State health officials are urging residents to get vaccinated and take other steps to protect themselves from infectious diseases to mitigate the strain on hospitals this winter by COVID-19, influenza and respiratory syncytial virus. That was the primary message of last Wednesday’s public health ECHO, held via Zoom and livestreamed on Facebook.
State Epidemiologist Dr. Joe Mclaughlin said that Alaska hasn’t yet been hit hard by this fall’s influenza or RSV outbreaks, but that national trends show strong waves and high levels of hospitalization, especially in children.
“That’s an indication that we are going to see likely higher rates of hospitalization in the pediatric age groups than we have currently seen,” he said. “We know that our hospitals are currently stretched pretty thin with the volume that they’re seeing now.”
Department of Health Section Chief Gene Wiseman said in the ECHO that around the state hospitals are experiencing capacity limitations. He said one of the largest factors in Alaska right now is just staffing, as the respiratory diseases hitting the wider nation aren’t yet hitting the state in a huge way.
Last week, Central Peninsula Hospital External Affairs Director Bruce Richards said that hospitalizations were picking up, with 25 patients treated for RSV this season. He said the hospital wasn’t “swamped,” but was seeing positive cases of RSV and the flu.
A major concern mentioned by Richards, echoed by Wiseman in Wednesday’s ECHO, is that hospitals in Washington and other northwestern areas are full and not accepting transfers. Both men referred to those hospitals as a relief valve for sicker patients, one that cannot be leaned on in the same way right now.
“When we’re talking about RSV and flu, they affect adults, but it’s a lot more worry about kids,” Dr. Coleman Cutchins said during the ECHO. “What’s happening right now in Alaska and throughout the Lower 48, pediatric hospitalization rates are very high right now and many hospitals are being forced to divert because they just don’t have enough beds. So we all need to do our part to help decrease the risk of transmission of these various respiratory viruses throughout our communities, especially to our vulnerable children.”
Dr. Lisa Rabinowitz said during the ECHO that vaccines are the first and best way to combat the viruses.
“We are here, we’re in respiratory season, and it’s pretty striking how — RSV and influenza — they’ve started earlier than many past years,” she said. “Winterize and immunize, it’s not too late to get your flu vaccine and get your updated bivalent COVID booster.”
For COVID-19 and influenza, vaccines are widely available in Alaska. Both vaccines can be administered at the same time.
The updated bivalent COVID-19 booster is available to anyone aged 5 years or older, at least two months after their last shot, whether that was a primary vaccine series or one of the previous booster doses. The bivalent vaccine targets both the original COVID-19 strain and two omicron variants, BA.4 and BA.5.
McLaughlin said that BA.5 and BA.4 remain the most prevalent variants of COVID-19 in Alaska. Both of those variants are directly targeted by the new bivalent COVID-19 booster available around the state. He said that, nationwide, three new COVID variants are being observed, with one new variant, BA 2.75, beginning to appear in Alaska. BA 2.75 was first identified in the United States late September.
Current guidance, McLaughlin said during the ECHO, is that anyone with symptoms should be tested, and should say home. Those who test positive should isolate for at least five days, and should wear a mask around others for five days after leaving isolation.
With at-home tests, officials on the ECHO said the fear is that patients may see a false negative. They said that each of the at-home kits include two tests, which both can be used. If one comes back negative, wait 24 hours then use the second. If that’s negative, but symptoms are persisting, try a molecular test at a testing site.
“A positive on any of these tests out rules a negative on any of the other ones almost all of the time,” Cutchins said.
Influenza cases nationwide are much higher much earlier than they usually are, McLaughlin said. That pattern is also being observed in Alaska.
Influenza and RSV are being watched especially closely because they target children, officials on the ECHO said. For influenza, McLaughlin said children from 0 to 6 months of age are at highest risk for hospitalization.
The influenza strain being observed in Alaska and the U.S. is H3N2, McLaughlin said.
“Typically, when we have H3N2 strains circulating, those are often associated with slightly more virulent forms of influenza or illness,” he said. “You tend to see higher hospitalization rates and higher fatality rates.”
Those sick with the flu should consider treatment, McLaughlin said. Especially those at increased risk of serious illness, adults who are at risk for flu complications, the elderly and those with underlying medical conditions. Antiviral drugs are available, but work best if started early.
“If you’re in a higher risk group, and you do have flu-like symptoms, it is important to go ahead and get tested as soon as possible,” he said. “If you’re eligible, go ahead and get started on those antiviral medications.”
The influenza vaccine being distributed in the state is quadrivalent, meaning it protects against four strains of the flu, Dr. Louisa Castrodale said. For that reason, even those who have already contracted the flu are still encouraged to get the vaccine, as it can still provide protection against other active strains that may become more prevalent in the spring.
Most people who get infected with RSV, McLaughlin said, will have mild illness and recover. The people at highest risk are young children, infants and the elderly. According to the Centers for Disease Control and Prevention, RSV largely manifests with flu or cold-like symptoms, including fever, runny nose, coughing, sneezing and loss of appetite. McLaughlin said complications can impact the lungs, worsening chronic health problems in infants with chronic lung disease or congenital heart disease.
There isn’t a vaccine for RSV yet, but McLaughlin said there are some in development that they hope will be available for adults next year.
For now, traditional mitigation strategies should be leaned on including covering coughs and sneezes, avoiding touching faces, avoiding contact with people who are sick, washing hands and disinfecting surfaces.
“RSV is really transmitted through those larger respiratory droplets as well as through touching contaminated objects,” he said.
“We have tools to fight these respiratory viruses. We know that masking and hand-washing and good ventilation, staying home when you’re sick, those all work. We’ve got safe and effective vaccines for flu and COVID. These are important tools that play into our whole community and hospital capacity,” Rabinowitz said. “It’s in all of our best interest to keep our hospitals functioning and able to take care of the sickest of us.”
Information about vaccines and their availability can be found at vaccines.gov.
Reach reporter Jake Dye at firstname.lastname@example.org.