Utah flu season could be worst in a while as hospitalizations surge early

Flu season started early this year, adding stress to health care workers already busy with unprecedented RSV cases and the ongoing coronavirus pandemic.

(Mark J. Terrill | AP) A patient is given a flu vaccine on Friday, Oct. 28, 2022, in Lynwood, Calif. Flu season started early this year, adding stress to health care workers already busy with unprecedented RSV cases and the ongoing coronavirus pandemic.

This year’s flu season is on course to be one of the worst in recent memory, sending more Utahns — mostly children and those over 65 — to hospitals and doctors’ offices than the state has seen in the last five seasons, according to state data released last week.

This uptick comes after flu cases decreased dramatically in the first years of the coronavirus pandemic, and Utah isn’t alone — the Centers for Disease Control and Prevention has reported similar trends across the country.

Lynette Brammer, who leads the CDC’s domestic influenza surveillance team, said during a Nov. 21 briefing that at that point in the season, there was a high number of flu cases and more hospitalizations than health care workers had seen in a decade.

The virus is “back with a vengeance” this season in part because so few people were infected in recent seasons, said Dr. Andrew Pavia, a pediatric infectious diseases expert with University of Utah Health and Intermountain Primary Children’s Hospital, during a Nov. 28 media briefing.

So far, however, it seems Utah hospital systems have not been overwhelmed with the earlier-than-normal surge, said Jill Victory, vice president of the Utah Hospital Association. She said Wednesday that Primary Children’s remains the only hospital struggling with patient capacity, with most patients sick from respiratory illnesses. RSV is the currently the main cause, but flu and lesser known viruses like adenovirus are also a problem, according to Intermountain Healthcare’s GermWatch dashboard.

Pediatric hospitals are often “at the mercy of” such respiratory viruses, said Dr. Per Gesteland, a pediatric hospitalist for University of Utah Health and Primary Children’s. And this year’s RSV surge is particularly bad.

“If you tack influenza on top of that, especially if you stack them like they are right now,” he said, “those are the outbreaks that really can stress and put together a big surge on our facility.”

Flu season is only just beginning, he noted, with cases typically taking off over the Christmas and New Year’s holidays.

“We have a lot more work to do, and I think the holiday gatherings are only going to extend or enhance that surge,” Gesteland said.

Utah’s flu season so far

Flu hospitalizations in Utah began increasing rapidly in November, about a month before normal, according to the Utah Department of Health and Human Services flu report. The influenza-like illness rate also showed a similar early jump.

As of Dec. 3, Utah has reported 347 flu-related hospitalizations this season. The dashboard also shows that 4.5% of all people seeking out-patient doctor visits had flu-like symptoms, like fever, cough and sore throat. This time last year, that number was 2.6%.

Health officials currently categorize the state’s flu severity as “moderate,” based on those metrics.

(Christopher Cherrington | The Salt Lake Tribune)

The dashboard states that children ages 0-4 and adults over 65 are currently seeing the highest hospitalizations rates. These age groups also are the most at-risk for infection and severe illness.

Health officials recommend getting the flu vaccine to reduce that risk.

“In order to reduce the risk of infection and severe illness, it is important to get your flu vaccine as soon as possible. It is not too late to get vaccinated,” health officials state on the dashboard.

Health department spokesperson Charla Haley said children’s flu vaccines were slow to arrive to providers taking part in the state’s Vaccines for Children Program this year, like public health departments, but said “that isn’t an issue now.”

To schedule a flu vaccine appointment, state health officials recommended contacting your healthcare provider or local health department or searching at vaccines.gov/find-vaccines.

Here is what else you need to know about this year’s flu season:

How many Utahns have died from the flu?

No Utah children have died from the flu so far this year, but it’s harder to know how many adults may have died, Harley said Wednesday, adding that health officials plan to track adult flu mortality “soon.”

Harley said it is always been difficult to determine if someone died from the flu, because death certificates often don’t list flu as the cause of death for people who die with flu-like symptoms. Some also die weeks after they were infected because of other illnesses brought on or exacerbated by the flu. Many who die from the flu are not tested for it.

State health officials once used a method that tracked influenza and pneumonia deaths and compared them to a seasonal baseline to show unusual increases that could indicate a certain virus outbreak was causing more deaths, according to department of health epidemiologist Janell Delgadillo. The coronavirus pandemic complicated that system, however, since COVID-19 now causes the most pneumonia deaths.

Another method the state is considering tracks influenza, pneumonia and coronavirus deaths — then compares those deaths to a baseline instead. The CDC uses this method.

As of Dec. 3, the CDC reported 14 children across the country have died from the flu so far this year. Nationally, the agency estimates there have been 8.7 million cases, 78,000 hospitalizations and 4,500 deaths.

‘Triple-demic’ of flu, RSV and coronavirus

Pavia and Dr. Russell Vinik, chief medical operations officer at University of Utah Health, warned Utahns in October of a “triple-demic” of COVID-19, flu and RSV spreading this winter and potentially overloading the state’s hospital systems.

Primary Children’s Hospital announced at the end of November that it was delaying some pre-scheduled surgeries and inpatient procedures because of the RSV outbreak.

During a Nov. 28 briefing on that announcement, Pavia urged Utahns to get a flu shot to protect themselves and children. He said some hospitalized children are sick with more than one virus.

“You might not mind toughing out a case of flu, but our kids really would appreciate your not getting it and passing it on to them,” he said. “So get your flu shot, get up to date on your COVID vaccination with your boosters — if not for yourself, then do it for our community.”

CDC director Rochelle Walensky said in a Nov. 21 briefing that “troubling early data show that not enough people have received their flu vaccine this year” and encouraged everyone age 6 months and older to get the vaccine.

Despite high infection rates, this year’s flu vaccine is “well-matched” against this year’s virus strains, Brammer, also with the CDC, said.

Outside of vaccines, Gesteland said people should wash their hands and cover their nose and mouth when sneezing and coughing to avoid spreading these viruses. Masking also helps, he said.