California faces onslaught of COVID, RSV, and the flu amid holidays

It’s the most wonderful time of the year to pack an extra COVID-19 test and box of chamomile tea.  

Recent data from the Centers for Disease Control and Prevention shows that COVID activity levels in California wastewater are “high,” indicating that we’re about to witness another swell in cases just in time for holiday travel. Now, as the region grapples with a test positivity rate of 9.3%, experts are asking the public to mask, ventilate indoor spaces and stay home when sick to prevent it from rising even higher.  

“COVID is now endemic,” Dr. Monica Gandhi, an infectious disease specialist, told SFGATE. She explained that we should expect to see a spike in coronavirus cases along with RSV, rhinovirus and a slew of other respiratory viruses that come out to play during the winter season — a time of year when these illnesses thrive as people gather indoors, she said. 

For now, she recommends getting the latest booster and ventilating these spaces as much as possible while visiting family. But other health experts worry that this year’s brew of respiratory illnesses could lead to a post-holiday disaster.     

Infectious disease specialist Dr. Peter Chin-Hong told SFGATE that he’s bracing for the “one, two, three punch” of Thanksgiving, Christmas and New Year’s travel that could lead to a surge of hospitalizations upon returning home. He says it’s important to consider wearing a mask indoors again, especially in “high-risk” environments like trains, buses and airports. 

Chin-Hong is worried for two reasons. First, people are getting sick to the point of being hospitalized, he said, adding that patients across the country are still dying of COVID at “unacceptably high” rates. In the past three months alone, there were more than1,000 COVID-related deaths in California, but that number “should be close to zero given tools we have,” Chin-Hong said. 

“It’s just a failure on many fronts to provide and get these tools accepted by the people who need them,” he added. 

The second reason he’s concerned is that apart from people getting sick, hospitals are slowly filling up again. “If you look at the hospital capacity, it’s really diminishing over time, and, of course, every winter we feel a strain,” he said. He’s worried that the confluence of RSV, COVID and the flu will strain hospital capacity even further, and suspects that the surge is already unfolding. 

“I think hospitals are beginning to fill up,” he said. “That data probably won’t even reflect what you may see because there’s always a lag between when people get infected and when they go to the hospital.” 

Just 24% of San Francisco’s population received the latest vaccine, SF Department of Public Health data shows. The same issue is in Santa Clara County, where only 19% of the population received the latest vaccine, and rates among the region’s Black and Latino communities are even lower, a Dec. 20 county news release said. 

If you test positive for COVID, Gandhi says to follow CDC guidelines and isolate at home for at least five days, though these rules vary depending on the severity of illness.

“I personally, as an infectious disease doctor, would like us to go back to a stay-home-when-sick model, which I think we never probably did enough before in 2019,” Gandhi said. If people choose to wear a mask during holiday gatherings, she recommends swapping cloth and surgical masks for a well-fitting N95 instead.

“But at the end of the day, if you do get infected, I think the real take-home point is not all is lost,” Chin-Hong told SFGATE. The key is to identify what you’re sick with as quickly as possible to see what medications are available to keep you out of the hospital. He also recommends taking advantage of Test to Treat, a program where qualifying individuals can receive free flu and COVID testing, treatment and telehealth appointments.