The 2023 viral season has begun, and with that, the viral-to-viral impact has affected transmissibility and the viral pattern. We are starting to learn more about the new viral seasonal winter pattern which runs from October to April.

Nationally, there is a slightly different pattern, however, in Arizona, last year RSV peaked in mid- to late-November, influenza peaked in late November, and COVID-19 lasted from late November through January. The following information can help you educate your patients throughout our respiratory season.

Coronavirus-19 (Covid)

The newest covid variant BA2.86 is less transmissible than XBB. We do know that Paxlovid works and Antigen testing is effective. Monoclonal antibodies do not work on this variant, nor XBB. Vaccinations are the best form of protection from severe illness. From August to September, there has only been an 8% increase in hospitalizations which are delayed from initial emergency department/urgent care diagnosis. Deaths from July to September have increased by approximately 5%. These represent low numbers in Arizona and throughout the country indicating we are early in the COVID-19 season. We will monitor closely and adjust surge plans as appropriate.

In June 2023, FDA advisors recommended an update to the COVID-19 vaccine to reflect omicron subvariant XBB.1.5. Clinical trial data shows robust immune response to currently circulating variants including EG.5 and FL1.5.1. Vaccination is recommended by the CDC/ACIP for everyone 6 months and older. This is a single dose mRNA vaccine and can be taken at least two months from prior dose. Last season, those who received a vaccine saw greater protection against illness and hospitalization than those who did not receive the vaccine. COVID-19 vaccines can be co-administered with any other vaccine, and you may mix and match Moderna and Pfizer-BioNTech products.

Respiratory Syncytial Virus (RSV)

RSV is one of the most common respiratory infections to cause hospitalization of infants. Seven out of 10 children will be infected by 1 year of life and almost all will be infected by 2 years of age. Ages 6 weeks to 6 months are most likely to be hospitalized. Each year, 100 to 300 children die from RSV and complications of RSV.

Additionally, annually in the U.S., 60,000 to 160,000 adults over age 65 are hospitalized and 6,000 to10,000 die from RSV. Most RSV deaths are 65 years or older and the most severely impacted patients have chronic medical conditions.

Vaccines are recommended for those less than 8 months of age and 60 years and older. The infant vaccine is a long-acting monoclonal AB vaccine. A single dose per season and has reduced the risk of hospitalization by 80%. The corresponding adult vaccine is a subunit vaccine, single dose. This vaccine is 83-89% effective at preventing lower respiratory infections.

Influenza

Influenza viruses are constantly changing referred to as “antigenic drift.” Influenza can also undergo an abrupt, major change referred to as “antigenic shift.” Surveillance of viruses can detect these changes and inform the public health response. This results in a new vaccine annually. The CDC estimates that flu has resulted in nine to 41 million illnesses, 140,000 to 710,000 hospitalizations, and 12,000 to 52,000 deaths annually between 2010 and 2020. Those who are younger than 6 months, greater than 65, pregnant and who have chronic medical conditions are at the highest risk from influenza. The influenza vaccine is recommended for anyone 6 months and older.

In addition to vaccination, frequent handwashing and masking are barriers to infection with respiratory viruses.

Surge plan

HonorHealth has a surge plan as we enter the respiratory virus season. This includes monitoring the viral activity for COVID-19 and influenza as well as monitoring team member illness, resource and bed availability.

As we increase in activity, appropriate changes in visitor restrictions, patient screening, masking and contact tracing will be implemented. HonorHealth will ensure the safety of patients, Medical Staff and employed team members. Please help us by maintaining excellent hand hygiene, and reach out to your chiefs with any questions or concerns.