COVID-19, flu and RSV rising across the Inland Empire – Press Enterprise

Dr. John Mourani, medical director of infectious disease at Pomona Valley Hospital Medical Center, is seen Tuesday, Jan. 9, 2024. The hospital is seeing more coronavirus patients. (Photo by Anjali Sharif-Paul, The Sun/SCNG)

As winter wears on, so do cases of COVID-19, flu and RSV.

Cases have climbed in Southern California in recent weeks, though doctors and public health officials said the illnesses haven’t reached peak-pandemic levels. COVID-19 cases were highest in January 2022, both in California and the nation, according to Johns Hopkins University’s Coronavirus Resource Center.

But COVID-19 isn’t the only virus causing problems this year.

The most recent data from various sources show that, in general, all three viruses are on the rise in the Inland Empire and beyond.

California Department of Public Health numbers from Friday, Jan. 5, show that statewide, COVID-19 hospital admissions are lower than they were on that date each of the past three years. Meanwhile, flu hospitalizations are higher.

Los Angeles County has reached the “medium” COVID-19 impact level, according to the Center for Disease Control and Prevention’s designation, and is requiring visitors to and workers at healthcare facilities to wear masks around patients. The county is also recommending that those at risk for severe illness — and those spending time with them — wear masks indoors. Most of California is currently designated as “low,” including Riverside and San Bernardino counties.

In Riverside County, the numbers for COVID-19, flu and RSV are all going up, Deputy Public Health Officer Dr. Jennifer Chevinsky said Friday. Also, high levels of flu are being seen across the county. However, she said, the county doesn’t appear to be in the same situation as last year, when virus hospitalizations spiked dramatically.

“At this point, influenza-like illness is quite a bit higher than COVID-19 and RSV,” Chevinsky said.

RELATED: Southern California dealing with a trio of viruses this winter — and yes, one of them is COVID

For the week ending Dec. 30, influenza-like illnesses accounted for 7.8% of all emergency department visits in Riverside County, according to the county’s weekly report, with about twice as many visits than there were at the same time last year. So far this season, more than 60% of emergency department visits for flu-like illness were children age 4 and younger, the report states.

Similarly, in San Bernardino County, 7.4% of emergency department visits the previous week were for influenza-like illness, according to county dashboard data from Jan. 1, which is similar to last year. The dashboard doesn’t include age information for that figure.

During that same week, influenza-like illness accounted for 9.5% of all emergency department visits in Los Angeles County, its Department of Public Health dashboard shows — slightly more than was seen at that time last year. Patients over 65 account for the most COVID-19-related hospital visits, while those under 18 have had the most visits for influenza-like illness. As with Riverside County, Los Angeles County’s flu cases are significantly higher than are COVID-19 and RSV.

Riverside County has retired its COVID-19 dashboard, which now directs visitors to a statewide dashboard that shows hospitalizations for COVID-19 and flu have steadily increased since November.

The case count on San Bernardino County’s COVID-19 dashboard was last updated in late November. Public health spokesperson Francis Delapaz said via email Tuesday, Jan. 9, that the county is creating a new dashboard that will be updated weekly. State data show San Bernardino County saw 107 to 139 COVID-19 hospitalizations per day from Dec. 21 to Dec. 30, numbers that are slightly higher than Riverside County’s during the same period.

Riverside, San Bernardino and Orange are three of five counties with “high” flu activity levels, according to a Dec. 30 California Department of Public Health report. The rest are categorized as “moderate.”

Three viruses taking hold

Influenza, or the flu, and respiratory syncytial virus, or RSV, tend to peak during winter months. The COVID-19 pandemic disrupted regular patterns, and in 2020, the Centers for Disease Control and Prevention says, both flu and RSV “circulated at historically low levels.”

But currently, all three viruses are circulating, and experts say getting sick with more than one at a time can lead to worse outcomes.

“Going back about a month, there’s been an increase in flu-like illness, and, when we tested, a lot of influenza-A and a lot of COVID,” Dr. Rodney Borger, chair of the department of emergency medicine at San Bernardino County’s Arrowhead Regional Medical Center in Colton, said Friday.

“What we’re starting to see is hospitals at their capacity,” he said. “It’s starting. Hopefully things will decrease.”

Borger said hospitals generally sit in the 90% occupancy range, even without surges of respiratory illness, so it doesn’t take much for them to reach 100%.

“That’s one thing I wish we would’ve learned during the pandemic,” he said. “We should have created more capacity in the system.”

But by and large, he said, patients with respiratory illnesses have been doing OK, and the type of COVID-19 they’ve been seeing is milder than some previous strains.

At Pomona Valley Hospital Medical Center in eastern Los Angeles County, the past few weeks have seen “a significant increase” in COVID-19 cases, Dr. John Mourani, medical director of infectious disease, said in Monday, Jan. 8, email.

“Those who are being admitted to the hospital tend to be older and have chronic health conditions that put them at higher risk for severe illness from the COVID-19 infection,” he wrote.

Dr. James Washington, medical director at Kaiser Permanente Moreno Valley’s neonatal intensive care unit, said Friday that RSV is currently the No. 1 enemy.

“As far as the respiratory viruses are concerned, the one we’re most concerned about would be RSV, and then also flu and then also COVID,” said Washington, who is also assistant medical director at the Kaiser Permanente Riverside NICU and assistant chief of neonatal-perinatal medicine for Riverside County.

Washington said his patients, who include those who are pregnant and infants in the neonatal intensive care unit, require extra care. Newborns with other health issues are more prone to worse outcomes from respiratory viruses, he said. And, in the past year or so, he’s also seen more pregnant people with COVID-19, which can raise risk for the infant “if moms are so sick that they have to deliver early.”

Inland doctors are seeing patients who have more than one respiratory virus.

“People are coming up positive for more than one of those things,” Washington said, adding that “it’s something we don’t usually see.”

Borger, the San Bernardino County doctor, said a few patients have come to the ER with multiple respiratory viruses, “and they’ve been quite ill, some of them.”

It can be hard to track how many individuals have more than one virus at a time, Chevinsky said, because they aren’t all recorded, But she said it is happening, and it “certainly can contribute to more severe illness.”

Doctors urge vaccinations, precautions

Mourani said the seasonal peak is yet to come, and “we expect to see respiratory virus infections continue to rise through the winter months.”

Chevinsky said future trends are hard to predict.

“It wouldn’t be out of the ordinary for numbers to continue to go up after the holidays,” she said, but the hope is that individuals will see the trends, and public health messaging and take preventive measures.

Borger agreed that it’s hard to tell.

“There’s just too many variables,” he said.

Experts recommend getting vaccinated, wearing masks, washing hands regularly, disinfecting commonly touched surfaces and avoiding close contact with sick people.

It’s not too late to get vaccines, Chevinsky said, which are available for COVID-19, the flu and for RSV for certain groups.

There are two new vaccinations for RSV, Washington said: Beyfortus, for infants, and Abrysvo, for individuals in late pregnancy and those over 60.

Of those eligible for COVID-19 vaccinations, 5.7% of San Bernardino County residents and 6.8% of Riverside County residents are considered up-to-date as of Jan. 1, according to a map. Statewide, that number is 12%.

The CDC reports that flu vaccination rates are down nationwide this season, The coverage rate for children was estimated to be 43.9% as of Dec. 23, which is 5% lower than it was at that time last year, and nearly 10% lower than in December 2019, just before the pandemic. Similarly, an estimated 43.8% of U.S. adults are covered by flu vaccines, and millions fewer doses have been administered compared to the last few seasons.

“In terms of community spread, it’s really helpful if sick individuals stay home and get tested,” Chevinsky said.

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