Respiratory infections rise in county

Published 11:30 pm Thursday, December 8, 2022

Local health officials have sounded the alarm as respiratory infections surge and hospital beds fill up in Clatsop County.

In a statement on Thursday afternoon, Columbia Memorial Hospital, Providence Seaside Hospital and the Clatsop County Public Health Department expressed concern about the demands on the local health care system as cases of influenza, coronavirus and RSV — respiratory syncytial virus — rapidly increase.

RSV is a common childhood illness that often only causes cold symptoms, but can lead to serious complications, specifically in older adults, infants and people with underlying medical conditions.

Judy Geiger, the vice president of patient care services at Columbia Memorial in Astoria, said most of the hospital’s 25 beds are occupied.

“CMH has plans in place in case higher numbers of patients needing hospitalization materialize,” she said.

Providence Seaside did not respond to requests for further information on capacity at the 25-bed hospital.

As temperatures get colder, viruses become more prevalent and people stay indoors more often, leading to higher rates of sickness, the county said.

The statement called on residents for help with mitigating infections, urging people to get flu vaccinations and coronavirus boosters. There is no vaccine for RSV.

The county also suggested that people stay home when sick and distance themselves from others who are sick. Wearing masks in crowded indoor settings away from home was also encouraged, especially for people at increased risk for severe illness.

When a child is sick with mild symptoms, officials advise that parents keep the child at home, use over-the-counter medicine, such as acetaminophen or ibuprofen, to deal with fever and pain and provide fluids to prevent dehydration.

Chris Strear, the chief medical officer at Columbia Memorial, recommended that unless symptoms are severe or quickly getting worse, people should contact a health care provider or pediatrician before going to an emergency room.

The statement in Clatsop County came as respiratory infections are driving patient numbers in hospitals to maximum levels across Oregon.

“Things will get worse before they get better,” said Dr. Dean Sidelinger, the state epidemiologist, who was joined by other medical professionals on a video press call Thursday.

Sidelinger said the trio of illnesses has pushed intensive care hospital bed demand to a level that “never happened during the darkest days” of the COVID-19 pandemic.

Hospitals in the Portland metro area have shifted into crisis standards of care, Oregon Public Broadcasting reported. The hospitals include Providence, Legacy Emanuel, Kaiser Permanente and Oregon Health & Science University.

RSV-related cases in children showed a fivefold increase between Oct. 23 and Nov. 13. It peaked Nov. 19, but remains above rates of any previous peak. Seriously ill children will need long-term care to recover.

Sidelinger said there were no plans for a mandatory mask mandate, but urged people of all ages to wear masks indoors in crowded situations, such as stores or events.

Dr. Wendy Hasson, the medical director of the pediatric intensive care unit of Randall Children’s Hospital at Legacy Emanuel in Portland, said parents of small children should take additional steps, avoiding gatherings where infections can spread.

“Now is not the time to go to indoor places, birthday parties,” she said. “Parents of very young babies (are) empowered to say ‘no’ to visitors.”

Gov. Kate Brown on Wednesday authorized the deployment of volunteer teams to hospitals with staffing emergencies. She also asked for $25 million in state funds to pay for out-of-state nurses and medical staff training in intensive care of respiratory diseases.

The flu season has proven severe as well, with cases doubling week over week for five consecutive weeks. Hospitals are now seeing a 30% positive test result for flu in patients, up from 1% a month ago. Hospitalizations for flu are especially rising among people 65 and older.

“The hospitalization rate in the elderly is up tenfold,” Sidelinger said.

The trajectory for flu is expected to rise as holiday gatherings bring more people together in enclosed spaces where the virus can spread easily.

While COVID-19 has not dominated the health picture as it has in the past two holiday seasons, it is on the rise again. The current omicron subvariant has pushed virus hospitalizations from a daily average of 235 to 347 over the past month, a 48% increase. The number of COVID-19 patients in intensive care units around the state has risen from 27 to 35 over the same period.

The latest weekly death toll was 28, though Sidelinger called mortality a “lagging indicator” and the sheer number of cases could drive that figure up later in the winter months.

“The COVID-19 pandemic is not over,” Sidelinger said.

Respiratory infections have hit children especially hard. Gravely ill children have to be sent to one of three specialized hospitals in the Portland area that have pediatric ICUs.

“We haven’t seen anything like this before, this unprecedented surge of demand for care,” said Dr. Ray Moreno, chief medical officer at Providence St. Vincent Medical Center.

Dr. Matthias Merkel, senior associate chief medical officer at Oregon Health & Science University Hospital, saw the situation on a personal level when he brought his daughter to OHSU’s emergency room on a noncritical matter.

“I had to wait for 12 hours in my own emergency room because ambulance after ambulance arrived with children who needed immediate care,” Merkel said.