Influenza cases are surging early across the U.S., as are other respiratory viruses, causing concern that the combined effects of a potential COVID-19 wave this fall could overwhelm health systems in what some have dubbed a "tripledemic."
Data released Friday from the U.S. Centers for Disease Control and Prevention showed the nation's cumulative hospitalization rate for flu at this point in the season at its highest level in 13 years. The agency said the Southeast region is one of two regions reporting the highest levels of flu activity in the U.S.
The first influenza-associated pediatric death of the season was also reported last week, althougth the CDC did not release any details.
Meanwhile, many children's hospitals in parts of the nation are grappling with an influx of young patients with respiratory syncytial virus, a common respiratory virus that can cause severe breathing problems for babies. High patient volumes combined with labor shortages have left hospitals in some areas of the country without any available beds.
Prior to the pandemic, the respiratory virus typically circulated during the winter, but cases dropped dramatically in 2020 due to COVID-19 mitigation measures. The virus then came roaring back in summer 2021 once children returned to more pre-pandemic activities.
Dr. Charles Woods, a pediatric infectious disease specialist and CEO of Children's Hospital at Erlanger, said in a phone interview that the Chattanooga region is experiencing another early surge of the respiratory virus this year. In 2021, the virus hit in July and August, while this year cases peaked between August and September, he said.
"We may keep a bit of RSV for another four to six weeks, but we think we've seen our surge here already," Woods said, meaning it's unlikely the virus will cause a "tripledemic" scenario. "But there are places where it's surging, and maybe some of the other viruses are popping up, as well. There are a good number of children's hospitals where the beds are full."
While the worst of the respiratory virus has likely passed for this season in Chattanooga, Woods said the children's hospital is starting to treat more influenza patients.
"So our concern is that we will see a flu epidemic," he said. "I don't know if it'll be a 'twindemic' here, because by the time flu really gets going in another few weeks, RSV may be dwindling."
Last year, Woods said, flu began ramping up in December, and hospital officials were concerned about managing flu patients alongside COVID-19.
"After the holiday break happened, I thought the flu was going to storm back. But then omicron came in as this massive wave, and it was like influenza disappeared," he said, adding that researchers are still trying to determine what role omicron might have played in minimizing the flu. "Whatever happened, we didn't see the twindemic."
Right now, Woods said data suggests this flu season will be significant.
"We've got a lot of people who haven't had flu infections for at least the last two years," he said. "So our general population immunity to the circulating virus strains is going to be less, just because we didn't have as much natural exposure. And most people, lots of people actually, don't get the vaccines."
Dr. Stephen Miller, health officer for the Hamilton County Health Department, said in a phone interview that the good news is that COVID-19 -- particularly hospitalizations -- is right now near the lowest level seen throughout the pandemic.
"People in the community are still contracting COVID, but since it's (mostly the BA.5 omicron variant), the symptoms are much milder," he said. "We're not seeing so many of the young and old in the hospital as we did before, so that gives me some heart going into the fall and winter season."
Like Woods, Miller is eyeing flu on the horizon while continuing to monitor new COVID-19 variants.
Although flu cases are rising, Miller said it's too early to say if this will be the worst flu season in recent history for the Chattanooga region.
"The only way we can really combat this is to -- once again -- hand washing, masking when appropriate and get our vaccinations up to date," he said.
While COVID-19 is capable of causing serious illness and death in children, Woods said it has yet to have the same effect on children as adults. But a bad flu season could be what pushes Chattanooga's only children's hospital to the brink.
"Historically, RSV and influenza have put more children in the hospital, overall," he said. "When you've not had children getting infected every year, you have a higher level of susceptibility for a season or two of the flu or RSV -- more children get sick enough to be hospitalized -- and that puts pressure on bed capacity."