COVID, Flu Season, RSV, And More: A Look At Local Case Numbers And Illness Trends

What do you get when you combine the worst RSV season in years, the ongoing presence of COVID-19, and a cold and flu season triggering higher-than-average levels of illness in many parts of the country? It all has healthcare professionals worried about a “tridemic” this winter – a situation that could spell trouble for hospitals, schools, workplaces, and the community at large. In the midst of National Influenza Vaccination Week – which runs from December 5-9 – The Ticker checks in with area healthcare authorities to find out where caseloads stand locally.

The good news? COVID-19 is mostly under control in northern Michigan – at least for now.

“Our hospitalizations for COVID have really been fairly stable over the past couple of months,” says Dr. Walt Noble, chief medical officer at Munson Medical Center. “We’ve seen numbers in the low 20s or even in the teens for COVID patients hospitalized within our system, and that’s all eight Munson hospitals. We can manage those numbers, and they're not impacting our critical care capacity much at all.”

Are these lower numbers a sign that the pandemic is over? Not necessarily. According to Dr. Jennifer Morse, interim medical director for the Grand Traverse County Health Department (GTCHD), case numbers in the community are likely higher than they look on any official report, with several factors contributing to the undercount. First, Morse says that most people have gotten used to testing for COVID at home when they feel ill. Those cases are rarely officially counted, unless someone has to seek medical care or be hospitalized. Second, hospitalizations are down because most of the people who have been getting COVID are getting milder cases.

“Some projections were predicting that we would see a bit of a surge right around now,” Morse notes of local and state COVID numbers. “But we're actually not seeing that happening. We’re hopeful that we may be just be missing that surge because the booster is working and because we're not seeing mutations that are escaping the booster. The mutations that are happening with the virus right now are all staying within subvariants of omicron, which seems to be well-covered by the booster and which is less likely to put people in the hospital.”

Still, Morse is hopeful that people will be cautious throughout the holidays by monitoring their health, self-testing if they feel sick, and staying away from gatherings if they or their children fall ill.

Both Morse and Noble also note that the same protections for minimizing the spread of COVID-19 – washing hands, not touching the mouth or face, sanitizing frequently-touched surfaces, wearing masks in public places, and staying home when ill – are all effective for avoiding other illnesses too. An across-the-board decline in those types of vigilance, they say, could explain why other viruses have been more problematic this year.

Case-in-point is respiratory syncytial virus, or RSV, a common virus that causes infections of the respiratory tract. Most adults only experience common cold symptoms with RSV, but the virus can be dangerous for infants and the elderly, causing airway obstructions in the former and pneumonia in the latter. While there is an “RSV season” every fall/winter, Noble says the virus has been “much more active” this year than in past seasons. Morse concurs, noting that most of the country has experienced something of a pile-up effect with RSV this autumn.

“Every kid pretty much has had RSV by the time they're two, and then we do tend to re-catch it throughout our life, just as a normal cold most of the time,” Morse explains. “But the last few years, because we've been using non-pharmaceutical interventions to prevent COVID, we've also been preventing RSV. By wearing masks, by avoiding each other, by staying home when we're sick, we've had 2-3 years where we haven’t had much of an RSV season.”

This year, a tapering-off of COVID restrictions and precautions – particularly masking in schools – meant that RSV was spreading again. And since there hadn’t been a “normal” RSV season since 2019, that comeback proved severe.

“We've had children born and have a couple of years of life without getting RSV, so we have a lot of people that aren't immune naturally,” Morse tells The Ticker. “And then we’ve also had adults and young kids not have that natural boost to their immunity by touching RSV again. We just have a lot of people that either aren't immune from prior illness, or haven't had that natural boost to their immunity, so RSV has had an opportunity to spread really quickly and to infect a lot of people this year.”

Earlier in the fall, Noble says RSV was causing “significant pediatric hospitalizations” downstate, to the point where many pediatric intensive care beds were filling up to capacity. “That was concerning for us, because we don’t do pediatric intensive care,” Noble says of the Munson system. But while Munson did have to lean a bit more on its pediatric nurses than usual, Noble says northern Michigan largely avoided the more severe issues with pediatric RSV that southern parts of the state saw. “And fortunately, it looks like the trend has peaked,” he adds.

The worry now is whether the U.S. will see a similarly severe cold and flu season, for the same reasons that RSV flared up this year. Per the Centers for Disease Control (CDC), the U.S. is currently tracking higher-than-usual early season incidence of influenza, with 35 states reporting high or very high activity. The CDC estimates that between October 1 and November 12, there were 4.4 million cases of influenza in the U.S., leading to 38,000 hospitalizations and 2,100 deaths.

“We do anticipate that we’re going to see some increased activity in the community,” Noble says. “Some good news is that it appears the flu vaccine will be very helpful this year, at least from looking at the testing that’s been done throughout the country.”

At the moment, though, Morse says GTCHD and Michigan as a whole are seeing lower vaccination rates for the flu “than we’ve seen the last four years.” To encourage locals to get their flu shots, GTCHD is holding a flu clinic tomorrow (Thursday) from 8am to 4:30pm at its main location at 2600 LaFranier Road. Walk-in vaccinations are available for anyone 18 and older, while appointments can be scheduled for those under 18 by calling 231-995-6131.