Combined challenges this season of flu, RSV, COVID-19 worry hospital officials

Viruses present triple threat for health care professionals

Mike Easterling
Farmington Daily Times
  • Flu activity already is higher in New Mexico than in any other western state, according to the CDC.
  • Flu activity is categorized as moderate here, which rates in the middle of the CDC’s activity level scale.
  • Dr. Brad Greenberg of the San Juan Regional Medical Center Greenberg said there are several unknowns surrounding the potential severity of this year’s flu season.

FARMINGTON — A silver lining to the COVID-19 pandemic that began in the winter of 2020 in the United States is that influenza activity was greatly diminished in many parts of the country, including San Juan County.

That had a lot to do with the social-distancing and mask-wearing precautions that many people were taking, which helped limit the spread of numerous illnesses, not just COVID-19. But after two years of seeing very few flu cases, officials at San Juan Regional Medical Center are preparing for a return to higher numbers this year — a development that is part of another challenging viral landscape, said Dr. Brad Greenberg, emergency physicians and the hospital’s medical director of emergency preparedness.

“It’s not just about influenza,” Greenberg said, describing his concerns about the traditional start of flu season.

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Greenberg said that in addition to the flu, health care professionals remain concerned about the spread of COVID-19 and a surge in respiratory syncytial virus, otherwise known as RSV, a common respiratory virus that has been especially active this year. Instead of facing the issues caused by just one of those illnesses, or two of them, medical professionals are dealing with a situation this fall in which all three viruses are commanding their attention.

While it is too early to tell how severe the flu season will be, Greenberg said there already are signs that there will be no reprieve from that virus this season like there has been for the last two years. He said figures compiled by the U.S. Centers for Disease Control and Prevention show that there already have been an estimated 6,900 hospitalizations and 360 deaths related to the flu this year across the country.

A vehicle enters the drive-thru influenza vaccine clinic on Saturday, Oct. 29 in the San Juan Regional Medical Center parking lot in Farmington.

“The numbers are relatively high and higher than we’ve experienced the last couple of years,” he said.

The weekly influenza summary update issued by the CDC, which includes data through the week of Oct. 22, shows that while influenza is not as active in New Mexico as it is right now in places like New York, Washington, D.C., many middle-Atlantic states, the South and even Texas, it has made inroads in the Land of Enchantment.

Flu activity is categorized as moderate here, which rates in the middle of the CDC’s activity level scale. But that rates at the top of all western states.

Greenberg said there are several unknowns surrounding the potential severity of this year’s flu season. This year is likely to be the first time since the 2018-2019 season that large numbers of people will not be practicing social distancing or wearing a mask in public, he said, and that is likely to lead to more flu infections, he said.

“There’s still a role for masking,” he said, encouraging people to practice that basic precaution.

RSV: Virus has hit kids hard in some parts of the country, but not in San Juan County

The other element is more challenging to understand, he said, having to do with what some medical professionals already have dubbed “the immunity gap.” Essentially, that means that because of all the social distancing, mask wearing, hand washing and other precautions that people have undertaken for the last two years, their natural immunity to viruses may have waned.

“It could have left us more vulnerable,” he said. “For the last two years or so, a lot of us have had very limited exposure to those viruses.”

Eva Rojas, the hospital’s infection control nurses, said she is very concerned about what she has seen in regard to viral transmission on the East Coast already this year, especially in the pediatric community.

Greenberg said the hospital already is admitting patients with RSV — a time frame that is well ahead of the normal schedule – and recently has begun to see an increase in COVID-19 patients, as well.

Drivers wait in line to receive a shot during an influenza vaccine clinic on Saturday, Oct. 29 in the San Juan Regional Medical Center parking lot in Farmington.

“Our local concerns echo those of the CDC,” he said, explaining that hospital officials are worried about the possibility of facing a situation in which all three of those viruses are surging simultaneously, making it challenging for health care professionals to manage the demands of all those cases.

He noted that burnout already is a major issue in medicine, with more than 330,000 health care workers having left the field since 2021. Manpower shortages remain a significant concern in many parts of the country, he said.

“It’s really important for folks to do their part,” he said. “They means getting vaccinated for COVID and influenza, and staying at home when they’re sick and making good choices about other kinds of measures, such as wearing masks and washing their hands a lot.”

As it does every year, the hospital held two free drive-thru flu vaccination clinics in late October. The first one, which took place on Oct. 22, drew 175 people, while Rojas said she wasn’t sure how many people took advantage of the second one. But turnout for the first one was a bit lower than normal, she said.

“No one likes getting shots,” Greenberg said, acknowledging that there may be a bit of “vaccination fatigue” going on among some folks. He said he also understands that a lot of people are frustrated by the amount of medical information they’ve been expected to ingest over the last two and a half years.

But in the interest of protecting themselves and others, he strongly encouraged everyone to get a flu shot this year, along with a COVID-19 vaccination or booster. Because this remains uncharted territory, he said medical professionals simply don’t know how those three viruses will interact with each other this winter and what kind of crisis they could generate.

San Juan Regional Medical Center personnel already are having discussions about what such a crisis might look like and how they would respond to it, he said.

“Our efforts are being directed toward how to prepare for an influx of patients,” he said.

Greenberg chuckled when he was asked if he longs for the days when an active flu season was essentially all he had to worry about, explaining that that hasn’t been the case for a long time. New or enhanced viral respiratory illnesses have been accompanying flu season with regularity for close to 15 years, he said.

“It kind of seems like this (era) of uncertainty and the ability to manage change is the new normal,” he said, explaining that the hospital is poised not just to react to those challenges, but anticipate them so it can meet them head on.

Mike Easterling can be reached at 505-564-4610 or measterling@daily-times.com. Support local journalism with a digital subscription: http://bit.ly/2I6TU0e.