Flu, RSV on the rise — there’s COVID, too. What to know ahead of the holidays in Florida

It seems everyone is getting sick. Sniffles. Coughing. Sore throat. And worse.

While people can get sick at any time of the year, they don’t call it cold season for nothing. And cold season is here until late winter.

It’s also flu and RSV season in Florida. And don’t forget about COVID — it’s still around.

Flu season started early and has led to more people in the hospital at levels not seen in more than a decade, according to the U.S. Centers for Disease Control and Prevention. The last time flu hospitalizations have been this high was during the 2009 H1N1 swine flu pandemic.

Children’s hospitals are also alarmed over respiratory syncytial virus, or RSV, a common childhood virus that causes cold-like symptoms. So much so that a pediatric organization sent a letter to President Joe Biden and Health and Human Services Secretary Xavier Becerra asking the administration to declare an emergency and a national response.

And some health experts are also worried that COVID cases, which have been on the decline, will start to increase again during the holidays, like they did last year as people gathered inside in close quarters around festive tables.

So what’s the sickness situation looking like in South Florida ahead of the holidays? Let’s take a look:

Flu and colds

Florida is seeing high levels of patients reporting influenza-like symptoms such as fever, cough and a sore throat, according to the CDC. The Florida Department of Health also is reporting an increase of flu and influenza-like illnesses in much of the state, including in Miami-Dade, Broward and Monroe counties.

Both Jackson Health and Broward Health, public hospital systems in South Florida, have also noticed a steady increase of patients with cold-like symptoms, though many patients are able to recover at home. And while some people have the flu, doctors say others are sick with common respiratory viruses such as rhinovirus and parainfluenza.

There wasn’t much flu circulating the past two seasons during the COVID-19 pandemic, when people were wearing masks and traveling less. Now that life is back to normal, flu is forecast to make a comeback.

“Now that masks are off and we’re heading into the holiday season, we expect to see some pretty big increases in people. ... with influenza-like illness, some RSV, some flu and certainly some COVID,” said Dr. Hany Atallah, chief medical officer for Jackson Memorial Hospital in Miami.

U.S. health officials look to countries like Australia in the Southern Hemisphere to get a forecast on what type of flu season could be coming our way. And Australia has had its worst flu season in five years. That means the U.S. might have a strong flu season, too.

In typical years, “a good percentage of the population gets infected with influenza, and their immunity after infection lasts longer than what we get from vaccination,” Andrew Pekosz, a virologist and professor of microbiology at the Johns Hopkins University School of Public Health told AARP. “What we’re seeing is a couple of years where we didn’t see infection. So more people may be susceptible to influenza in this coming season.”

So far this season, there have been at least 4.4 million illnesses, 38,000 hospitalizations and 2,100 deaths from the flu, according to CDC estimates.

Dr. Atallah is encouraging people to get their flu shots and continue following other safety measures, such as frequent hand washing, to reduce their risk of getting ill during the holidays. Anyone who has trouble breathing should seek medical care.

“Prevention is key,” he said.

Atallah also said ERs tend to get overwhelmed this time of year, so going there for a cold “can impact our ability to be able to take care of those people who need our services immediately, and those people who are sicker.”

RSV

Florida is seeing an above average number of cases of respiratory syncytial virus, or RSV, which could lead to an increase of pediatric emergency department visits compared to previous years, the Florida Department of Health announced this month.

RSV is a common childhood virus — almost all kids will have an RSV infection before age 2 — that causes cold-like symptoms such as coughing and fever.

While most RSV infections are mild, some babies, young children and older adults can get severely ill, particularly those born premature or who have weaker immune systems or a medical condition such as asthma and chronic lung disease. RSV is the most common cause of bronchiolitis and pneumonia in children younger than 1.

Last month, Salah Foundation Children’s Hospital at Broward Health in Fort Lauderdale had to open overflow areas one weekend after its pediatric intensive care unit filled up with sick patients. While the hospital is still seeing cases of RSV, it hasn’t surged.

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Instead, other common viruses that tend to get kids sick like rhinovirus are starting to catch up with RSV, said Dr. Francis Amador, the director of the children’s hospital pediatric emergency department.

“In the good old times those were viruses we didn’t even test for but for some reason post-COVID many kids are responding in a more deteriorating way ... they’re getting sicker” than they used to be, said Amador, noting that some of the kids are experiencing more complicated symptoms such as shortness of breath and high fever.

Some South Florida doctors who spoke with the Miami Herald recently said it’s possible more kids are getting sick with RSV and other illnesses this year because fewer of them were exposed to these viruses during the pandemic.

Amador said the hospital is expecting to see a “spike in influenza and RSV and many of the other viruses that are causing all these complications.”

On Monday, the American Academy of Pediatrics and the Children’s Hospital Association sent a letter to President Biden and Health Secretary Becerra asking them to declare a state of emergency over the surge of pediatric respiratory illnesses, including RSV and influenza, along with mental health.

The way RSV spreads is similar to other viruses — by an infected person coughing or sneezing, or you touch a contaminated surface like a doorknob and then touch your face, or by direct contact such as kissing a child with RSV.

Ways to reduce the spread of RSV may sound familiar in the COVID age: frequent hand-washing, avoiding close contact with sick people, cleaning frequently touched surfaces.

And because RSV symptoms are similar to those of other viruses, parents won’t know their children are infected with RSV unless they get tested. Parents should treat it like a cold, ensuring children stay hydrated and give them acetaminophen or ibuprofen, as needed, to help with fever or other symptoms. Anyone who has trouble breathing should seek medical care. No RSV vaccine exists yet, but one is in the works.

COVID-19

COVID-19 cases and hospitalizations in the United States have been on the decline the past several months. However, cases have begun to rise in “about half of the states and are falling in the other half,” though these shifts, in most places, have been minor, according to the New York Times.

“Reports of new cases have been roughly flat in the past two weeks, though rising test positivity suggests that they may not stay that way,” the New York Times reported.

In Florida, where COVID cases have been on the decline, cases rose slightly this month but remain low.

“We’re not seeing those sicker patients that are getting pneumonia or having to be admitted to the hospital,” said Dr. James Roach, the chief medical officer at Broward Health Medical Center. “COVID is becoming more like the flu and less like the variant strains that we had with delta and omicron.”

As of Thursday, Nov. 17, Florida has added an average of 1,690 cases per day in the past seven days, according to Miami Herald calculations of CDC data. That’s down from an average of 1,761 cases in the previous seven-day period.

The CDC is also once again listing Miami-Dade, Broward and Monroe counties as having a low COVID-19 risk level. They were under a medium risk earlier this month.

That doesn’t mean you should let your guard down.

After all, no one wants to get sick on Turkey Day.