Leaders with the Multnomah County Health Department on Tuesday, Nov. 29, briefed the Board of County Commissioners on a “trifecta” of seasonal illnesses causing local hospitals to implement crisis care protocols.
The briefing featured testimony from Dr. Jennifer Vines, Multnomah County’s Health Officer, and Chantell Reed, the County’s Deputy Public Health Director. Together, they presented recent data and trends on COVID-19, influenza and respiratory syncytial virus (RSV), as well as recommendations to lower risk this holiday season and winter.
“We’re at a difficult moment,” Dr. Vines said. “Hospitals are strained. Our pediatric specialty care hospitals are in crisis care — all of them.”
“We have this trifecta of illnesses,” Reed added.
One of the main drivers of the current surge in hospitalizations is a huge increase in RSV cases. The virus is a very common illness, appearing every winter, that infects the airways. There is no vaccine, and infants and older adults are most vulnerable.
Prior to the pandemic, about 80% of babies would become infected with RSV during their first winter. Most infants and toddlers experience mild symptoms. However, “a very small number” need to be hospitalized to receive fluids, oxygen or even help breathing.
“This is part of what you’re hearing about in terms of the burden on our pediatric hospitals right now,” Dr. Vines said.
Older adults and people with underlying conditions are also more vulnerable to the virus. While the majority of those currently hospitalized are younger than 5 years, people of all ages can experience severe cases.
Dr. Vines noted that according to reports from state systems that track the prevalence of certain viruses, the Portland metro region — northwest Oregon and southwest Washington — has seen a dramatic rise in RSV: “pretty much a doubling or even tripling in the last few weeks over the month of November.”
Unlike COVID-19, RSV does not spread through the air. Most people become infected through close face-to-face contact. To prevent the spread, experts recommend hand washing, sanitizing surfaces, masking and reducing face touching.
Commissioner Lori Stegmann asked Dr. Vines about the average trajectory of RSV cases: “How long does a person have it, and how does that compare to COVID?”
It’s an illness that usually lasts several days, and most people are going to be fine, Dr. Vines said.
She added, “What we’re asking parents to watch for is around day 5 of illness, kids may take a turn for the worse and may have more trouble breathing.”
COVID-19 hospitalizations increase after plateau in cases during the fall
Beyond RSV, experts are also seeing an uptick in COVID-19 patients. The increase in patients is further straining the system, Dr. Vines said, making it more difficult for hospitals to free up resources to accommodate the most serious cases.
To reduce the risk of severe illness, public health officials urge people to get the bivalent booster in addition to completing their primary series. While nearly 70% of Oregon residents have received two doses of the vaccine, only 12.8% have received their booster.
The good news is that the current bivalent booster mostly matches the most prominent strains of the COVID-19 virus right now. That means the vaccine offers a high level of protection.
“I got my COVID booster and flu shot the weekend before — it was great,” Commissioner Jessica Vega Pederson said. “My daughter got it too, and my son and husband got it as well. I encourage everyone to do it.”
Health officials are also worried about a massive spike in influenza cases. Of those hospitalized with the flu, roughly 40% are older than 65 years. Everyone six months and older is urged to receive a flu vaccine.
“The flu climb — is that normal, what we would have expected to see pre-pandemic?” Commissioner Susheela Jayapal asked.
It’s difficult to pinpoint, Dr. Vines responded, but it’s likely because there is lower population-level immunity. Since fewer people have been exposed to the flu recently, people may be more susceptible to it.
County hosts low-barrier vaccine clinics
To address the current increase in respiratory illness, County health workers are focused on direct outreach to those most at risk. That includes culturally specific communities and multi-generational households.
The County is currently working on increasing access to low-barrier flu and COVID-19 vaccine clinics — both directly and through partnerships, Reed said. Health workers are also distributing free masks through community networks.
Reed urged anyone who needs help to call the Health Department Call Center at 503-988-8939. Health workers and community partners are standing by to help individuals and families access crucial resources, including vaccines, masks and even rent assistance.
“We have resources to support families,” Reed said. “I cannot say enough: please call the Call Center.”
“I know it’s hard to talk about — that’s what we appreciate about all of you,” Chair Deborah Kafoury said. “We’ve had tough conversations and we know the goal is to help our community, stay safe and healthy.”