How are public health officials getting an accurate snapshot of what rates of COVID-19 and RSV look like?
If it feels like a lot of people have been sick lately, you’re not wrong.
Looking at the prevalence of COVID-19 in wastewater samples, Sacramento County is in the largest surge of the virus since January of 2022. Coupled with rising rates of RSV and flu, chances are you or someone you know has been sick these past few weeks.
And with many people returning to their usual work or school routines, there is more potential for the viruses to spread.
“This was predicted to be, the week or two after Christmas, that we would start seeing this surge,” Dr. Dean Blumberg, chief of pediatric infectious diseases at UC Davis Health, told CapRadio Insight host Vicki Gonzalez.
But unlike the early days of the pandemic or even the RSV surge of last winter, Blumberg said we haven’t seen issues with hospital capacity so far. While the four-county Sacramento region is in the middle tier of the Centers for Disease Control and Prevention’s COVID hospitalization rates, capacity has been less of an issue.
“I know at UC Davis we still have hospital capacity,” he said. “We're not over-full. It's not a crisis situation.”
Blumberg spoke with Gonzalez about the current state of respiratory viruses in the Sacramento region, the importance of vaccinations and what we’ve learned over the past four years.
This interview has been edited for clarity and length.
Interview Highlights
How would you describe the current situation in California, especially in our area, when it comes to cases of COVID-19, RSV and the flu?
Now on the one hand, we are seeing a large increase in the number of COVID cases and flu cases. On the other hand, since most people have some immunity, at least partial immunity to COVID, we're not seeing a large surge in hospital admissions due to COVID. We are seeing some admissions due to influenza. So it is the winter respiratory virus season. It looks like we're seeing a lot of admissions for winter respiratory viruses now. And as you mentioned, a lot of people in the community are sick.
Although RSV has been around for quite some time, I feel like the general public has become more aware of RSV in the last year or two. Has the risk of RSV, especially to babies, younger children and older adults, become more of a public health risk?
I think we became more aware of it because of the pandemic when we saw historically low rates of transmission of respiratory viruses like RSV due to the COVID measures. And then when we came out of all the lockdown and mandatory masking, then we saw a really catching up with RSV. In addition to that, we've got increasing research showing that RSV not only is a problem for babies and children but it causes significant morbidity and mortality in older adults.
Having influenza, COVID and RSV circulating at once, how does that complicate what you all do at the hospital?
I think one of the main things that we've learned with the pandemic is that the main thing that we need to be aware of is hospital capacity. And so that's why we really needed all those dramatic actions early in the pandemic because we saw all over the world that hospitals were full. There was no place for patients to go when they were sick, and people died because of that. So we're really closely monitoring hospital capacity. And that's what we did here in Sacramento. All the hospitals in Sacramento cooperated with Sacramento County Public Health to monitor bed capacity last year when we had the so-called “tripledemic” just to try to facilitate that so that if people needed to be in the hospital that we would know where the beds were.
What does hospital capacity look like in our area right now?
I don't know about all the hospitals in the area, but I know at UC Davis we still have hospital capacity. We're not over-full. It's not a crisis situation. So we certainly have availability, whereas last year things were very tight with RSV and with such a high volume of cases of RSV. So this year we've got of course the new RSV monoclonal antibody, the vaccine that we can give children and there's been some shortages of it, but people really want to get it. Doctors really want to give that to kids and parents want that, they're aware that RSV can cause hospitalizations and can cause serious disease in babies. So we've really seen a good demand for it even though this is just the first year that it's been available.
What do vaccination rates look like right now?
Flu vaccines seem to have peaked at about 50% of eligible patients. That's not great, but it's better than with COVID. The updated booster, less than 20% of people in the U.S. have received that. That's a real concern because there are people who are still at significant risk of severe disease and dying, and I would hope that they would take advantage of getting the vaccine. Even with the new variant that’s circulating, the current vaccine looks like it reduces hospitalization by about 60%.
Why do you think that is? Why do you think vaccine rates for COVID-19 have dropped that significantly over the years?
I think part of it was that it wasn't seasonal. We seem to be constantly being hit over the head year-round that there's a new variant, there's a new vaccine, get vaccinated again. That gets really tiresome. I think if we settle more into the seasonal pattern where it's a once a year thing, if COVID ends up being more seasonal — which we do expect that it’s going to be a winter respiratory virus — I think hopefully it'll become more routine and then people won't be so tired of it. It will become routine. Just get your flu shot, get your COVID shot and hopefully we can at least get up to the 50% vaccination rates that we have with influenza.
How are public health officials getting an accurate snapshot of what rates of COVID-19 and RSV look like?
It's really hard to tell these days because of home tests. A lot of people test at home and we don't know what those results are.
So there's two main ways that public health can figure out the level of our COVID in the community and one is by looking at hospital admissions. But that'll of course only tell you about severe cases. And the other is the wastewater surveillance and that appears to be very promising. That's a really new tool that we have and you know, according to the current wastewater surveillance that is going around with COVID now, It looks like this is going to be the second largest wave of covid since the pandemic began.
How does that make you feel as a public health official who's been talking about this, you know that, you know four years in you know, we're kind of rivaling numbers from you know, the worst of it?
It makes me nervous because I know it's on the rise and with the JN.1, the current variant that's on the increase, this was predicted to be, the week or two after Christmas, that we would start seeing this surge. So it does make me a little bit on edge. I'm hoping that we don't have a lot of hospital admissions. And of course because most people do have some immunity, the hope is that most of these cases are relatively mild, that they’re outpatient, that they're more annoyances rather than resulting in killing people.
