We have become accustomed to living in the Age of Covid. Even blasé about it. For almost three years, we have faced existential threats from potentially every person we come close to. It has been wrenching for all, and terribly painful for far too many. But with vaccines, we saw the surge in hospitalizations and deaths wane. The headlines went away.
But Covid didn’t go away. And it won’t. It will keep on mutating, sometimes allowing the virus to evade our immune defenses and therapeutics.
If that isn’t enough to make us all keep up on boosters, we are now seeing rapidly rising case numbers of two other serious respiratory viruses. Influenza, which causes a spike in deaths every winter, is off to an early and aggressive start. It is a champion mutator, requiring new vaccine formulations every year to combat it.
And the less well known Respiratory Syncytial Virus (RSV) has become, in the past year, a growing threat. Long known to pediatricians as a potentially life-threatening condition in young children, it is now commonly sickening older people. I learned a lot about it when I was infected while traveling last December. I was sick for three weeks, and I know others who have been quite ill with the virus.
We are now seeing, very early in the season, case numbers larger than are usual even later in winter. One hypothesis is that the precautions we took against Covid over the last few years reduced our exposure — and thus our immunity — to other respiratory viruses.
Emergency departments are seeing large volumes of all three respiratory infections. Sick patients are sometimes turned away for lack of capacity to care for them, or they are “boarded” in emergency rooms waiting for a bed. Dr. Paul Biddinger, chief of emergency preparedness at Mass General Hospital, says he is very concerned by “the high levels of crowding that we see today.”
It isn’t only patient volume. Staff shortages have become chronic because of both illness and “burnout.” Skilled hospital care is critical with respiratory illness. Hospitals currently face a statewide nurse vacancy rate of 56 percent and have come to rely heavily on traveling nurses working per diem to supplement beleaguered staffs. And with less available post-acute-care beds, people stay longer in the hospital, which is typically not reimbursed for “unnecessary” days.
At Cape Cod and Falmouth hospitals, influenza has indeed arrived early and strongly, but capacity and staffing have been adequate, probably reflecting the Cape’s higher levels of immunization, according to Chief Medical Officer William Agel. Covid bumped after Thanksgiving, but it has not strained the system. If there is a feel-good piece to this story, we’re it — so far.
What must be done? Quite simply, we must each work at staying healthy. That means limiting crowd exposure and, certainly, wearing a mask in public indoor spaces. While mask protection is not absolute, it is a simple intervention that has conclusively proved to reduce the risk of viral disease transmission. Your immunizations against flu and Covid should be current. (There is no vaccine for RSV.)
By taking good care of ourselves, we are doing the same for those around us — and for our overloaded health-care providers.
Brian O’Malley, M.D. is Provincetown’s elected delegate to the Barnstable County Assembly. Write him at [email protected].