People should brace themselves for a more severe flu season |

People should brace themselves for a more severe flu season

Due to the safety precautions imposed by the COVID-19 pandemic, last year’s flu season was extremely mild. But, with the loosening of pandemic protocols, this season for flu, RSV and other respiratory viruses is expected to be back to normal or likely worse than usual.

“I am very concerned,” Dr. Michelle Barron, senior medical director of infection prevention and control for UCHealth, said last week. “The thought is we are going to have a bad respiratory syndrome season.”

Barron said RSV, or respiratory syncytial virus, is a “canary in the coal mine” indicator for the respiratory infection season.

“Coming in November, we will start to see COVID again, and we are going to probably see a lot of flu. Last year had the mildest flu season ever on record,” Barron said. “Respiratory syncytial virus is something that we often see with flu in the fall. We see RSV, and we start to see flu a few weeks later.”

The concern for doctors is that Colorado and the country are seeing earlier and higher numbers of RSV cases, including two children hospitalized this summer at UCHealth Yampa Valley Medical Center in Steamboat Springs.

Summer hospitalizations for RSV are unusual, said Dr. Brian Harrington, Routt County public health medical director, noting RSV is a common respiratory virus that is concerning for children younger than 2 and especially dangerous for infants born premature. Doctors may give an RSV vaccine to selected high-risk or premature infants.

“We’ve seen a record number of RSV cases, not just in Colorado, but throughout the United States,” Barron said. “It’s a little scary to think about if we are already seeing RSV now. We don’t normally see that much.”

Lauren Bryan, YVMC infection preventionist, said looking at RSV cases at YVMC alone, the numbers consists of seven positive tests including two pediatric hospitalizations from July 1 to Sept. 28, compared with zero positive tests in the same time frame in 2020.

From July 1 to Sept. 28, there were 1,101 positive RSV tests throughout the UCHealth system compared with three during that time frame last year.

“Children’s Hospital did see higher RSV numbers presenting to their emergency department and children being admitted kind of early on, and it could be function of early RSV or a function of testing respiratory viruses early because of heightened awareness of COVID,” said Roberta Smith, Routt County director of public health.

Children’s Hospital tracks high pediatric cases of RSV, COVID-19

The mid-September issue of the Children’s Hospital Colorado “Bug Watch” provided this summary information.

“Although numbers have started to decline slightly, we are still seeing a large number of specimens positive for RSV and corresponding high numbers of children presenting to the Emergency Department and being admitted with bronchiolitis. COVID-19 numbers continue to rise in Colorado and remain high throughout the U.S. The American Academy of Pediatrics released numbers last week, demonstrating that COVID-19 cases in pediatric patients are the highest they have been since the start of the pandemic, accounting for 26% of all cases. Pediatric hospitalizations for COVID-19 are also increasing, but recent data from the CDC demonstrates pediatric hospitalizations are lower in communities with overall higher vaccination rates.”

“The usual season for RSV is November through April, but the typical season was disrupted during the COVID pandemic. So there has been an increase in spring and summer infections with RSV this year,” wrote Dr. Ron Famiglietti, long-time local pediatrician, in a recent health column about RSV published in Steamboat Pilot & Today.

Doctors say the time for local residents to get a flu shot is now, whenever it is convenient, as the flu vaccine is already in stock at medical offices and pharmacies. Both Barron and Harrington pointed out scientific studies show no advantage to waiting longer into the flu season to get the annual influenza vaccine. The flu shot takes about two weeks for antibodies and immunity to develop fully.

“The bottom line is everyone needs to be getting their flu vaccine, anyone six months of age and older,” Smith said. “Having not had exposure to respiratory virus because we were so protected from this, this could potentially set us up for a more severe flu season.”

Smith said the flu vaccine is “tried and true” and has been in use since the late 1930s. It can be given during the same appointment as a COVID-19 vaccine if desired and is quadrivalent, meaning the vaccine stimulates an immune response against four strains of influenza.

“Receiving vaccines is just part of staying healthy and part of that preventative health care routine that all of us should receive from our providers,” said Smith, adding the flu vaccine has a variety of options ranging from nasal spray to a higher dose for age 65 and older to no egg protein.

Harrington said, “Vaccines are always helpful,” but it is more difficult this year to predict the efficacy of the flu shot due to a lower patient sample size of flu cases during the pandemic.

Harrington said local doctors saw patients with upper respiratory tract infections during the summer, which is not a common time of the year for those cases.

One rule that is golden, Harrington said, is stay home if you are sick.

“Don’t go to work, to public gatherings or school if you are sick. It’s an important lesson that we all learned through the pandemic,” Harrington said. “Regardless of whatever infection you may have, it’s not good to be exposing others.”

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