WEYMOUTH – South Shore Health officials say the system is grappling with lingering staffing shortages and a full emergency room as people battle a trifecta of respiratory illnesses – COVID-19, RSV and the flu.
“We’re in a phase where we have the highest volume of respiratory illness in decades, essentially,” said Dr. Todd Ellerin, director of Infectious Diseases at South Shore Health. “We’ve been dealing solely with COVID for three years, and now we have unprecedented levels of RSV and unprecedented levels of the flu for this early in the season. It’s not like we haven’t seen this in January, but November and early December is very early.”
All but seven states have reported high or very high respiratory virus activity this week, according to the Centers for Disease Control and Prevention. Massachusetts is categorized as “very high,” with about 6% of doctors visits and 3% of hospitalizations related to the flu.
Rochelle Walensky, director of the federal Centers for Disease Control and Prevention, said last week that flu-related hospitalizations at this time of year are higher than the country has seen in a decade.
At South Shore Health’s Health Express urgent care locations, Ellerin said about 32% of patients who got tested for the flu last week came back positive, compared to 7% for COVID-19.
“So one in three people test for the flu had it. Millions of people have the flu around us,” he said. “It underscores the importance of getting a flu shot, which will decrease the likelihood of needing the hospital.”
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There are vaccines available for COVID and the flu, but not for RSV, or respiratory syncytial virus, which is especially dangerous for infants. All three of the viruses present very similar symptoms, such as fever, cough and upper respiratory symptoms. About 38% of people in Massachusetts have received a flu vaccine this season, according to the state.
Ellerin said RSV now appears to be on the decline, but was severe early in the season.
“Our pediatric units have never seen such severity leading to hospitalization that we’ve seen this year,” he said.
While flu cases are on the rise, Ellerin said COVID-19 cases are steady, with about 20 patients in the hospital with the virus. He said deaths from the virus are now rare at the hospital, in part due to advancements in treatment.
Ellerin said fewer people are wearing masks than during the previous two winters, and there is decreased population immunity to respiratory infections, like the flu. This is bringing more people into doctor’s offices, urgent care centers and the emergency room for treatment.
“In general, day-to-day, we haven’t seen these volumes. When you look at this year compared to last year, it’s significantly higher,” he said. “It’s respiratory illnesses, delays in care from the pandemic. All of these things are contributing to acute care visits.”
A big uptick in sick patients is exasperated by a persistent staffing shortage felt by health systems across the country. According to the Massachusetts Health and Hospital Association, there are currently an estimated 19,000 open acute care hospital positions across Massachusetts.
“All over the country, there are major staffing issues and health systems are over capacity, with staff working tirelessly around the clock to take care of patients,” he said.
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While there is “plenty of virus around,” Ellerin said the rise in respiratory illnesses hasn’t caused a huge spike in admissions into the hospital. He said it’s “nothing” like when the hospital was pushed to capacity with dozens of patients extremely ill with COVID-19.
Ellerin stressed it’s important to reserve the emergency department for severe cases, such as people with respiratory illness who can’t speak in full sentences. He said the first step should be a call to the primary care or pediatrician’s office, or visit an urgent care.
“If you need an ER we are here, and despite capacity issues we’re dong an amazing job for caring for emergent illnesses, but a lot of patients come in, go home and they didn’t need to be there,” he said.
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