Coronavirus, flu cases rise in D.C. region, worrying health officials

August 20, 2024

A surge in coronavirus and flu infections in recent weeks, driven upward as more people have come into contact with one another during the holidays, has health officials in the Washington region worried about a potential strain on area hospitals.

Virginia health officials on Thursday announced the state’s first reported child death due to the influenza virus this year, as respiratory ailments steadily increase. Emergency room and urgent care visits jumped by 12 percent the week before Christmas compared to the previous week, according to state officials.

Maryland health officials on Thursday announced that the state’s hospitalization rate for respiratory ailments rose past 10 per 100,000 residents, prompting a recommendation that hospital staff wear masks around patients and that all patients who are eligible be vaccinated for coronavirus, the flu and the respiratory syncytial virus — the virus commonly known as RSV, which can be dangerous for young children, the elderly and the immunocompromised.

In the District, new hospital admissions for the coronavirus have hovered at about 45 per day, with the flu and RSV adding to that total.

“We are definitely seeing the trifecta,” said Sarah Ash Combs, an emergency department doctor at Children’s National Hospital in the District, who herself was recovering from the flu on Thursday.

After cases related to respiratory ailments rose for the seventh consecutive week this month, with influenza A cases reaching 310 just before Christmas, Combs said, the hospital has come close to reaching capacity.

“We’re treating everyone who comes through the door,” she said. But “even though we do have space in the hospital, sometimes the issue becomes the space and capacity for the sickest of the sick children.” Hospital officials said they prioritize the most severe cases.

Health-care experts say the rise in cases is due to a variety of factors.

Attitudes about social distancing have relaxed considerably since the earliest days of the pandemic, when thousands of people per day were infected by the coronavirus, many of them dying before vaccines became widely available.

Also, relatively few people have received the latest coronavirus booster shots that are geared toward the several highly transmissible omicron subvariants in circulation. About 17 percent of the U.S. population has received the new, bivalent booster shot, according to the Centers for Disease Control and Prevention.

A new strain of the coronavirus, JN.1, is also feeding the surge, although health experts don’t believe it causes more severe illness than other strains. JN.1 is the most common variant in the United States.

New coronavirus variant JN.1 is spreading fast. Here’s what to know.

The yearning to interact with one another has made people susceptible to those subvariants and influenza A, a strong strain of flu virus that has joined the more mild H1N1 strain in spreading through the region.

“Over the past couple of years, we’ve sort of forgotten how serious an infection of influenza really is,” said Andrew Pekosz, vice chair of the W. Harry Feinstone Department of Molecular Microbiology & Immunology at Johns Hopkins Bloomberg School of Public Health.

He predicted the cases of respiratory ailments in the region will continue to rise over the next several weeks, following the patterns of other areas of the country that tend to see such infections rise first.

“This is another reminder that covid is still around. Influenza is still around. And with RSV, we’re just getting over the peak season. All these infections really are expected to be around for most of the winter.”

Nilesh Kalyanaraman, deputy secretary of public health services at the Maryland Department of Health, says public health officials and hospitals are on alert following the holiday increase in infection and hospitalizations related to respiratory ailments in Maryland. Kalyanaraman largely attributes the spike to many who have traveled without wearing masks and lagging coronavirus and flu vaccination rates, he said.

“We continue to say that masking, particularly wearing a K-95 mask, will help decrease transmission,” Kalyanaraman said. But, he added, “it is up to the individuals at this point.”

The severity of the flu, which kills about 52,000 people per year in the country, revealed itself in Virginia through the death of a child in the eastern portion of the state. State officials described the child as between 5 and 12 years old, and warned that flu illnesses have been rising with the colder weather.

Last week, 6.9 percent of all emergency room and urgent care visits in the state were flu-related, most of them involving children, a 12 percent jump from the previous week, according to the Virginia Health Department.

Heather Harmon-Sloan, who leads the department’s response to the coronavirus, said that spike has accompanied a surge in emergency room and urgent care cases related to the coronavirus — representing about 3.5 percent of all those patients — while an earlier spike in RSV infections in the state has only recently begun to show signs of peaking.

“It is a little concerning to have all three at high levels as we all get together for the holidays,” Harmon-Sloan said.

Overall, the rate of hospital admissions related to the coronavirus in Virginia is still relatively low, at 7.87 patients per 100,000 residents, Harmon-Sloan said.

But some pockets of the state — particularly in the rural Southwest, where vaccination rates have been low — have exceeded a coronavirus hospitalization rate of 20 patients per 100,000 residents.

The staff at the Ballad Health network of hospitals, which serves Southwest Virginia and northeastern Tennessee, have felt the crush of the coronavirus as well as other respiratory illnesses.

Lisa Smithgall, the chief nursing executive at Ballad, said the number of flu-related hospitalizations in the hospital has nearly doubled, to 457, since the start of the month.

“We’ve seen this great jump, primarily in the last week or so,” she said. “With Christmas and the New Year’s holiday, we anticipate that spreading.”

Among the ill have been an increasing number of hospital staff, Smithgall said.

But with some hospitals already short staffed, some of those workers will be brought back earlier than the usual five-day period after their initial symptoms began, she said.

A CDC “contingency staffing” guideline allows hospitals facing a crisis to do so if those workers show signs of recovery.

“That will permit us to bring people back to work a little earlier so we can keep our staffing levels up to handle the increase in patient volume,” she said. “So, we’re still able to meet the needs of our community at this point.”

correction

A previous version of this article incorrectly reported that Children’s National Hospital in D.C. had 310 cases of respiratory illness just before Christmas. It had 310 cases of influenza A at that time. The article has been updated.

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