If you feel like everyone around you is sick right now, you’re not alone.
A number of contagious respiratory illnesses are increasingly spreading across North Texas. Pediatric hospitals especially continue to struggle with RSV, or respiratory syncytial virus.
But the exact breakdown of what viruses are making North Texans miserable is hard to track. The signs of flu, COVID-19 and RSV are similar and since many people are never tested for what is making them ill, it’s difficult to get a full picture of what’s out there.
Besides, virus test results rarely change how doctors treat sick patients.
There is no cure for RSV, the flu or COVID-19, and most infections go away on their own. If an infection is caught early enough, doctors can prescribe antivirals for the flu and COVID-19 that can lessen the length and severity of an infection, although they won’t get rid of the infection.
Tests for the viruses provide epidemiologists with some sense of the rate at which each illness is circulating, but the results don’t paint a perfect picture of the viral landscape. At-home COVID-19 test results are rarely reported and RSV tests are in short supply.
“There are tests that can be done, but you’d have to go to the doctor to have it done, and really what difference does it make?” said Catherine Troisi, an infectious disease epidemiologist with UTHealth Houston School of Public Health.
“In terms of public health, we want to know what’s out there, but to you and me, all we know is we don’t feel well and we are pretty sure that we will get better soon,” she said.
Here’s a look at some of the viruses spreading right now:
The latest on the flu
Dallas County Health and Human Services reported 908 positive flu tests in the week ending Nov. 5, more than double the 414 positive flu tests from the week ending Oct. 29. Tests positive for RSV, or respiratory syncytial virus, also increased slightly between Oct. 29 and Nov. 12 in the North Texas region, according to Texas Department of State Health Services data.
Texas health care providers are not required to report RSV test results to the state, so statewide RSV data is incomplete and used only to measure trends in RSV activity, DSHS press officer Douglas Loveday said.
The primary strain spreading in North Texas this season is Influenza A, known as H3N2. The strain is associated with more severe illness in the elderly and young children, CNBC reported.
Public health experts expect these viral trends will continue in coming months as people travel and gather with friends and family for the holidays.
Troisi said public health measures used during the height of the COVID-19 pandemic can make a difference in preventing the spread of the flu, which can cause problems for people who have compromised immune systems.
“We know that masks work because we weren’t seeing flu and RSV at the beginning and middle of the pandemic when people were wearing masks,” she said.
Serious RSV problem
RSV often makes headlines for how it infects babies whose immune systems haven’t been exposed to the virus. That’s certainly true of the last few months: Children have been particularly hard-hit by RSV as they experience their first fall without COVID-19-induced public health measures like masking and social distancing.
About 96% of inpatient beds at pediatric hospitals in North Texas are full, said Steve Love, president and CEO of the Dallas-Fort Worth Hospital Council. The region is tracking and updating the number of available pediatric beds every four hours so that hospitals are aware of which other facilities have openings.
Cook Children’s pediatric hospital in Fort Worth, which activated internal disaster procedures due to high patient volumes in early November, is reserving tests for its sickest and youngest patients.
There have been no publicly reported deaths from RSV in North Texas this season. Parkland Health and Cook Children’s said they have not had any deaths from the virus. Children’s Health did not immediately respond to a request for RSV data on Thursday.
Most people over the age of 2 won’t need to be hospitalized with an RSV infection. Still, the virus can keep older children and adults bedridden for days with unpleasant, flu-like symptoms, including cough, runny nose, fever and body aches.
“Adults might not get this severity from RSV as they might when they’re young, but folks with respiratory problems like asthma and COPD can get pretty sick from the virus,” said Dr. Gilberto Salazar, an emergency physician at Parkland Health and associate professor of emergency medicine at UT Southwestern Medical Center.
A break from COVID?
For the first time in more than two years, COVID-19 may pose less of a threat of overwhelming hospitals than other respiratory viruses. A handful of omicron subvariants – each highly contagious but less severe than other COVID-19 variants – are vying for dominance in Texas, according to DSHS data.
Unlike with earlier strains, the current circulating COVID-19 subvariants are far less deadly for people who have some form of immunity, either from previous infections, vaccinations, or both. The virus can still cause severe illness for people who are immunocompromised or unvaccinated.
North Texas hospitals reported 250 COVID-19 patients on Thursday, a far cry from the more-than 4,000 COVID patients hospitalized in the region at the peak of the omicron outbreak last January. COVID-19 hospitalizations still outpace those from the flu in North Texas, but flu hospitalizations are increasing, Love said.
Though it’s promising that fewer people are being hospitalized with COVID-19, that doesn’t mean this is the end of the coronavirus, said Troisi.
“The problem with a lot of people getting infected, even if they’re not being hospitalized or dying, is that that means the virus is replicating and can be making new variants,” she said. “There’s no guarantee that a new variant that does cause more infection or is better at evading the immune system could not arise.”
Vaccines continue to be the most effective protection against severe illness from the flu or COVID-19, said Salazar.
Anyone 6 months and older can receive the flu shot and the initial COVID-19 vaccine series. The new bivalent booster dose, which protects against both the original and omicron COVID-19 strains, is available for anyone 5 and older who received their previous COVID-19 dose at least two months prior.
There is no RSV vaccination, although scientists are working to develop one.
“If you want to travel and be with family and do it safely, I would say that avoiding going to get togethers where people are sick and having your vaccinations are going to be the two biggest components,” Salazar said.