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COVID-19 and the flu aren’t the only respiratory viruses of concern this year

A sign at the entrance to the Children's Pavilion of VCU Medical Center
Crixell Matthews
About 95% of beds at the Children's Hospital of Richmond are full due to an influx of influenza, parainfluenza viruses and RSV. (File photo: Crixell Matthews/VPM News)

COVID-19 and the flu aren’t the only respiratory viruses on the loose this fall. RSV, respiratory syncytial virus, has been on the rise across Virginia in recent months — causing a surge in emergency room visits for young kids. The confluence of these viruses has some experts calling it a “tripledemic.”

“When we think about what we've been seeing most recently, we're talking about really young babies in the hospital for RSV infections,” said Elena Diskin, epidemiology program manager for the respiratory disease program with the Virginia Department of Health.

Premature babies and those only a few months old are at the highest risk of severe illness, she said, with the majority of RSV hospitalizations occurring in those 4 years of age or younger. People who are immunocompromised are also at a higher risk for serious RSV infections.

Dr. Shari Barkin, chief physician at the Children’s Hospital of Richmond at VCU, said parents should keep an eye on their children for signs of serious RSV, including difficulty breathing and discoloration around the lips.

“If you see that they're breathing a lot harder than usual — and that they're really tired because of that — or if there's any color change around their lips … so it looks blue, dusky blue, or purple … that's when we want to make sure that we see you,” Barkin said.

At the Children’s Hospital of Richmond, Barkin said RSV cases are going down a bit. But combined with rising cases of the flu and parainfluenza viruses, the hospital is at 95% capacity.

“The wait time can sometimes be four or more hours,” Barkin said. “The combination of having things like RSV and the flu that are affecting vulnerable children results in us seeing a higher volume and higher complexity for those kids when they're in the hospital.”

RSV cases in Virginia are still elevated, Diskin said, adding it’s possible the virus has reached its peak for the season as emergency visits have started to come down a bit.

“However, the numbers are still really high,” Diskin said. “So, it is definitely something we're still keeping on our radar.”

Charlottesville, Central Virginia and Northern Virginia all recently had surge-level conditions of RSV. The Virginia Hospital and Healthcare Association began asking area hospitals to track the number of available pediatric beds to assess the situation.

While there are some beds available now, there are still “considerably less than where it was prior to the surge,” according to Julian Walker, vice president of communications for the Virginia Healthcare and Hospital Association.

“We are not in quite the same sort of peak conditions as we were several weeks ago,” Walker said. “But that doesn't mean that it's still not an issue that we're monitoring or that it's not an issue that our members are concerned about.”

Diskin urged Virginians to take precautions this holiday season, including staying home when they’re sick and regularly washing their hands. Barkin said she advises parents to avoid crowded places, keep windows open during indoor gatherings or gather outside if possible, and continue masking.

“We know that by wearing masks last year, we reduced RSV by 98%,” Barkin said. “It's an easy thing that's in our toolkit.”

And she urged residents to get updated vaccine shots prior to holiday gatherings to protect themselves against COVID-19 and the flu.

“It doesn't necessarily mean you won't get either [COVID-19 or the flu],” Barkin said. “But it does mean that it decreases the severity such that you can reduce mortality by up to 50% in kids.”

COVID-19 and flu vaccines are available for children 6 months of age and older, while the COVID-19 booster has been approved for children 5 years old and up.  

Vaccines are available around the state, and the Richmond and Henrico Health Districts regularly host walk-up COVID-19 vaccine clinics


Megan Pauly covers education and health care issues in the greater Richmond region.