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As respiratory virus season hits Virginia, physicians offer advice

Matt Rourke
The Associated Press File
A health worker administers a dose of COVID-19 vaccine during a vaccination clinic in Reading, Pa.

RSV is at a multiyear high in Virginia, and COVID-19 and flu infections are increasing.

Cases of Respiratory Syncytial Virus Infection are at a multiyear high in Virginia this season. And both COVID-19 and flu cases are increasing, though at a more moderate pace, according to Virginia Department of Health data.

Some regions have been harder hit than others. Southwest Virginia has often had COVID rates more than double other parts of the commonwealth. Parts of Southside, West Central and Eastern Virginia, the Shenandoah Valley and Hampton Roads also have higher rates.

Region-level data from the state health department shows flu rates are moderate in Northern Virginia and low in the rest of the commonwealth, though they have increased in recent weeks.

Virginia Department of Health
Visualization of rates of COVID-19 infections in Virginia by county over the last 13 weeks.

Dr. David Chernoff has seen that rise in the Shenandoah Valley. He’s a physician and the regional medical director at Carilion Clinic’s family medicine practice in Staunton.

Chernoff said that while COVID this season is not as bad as in previous years, he’s fielding an increasing number of patients with respiratory viruses.

“We're seeing an uptick in all the respiratory viruses,” he said. “So far, it's been COVID that I've seen the most of because that got an earlier start. [But we] are starting to see an increase in influenza now as well.“

He also cautions that it’s early in the respiratory virus season and there could be outbreaks of flu, RSV and others.

“Right now, it really hasn't spiked yet. But that certainly can change over the next couple of weeks to couple of months,” he said. “Likewise, RSV, I don't think we've had a huge spike of it right now. But it's still early in the season.”

Neither county- nor region-level data on RSV cases are available in Virginia. But case numbers in the commonwealth as a whole have sharply risen in the last three months. RSV cases are the highest they’ve been in the two years the CDC has publically available data for. This coincides with a large spike in rates around the country.

While data shows respiratory virus cases have been increasing, numbers for COVID may be even higher than reported in official counts. This is because of the world’s increasing reliance on at-home tests, which are generally not reported to health agencies. For flu, a similar undercount could come from people simply not reporting illnesses because they see it as routine.

Cases of respiratory viruses also jump each year as people around the U.S. gather for the holidays, said Dr. Jennifer Derby.

She’s a primary care physician at Sentara Health’s rural Timber Way clinic, located about 20 minutes north of Harrisonburg.

Derby listed nearly 10 viruses she’s seen so far this season: “All of those things kind of go together with the changes in weather, increased susceptibility, close-knit gatherings. All of those things helped us spread those viruses if we don't use good sanitation and precautions.”

Focus on prevention

For both Derby and Chernoff, these seasonal spikes highlight the importance of working to prevent the spread of viruses. Things like wearing a mask and regular hand-washing can lower the odds of catching and passing along the viruses, they said.

“The number one most important thing is good handwashing,” said Chernoff. “Because many of our viruses are spread, at least in part, through contact: We sneeze, we cough, we get virus on our hands, we rub our nose, whatever. And we can then spread it easily to other persons unless we wash that virus off our hands.”

But not all hand-washing is equally effective. Derby said hand-washes should be at least 20 seconds.

“Remember to say your ABCs or something along those lines while you're washing your hands under warm water with soap or using an alcohol-based hand sanitizer,” she said.

Derby also recommended wearing masks, especially in high-risk settings.

“When you're in areas that have lots of COVID, particularly things like nursing homes or clinics where other people are sick, make sure to wear a mask,” she said. “Cover your sneeze and your cough, things like that.”

The benefits of wearing a mask are not abstract, according to Chernoff.

“I spend all day wearing an N95 mask,” he said. “I've had patients who have sat in the room with me who have COVID, and I have not gotten ill so far after three and a half years.”

On top of strategies to reduce exposure, both doctors point to vaccines as an essential tool in fighting respiratory viruses.

Research consistently shows vaccines remain a safe and effective way to both lower the odds of catching many viruses and to reduce the severity of an illness. They also lower the risk of complications like long-COVID, a condition where symptoms like chronic pain, fatigue and brain fog occur after an infection.

The doctors also both individually mentioned new RSV vaccines for people older than 60, babies and people who are vulnerable to serious illness due to being immunocompromised or living with disabilities.

While adding COVID and RSV vaccines to the yearly flu shot and the vaccines children need to attend public school can feel like a lot to some people, Derby said there’s a simple solution: getting multiple shots at once.

“The first thing that I'm going to tell you is, ‘When you get your vaccines, if you get one vaccine, or if you get three vaccines, it is not going to make a difference in terms of the amount of pain that you feel,’” Derby said.

“Lots of pharmacies are offering, right now, both influenza and COVID together,” she continued. “And they’ll give you other vaccines if you meet criteria for them. So, make sure to ask about that.”

While these new boosters are effective, research shows efficacy decreases over time.

“I think that the take-home is that you need to know that what worked for you three years ago is not going to work for you as much today,” said Derby. “Although, it's better that you got any vaccination at all.”

Beyond the benefits for the person who gets the shot, both doctors stressed the importance of getting vaccinated for the people the recipient is around.

“It breaks my heart when somebody says, ‘I don't get the flu so I'm not going to get my flu shot,’” said Derby. “Because you may not feel symptoms but you might be a carrier, and you are at higher risk if you do not get that shot of transmitting [the flu] to other people that might be susceptible to it.”

“You may be somebody who doesn't get terribly sick, but you bring it home to your wife, and she may get horribly sick,” said Chernoff. “So we have to look out for the other people in our family and our communities.”

Where to get vaccinated

Find where to get vaccinations on the U.S. vaccine website:

Most pharmacies offer vaccinations against COVID and flu, as well as many other viruses. Both private insurance and public insurance — like Medicare and Medicaid — allow most people to get many vaccinations free of charge.

The nearly half-million non-elderly adult Virginians who are uninsured can call their local health department with questions on how to enroll in free, public health insurance coverage or how to find free or low-cost vaccination options.

Henry Brannan covers rural health care in the Shenandoah Valley and Charlottesville area for VPM News and WMRA. The position is in partnership with Report for America.
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