The big three respiratory viruses are rising in California, but are causing fewer hospitalizations than last year

Turkey dinners with family and friends may be in the rearview mirror, but COVID and influenza hospitalizations are both on the rise post-Thanksgiving — though less than at this time last year.

California ended its state of emergency for COVID-19 in February, and just last week the California Department of Public Health quietly replaced the state’s COVID dashboard with a new respiratory virus dashboard that tracks hospital admissions, deaths and test positivity rates for COVID and influenza side-by-side, marking COVID’s gradual evolution to an endemic virus, like the flu.

The new site appeared Friday, released as we embark on our fourth winter respiratory virus season with COVID in the mix.

“COVID is still the main cause of new hospitalizations and deaths nationally … and I think what we see at UCSF is a reflection of that,” said Dr. Peter Chin-Hong, an infectious disease specialist at UC San Francisco.

Chin-Hong said about 20 people currently are hospitalized with COVID at UCSF, compared to about 10 early in November. The number is rising, but still much lower than last winter’s peak, when about 100 COVID patients were hospitalized there, and this year’s summer surge when about 40 patients were hospitalized, he said.

The percentage of emergency room visits to Kaiser Permanente Northern California facilities for Respiratory Syncytial Virus — or RSV — is also on the rise, from under half a percent in early November to nearly 1.5% of all ER visits in the week ending Nov. 25, according to data the HMO reported to the state health department.

The highly contagious respiratory virus usually causes mild, cold-like symptoms that can require a week or two of recovery, but the disease can cause life-threatening pneumonia or swelling of the small airway passages in the lungs of older adults and infants.

At this point last year, flu and RSV activity was already high around the state, while it’s taken longer to reach that point this year, according to state-level data from the Centers for Disease Control and Prevention. Since the first week of October, 22 California residents have died from influenza, and 11 from RSV, including one child. For the same period last year, 36 people had died from influenza and 14 from RSV, including three children. Last year’s virus season saw nearly 300 RSV deaths and 700 flu deaths statewide, a marked increase from the previous year.

According to the state’s new respiratory virus dashboard, hospital admissions for COVID are similar to where they were at this time last year, around 300 daily, while hospital admissions for influenza are a fraction of where they were in late November of last year, just above 50 a day last week, compared to over 300 a day in late 2022.

“The worry is that hospitalizations will continue to go up with COVID, given the relatively low vaccine uptake for COVID specifically,” Chin-Hong said. “Older than 75, and didn’t get a recent shot, that’s the general [type] of the people who continue to come in.”

While there is less illness reported this year, the rates are on the rise and it’s impossible to predict how high they will go. “It’s dicey,” Chin-Hong said. “I’m waiting for this storm, and the storm might not even come … but the clouds look dark, you know?”

The Association of Bay Area Health Officials is urging people to take extra precautions “as levels of circulating respiratory viruses increase and people spend more time indoors for the holiday season,” the health officers said in a news release.

They encouraged everyone 6 months and older to get the annual flu and COVID vaccines and reminded the public about best practices for limiting the spread of winter viruses, such as staying home if sick, frequent hand washing, wearing masks in crowded spaces, getting vaccinated, and improving ventilation in indoor settings.

In the past, there wasn’t much you could do about RSV, but the Food and Drug Administration in May approved the first RSV vaccine for adults age 60 and older, and for pregnant women in the last months of pregnancy, from 32 to 36 weeks.

“COVID-19, flu and RSV immunizations are currently available including the recently announced RSV vaccines for adults 60 years and older, RSV vaccines for pregnant people, and currently limited supplies of RSV immunizations for infants and toddlers,” the CDPH Office of Communications wrote in an email.

“People still have time, and can still do a lot to keep their families and their loved ones safe, by getting these vaccines now, it’s not too late,” said Chin-Hong.