This article appeared in the Detroit Free Press. Read more here.
The big three respiratory viruses — influenza, coronavirus and respiratory syncytial virus, better known as RSV — are spreading misery across Michigan yet again, as people flood doctor’s offices, urgent care sites and emergency departments seeking treatment and many fill hospital beds.
“At the moment, I would say we are in the thick of it,” said Dr. Natasha Bagdasarian, the state’s chief medical executive. “We’ve got lots of COVID circulating, lots of flu, and RSV as well.”
Though real-time case tracking for these viruses isn’t precise and has become harder since the COVID-19 public health emergency ended in May, Bagdasarian and other health leaders are able to evaluate viral activity by watching hospital admissions, reports of positive flu and COVID-19 tests, through wastewater testing and other data.
“With RSV, it’s possible that we have plateaued,” Bagdasarian told the Free Press. “The rates are not as high for RSV hospitalizations as they were last year. And for influenza and COVID, those numbers still look like they’re on an upward trajectory. … I think we have yet to see the worst for COVID and flu.”
High flu activity, COVID-19 hospitalizations
The U.S. Centers for Disease Control and Prevention now lists Michigan among states with high flu activity. The majority of cases spreading through the last week of December were types of influenza A.
The flu surge comes as 1,200 Michiganders were hospitalized with COVID-19 as of Monday, according to data from the state health department. That compares with 884 one month earlier — a 35.7% increase.
“Our COVID hospitalization rates look a little bit higher than they were in last winter and our flu rates are not quite as high as they were at the peak of last winter,” Bagdasarian said. “If I had to say which one is really the dominant virus right now, it does look like it’s COVID again.”
This time, the JN.1 subvariant is dominant across the U.S. and in the Midwest region, according to the U.S. Centers for Disease Control and Prevention. JN.1 was classified in December by the World Health Organization as a variant of interest because of its rapid spread globally. However, the WHO reported: “available limited evidence does not suggest that the associated disease severity is higher as compared to other circulating variants.”
Though we’re once again seeing a COVID-19 spike, it’s nowhere near the level of previous pandemic peaks. In early January 2022, when the omicron variant became the dominant strain circulating, more than 4,600 Michiganders were being treated in hospitals statewide with the virus.
Hospitals stretched thin
Even though Michigan’s COVID-19 hospitalizations haven’t hit levels seen during pandemic peaks, hospitals statewide still are strained because they’re also filled with flu and RSV patients along with others in need of care, said Dr. Charles Gibson, vice president for medical affairs for Corewell Health in western Michigan.
“That’s the real bugaboo,” Gibson said. “It makes it quite tight around here because you have got to have a bed for every patient, a physical bed. And then, more importantly, you have to have appropriate staffing to be able to take care of all those patients.
“That also backs up all of the other stuff that tends to come in — the broken legs and the car crash injuries and the person that’s having chest pain or shortness of breath not related to a respiratory illness. … We still have to be able to take care of all those types of patients, too.”
Hospital leaders have to consider how many surgeries and other procedures they can accommodate at times like these “so that we can maintain our day-to-day operations but also accommodate the influx,” said Gibson of Corewell’s 21 hospitals, which span the Lower Peninsula. “It’s a really big deal when our capacity gets hit.
“We’re seeing an influx into our care spaces — whether it’s the inpatients in hospitals that are a little bit sicker and need to be admitted coming to the ED, our walk-in clinics, our primary care offices. They are all at higher volumes across the board. We’re certainly feeling the impact of these respiratory illnesses.”
It’s not too late to get vaccinated
To keep people out of hospitals as infections with these viruses climb in Michigan, Bagdasarian and Gibson said it’s key to use the tools that are available — vaccines for all three viruses, monoclonal antibody treatments to protect infants and toddlers from RSV, and antiviral medications for flu and COVID-19.
“It’s not a secret that the vaccines can save lives,” Gibson said. “We learned that in past pandemics going back to the early 1900s as well as during the COVID pandemic. These things have a real impact.”
Yet fewer than 10% of Michiganders are up-to-date on COVID-19 vaccines, Bagdasarian said. And roughly one quarter of Michigan residents — about 2.6 million people — have gotten a flu shot this season.
That’s the lowest rate of flu vaccine uptake in four years, she said.