Tompkins Weekly

Respiratory illness cases rise across region as winter nears

County Health Department recommends precautionary measures


At the Tompkins County Health Department Immunization Clinic, Community Health Nurse Jessica Clark Manderville vaccinates someone. Due to an increase in respiratory illnesses in the region, the Health Department is recommending that all who are able get fully vaccinated against COVID-19 and the flu. Photo by Shira Evergreen.

Last month, the Tompkins County Health Department (TCHD) announced that the region has seen a significant increase in cases of respiratory syncytial virus (RSV) and the flu. Due to this rise, local health leaders are recommending that residents take precautionary measures to protect themselves and their loved ones this holiday season.

According to TCHD, RSV “is a highly contagious, common respiratory virus that commonly causes mild cold-like symptoms in older children and adults.” Most people who get RSV recover within a couple of weeks, but for some — especially infants and older adults — it can turn severe. RSV often causes bronchiolitis and pneumonia in children younger than 1.

Symptoms of mild RSV include runny nose, coughing, sneezing, fever, wheezing and decrease in appetite, which are similar to the symptoms of flu and COVID-19. There is no known cure for RSV, and unlike COVID-19 and the flu, there is also no vaccine.

TCHD Medical Director Dr. William Klepack broke down some of the differences between these three respiratory illnesses and told what residents can do to slow their spread.

Klepack said that, compared to COVID-19, it isn’t as easy to document the spread and prevalence of RSV, primarily because “there’s no methodology that would be effective to identify contacts of a person with RSV and then do something preventive to keep other people from becoming sick and, therefore, limit the spread of it.” Still, what data was available from last month showed a national increase.

“We’ve gone from, in late September, having about 5% of people testing positive for RSV to going to 18 to 19% of people positive for it,” Klepack said. “So, that’s a rise about three or four times in the number.”

In the case of influenza, the state’s flu tracker (nyshc.health.ny.gov/web/nyapd/new-york-state-flu-tracker) shows that flu season has started early this year, with just under 11,700 cases as of the week ending Nov. 15, compared to 150 cases at the same time last winter.

While that is already significantly higher than last winter’s peak at just over 9,000 cases (week ending Dec. 18), it’s noticeably lower than the winter of 2019 into 2020, just before the pandemic hit the county (that winter peaked at just over 17,200). Klepack added that in the past, flu seasons that started early also ended early, so health leaders are hopeful that this year’s season will follow the same trend.

An attendee of a Tompkins County Health Department COVID-19 vaccination clinic in late 2021 at the Shops at Ithaca Mall receives their vaccination. Photo by Sheryl Sinkow Photography.

As for how RSV is spread compared to other respiratory illnesses, Klepack said RSV is much closer to the flu than COVID-19.

“Surfaces and hands tend to be much more important spreaders of [RSV and the flu] than they are for COVID,” he said. “Influenza and RSV can be spread by doorknobs, handshakes, keyboards, surfaces that have had the virus put upon them. And so, disinfection is more important for those two diseases. … With coronavirus, we know it’s almost always through the air and usually being within 6 feet of another individual. And with influenza and RSV, yes, through the air is possible also, but surfaces also are a mode of spread.”

There are also significant differences in the diseases’ contagiousness, Klepack said.

“With COVID, you’re contagious for two days or so before you even know you’re sick at all,” he said. “In influenza and RSV, that period is shorter. Certainly by the time you’re symptomatic, by the time you have your fever or your achiness or your cough, you’re contagious with influenza and RSV. And you may be contagious up to about a day before that, so a shorter period of time.”

Klepack said that the average person will be contagious for about a week if they are infected with either RSV or the flu, though it could be longer if someone is immunocompromised. With COVID-19, however, that contagious period lasts at least 10 days in the average person and longer in those with pre-existing health issues.

As for why the nation and region are seeing such substantial increases in RSV, Klepack said it has a lot to do with “having a susceptible population of people,” mainly children.

As he explained, for much of the pandemic, kids weren’t physically attending school nearly as often. So, while it’s relatively common for kids under 3 to get RSV, the move toward social distancing and similar safety measures meant that younger kids weren’t as exposed to RSV as they typically would be.

“Now, we have a large number of kids who have never been infected with RSV, so that the moment you have a person with RSV amongst them, there’s a lot of kids who are susceptible to contracting the virus, which is highly contagious,” he said. “In the last six months, particularly, people have been gathering together more. They’ve been using masks less. Sometimes, they haven’t been very careful about who and what and where they’re gathering. … So, you see the disease pick up again and flourish because of the number of susceptible kids.”

With all this in mind, Klepack said that the average resident “should be reasonably concerned about what you could call the triple threat — influenza, RSV and COVID.”

“We don’t want to get ourselves sick because it’s a miserable thing to do and to have to live through,” he said. “We don’t want to get our loved ones sick because that could be tragic. We don’t want to get our coworkers sick — that won’t be very nice. … And in general, we want to avoid getting our community sick. So, taking appropriate precautions is what is really needed.”

First and foremost, those precautions include getting vaccinated, Klepack said. There are vaccines available for influenza and COVID-19 through personal physicians, pharmacies and TCHD. For more information on TCHD’s vaccine offerings, visit tompkinscountyny.gov/health/immunizations.

Precautionary measures also include staying home if you are or suspect you’re getting sick, frequently washing your hands, wearing a properly fitted mask, disinfecting commonly touched surfaces and having good air circulation. And finally, plan ahead for any family gatherings this December.

“Make prudent judgments about who and where and when you get together with other people, especially now in the holiday times when you’re going to be together with relatives who are elderly and kids under 1 year of age, who are at high risk of getting hospitalized with these things,” Klepack said. “And make prudent judgments about using a mask or being careful, especially before being with those folks, and using your home antigen test to test for COVID before you get together with people who might be at risk, just to make sure you’re OK.”

Jessica Wickham is the managing editor of Tompkins Weekly. Send story ideas to them at editorial@VizellaMedia.com.

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