Respiratory Viruses to Continue Circulating this Season at Higher Levels

Posted on November 10, 2022

RSV, influenza, COVID-19 already putting strain on hospitals, OHA official says

PORTLAND, Ore. — Respiratory viruses are expected to circulate this season at higher levels than Oregon has experienced over the last two years as people gather indoors for the holidays, an Oregon Health Authority (OHA) public health physician said today.

But it’s unknown whether two of those viruses – RSV and influenza – will be more severe than pre-pandemic seasons, said Tom Jeanne, M.D., M.P.H., deputy health officer and deputy epidemiologist at OHA.

“Nationally, we are seeing some alarming trends of early – and, in some cases, very high – circulation of both viruses,” Jeanne said during OHA’s monthly COVID-19 update. “Given this concerning picture, we need to work together to protect hospital capacity so that all of us have access to critical care when we need it.

A recording of the Jeanne’s comments during today’s update is available on OHA’s YouTube page.

Jeanne explained that the COVID-19 pandemic has “placed incredible strain” on our health care system, with RSV further straining systems. Influenza will only add to this burden.

COVID-19 transmission is expected to increase as people gather indoors and immunity from vaccination and previous infections wanes. The seven-day moving average of new confirmed and presumptive cases has hovered between 350 and 400 cases, Jeanne noted. He said an Oregon Health & Science University forecast predicts that COVID-19 hospitalizations – now at 229 as of Wednesday, Nov. 9 – will increase slightly and peak at about 280 by early December.

Oregon also is seeing slow increases in the proportion of new Omicron subvariants with mutations of concerns, such as BQ.1 and BQ.1.1. These new subvariants account for less than 10% of variants circulating in Oregon; BA.5 still accounts for about 80%.

“We don’t expect that this winter’s COVID-19 wave will be as severe as last year’s Omicron wave,” 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 we’re concerned about.”

One of them, RSV – the most common cause of severe lower respiratory infection among infants and young children – will see increasing activity over 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 Oct. 29 and Nov. 5.

Health officials also are closely monitoring influenza activity throughout Oregon. Although influenza activity remains relatively low in Oregon, it is increasing slowly. Statewide test positivity was 2% last week; 5% positivity is considered a threshold for significant influenza circulation.

“We expect to surpass [5% positivity] within two weeks,” Jeanne said. “Influenza will add to pressure that will be placed on hospitals and health systems already dealing with the increases in other respiratory viruses, including RSV.”

But Oregon has reliable tools for combatting COVID-19, RSV and flu.

“First, everyone should get a flu shot and make sure they are up to date with COVID-19 vaccinations,” Jeanne said. “That means a bivalent COVID-19 booster for those who haven’t received one yet, or if you are still unvaccinated, the two-shot primary COVID-19 vaccine doses – followed later by the booster.” Plus, getting the booster and flu shot as soon as possible means they will have protection for Thanksgiving and winter gatherings.

And even though 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 masking indoors.

“Masking, particularly in indoor settings, is a powerful tool for reducing the spread of all respiratory viruses,” Jeanne said. “When respiratory virus activity is high, everyone should consider masking indoors when they are with people from outside their household. And those at increased risk of severe illness should consider masking indoors even when virus activity is lower.”

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