in short supply and is mostly being used for infants considered at higher risk.
There also are vaccines for COVID-19 and influenza, which the Centers for Disease Control and Prevention recommend for everyone ages 6 months and older. The current COVID-19 vaccine is based on one of the most recent omicron virus variants. And Roy said the current flu vaccine is so far a good match to circulating strains. The vaccines take two weeks to fully kick in but can still offer some protection before then.
Flu activity is still low in most of the state, according to the California Department of Public Health’s most recent weekly respiratory disease report, but those traveling out of state might want to take extra caution. The CDC says flu activity is trending up, and weekly positive influenza tests reported to the CDC have more than doubled since the last week of October. Most cases are in the South, with moderate activity in California.
So if you’re feeling a bit off and worried you might already have the virus, how can you find out for sure?
“There’s a lot of overlap with the symptoms — you can’t tell from symptoms alone,” Roy said, noting that the most likely culprit isn’t influenza, RSV or COVID-19 but our old friend the common cold. “Testing is the easiest way to know.”
For COVID-19, that’s easy. The federal government just announced that beginning Nov. 20, every U.S. household can again place an order to receive four more free COVID-19 rapid tests delivered to their home. Inexpensive at-home tests also are available at drug stores.
Doctors and medical offices can run tests for influenza and RSV, but you have to see them first, and they have to recommend a test, which usually would be done for those considered at higher risk.
Otherwise, Roy advised people to “make sure to wash your hands, cover a cough, stay home when you’re sick and if you do have to be around others, wear a mask.”