The Oregon Health Authority urges Oregonians to take precautions against influenza and RSV.
Respiratory viruses are expected to circulate this season at higher levels than Oregon has experienced in the past two years as people gather indoors for the holidays, said OHA deputy health director and deputy epidemiologist, Tom Jeanne. But it is unknown whether two of those viruses, RSV and influenza, will be more severe than pre-pandemic seasons.
“Nationally, we are seeing some alarming trends of early and in some cases very high circulation of both viruses,” said Jeanne. “Given this worrying landscape, we must work together to protect hospital capacity so we all have access to critical care when we need it.”
Jeanne explained that the COVID-19 pandemic has “put an incredible strain” on our health care system, with RSV further straining systems. Influenza will only add to this burden.
Transmission of COVID-19 is expected to increase as people gather indoors and immunity from vaccination and previous infections declines. The seven-day rolling average of new confirmed and suspected cases has hovered between 350 and 400 cases, according to Jeanne. The Oregon Health & Science University forecast predicts that COVID-19 hospitalizations, now at 229 as of Wednesday, November 9, will increase slightly and peak at about 280 in early December.
Oregon is also seeing slow increases in the proportion of new Omicron subvariants with mutations of concern, such as BQ.1 and BQ.1.1. These new subvariants represent less than 10% of the variants circulating in Oregon; BA.5 still accounts for around 80%.
“We don’t expect this winter’s wave of COVID-19 to be as severe as last year’s wave of Omicron,” Jeanne said. “We anticipate far fewer peak hospitalizations than we saw during the Omicron and Delta surges, thanks to high levels of population immunity. But there are other respiratory viruses that concern us.”
One of them, RSV, the most common cause of serious lower respiratory tract infection among infants and young children, will see increased activity in the coming weeks, as has been the case in other parts of the country. The virus has caused pediatric hospitalizations to more than triple between October 29 and November 5.
Oregon Association of Hospitals and Health Systems President and CEO Becky Hultberg said Oregon is seeing an increase in respiratory illnesses among children.
“These increases come at a time when the number of available hospital beds remains limited,” he said.
Hultberg said meeting the needs of all patients is the number one priority for Oregon community hospitals and clinics despite current and anticipated increases in hospitalizations.
“Our hospitals are ready to care for all who need it, and we plan for an increase in respiratory illnesses each year as we head into the fall and winter seasons,” he said. “While there is no vaccine for RSV, we recommend that parents make sure children are up-to-date on recommended immunizations.”
Respiratory syncytial virus (RSV) is the most common cause of serious lower respiratory tract infection in infants and young children.
- Symptoms of the disease include fever, runny nose, cough, and wheezing. When children are first infected with RSV, 25-40% of them will have symptoms of bronchiolitis or pneumonia and up to 2% of children will require hospitalization.
- In addition to premature babies, low birth weight babies or those with congenital or chronic cardiopulmonary disease, the most susceptible are babies 2 to 4 months old when maternal antibodies disappear. By the second year of life, about 90% of children will have been exposed to RSV.
- There is no vaccine or effective therapy available for RSV. Infants and children at risk of severe RSV infection can receive immune prophylaxis with monthly doses of a humanized murine anti-RSV monoclonal antibody during RSV season.
Health officials are also closely monitoring influenza activity throughout Oregon. Although influenza activity remains relatively low in Oregon, it is slowly increasing. Statewide test positivity was 2% last week; 5% positivity is considered a threshold for significant circulation of influenza.
“We hope to overcome [5% positivity] in two weeks,” said Jeanne. “Influenza will add to the pressure that will be placed on hospitals and health systems that are already dealing with increases in other respiratory viruses, including RSV.”
But according to Jeanne, Oregon has reliable tools to combat COVID-19, RSV and the flu.
“First, everyone should get a flu shot and make sure they are up to date on their COVID-19 shots,” Jeanne said. “That means a bivalent COVID-19 booster for those who have not yet received one, or if not already vaccinated, the two primary doses of COVID-19 vaccine, followed later by the booster.” Plus, getting your booster and flu shot as soon as possible means you’ll have protection for Thanksgiving and winter gatherings.
And while an RSV vaccine is not yet available, people can protect themselves through respiratory hygiene, such as covering coughs and sneezes, cleaning high-touch surfaces, practicing good hand hygiene, and wearing a face covering indoors.
“The use of masks, particularly in indoor settings, is a powerful tool to reduce the spread of all respiratory viruses,” said Jeanne. “When respiratory virus activity is high, everyone should consider wearing masks indoors when around people outside their household. And those at higher risk for severe illness should consider wearing masks indoors, even when virus activity is lower.”
The OHA held the medical briefing with reporters on Thursday, November 10.