St. Louis under siege

Sam, a 65-year-old city resident, had a sneaky feeling he should have passed on Thanksgiving dinner at his daughter’s house.

He said he was feeling “draggy” that morning and afternoon. He went to his daughter’s but had to leave early. That evening and the next seven days he said he took a “walloping” from “something.” He thought he might have had the flu but the symptoms didn’t seem to fit.  

Unlike Sam, Anna, 51, of Black Jack, MO got sick before the holiday. For about two weeks, she said she was “full of mucus, coughing and congested” but had no temperature or fever. She was never diagnosed but a nurse friend told her she most likely had the respiratory syncytial virus or RSV.

St. Louis County resident Janice, 40, started feeling flu-like symptoms the day after Thanksgiving. At first, she relied on over-the-counter medications but eventually went to a doctor because they weren’t working. She tested negative for Covid and the flu but while there she received her vaccines and a booster for both illnesses. Janice is still not certain what she had exactly.

The names of these individuals have been changed but there’s a familiar strain in their stories. All were sick during the month of November, and none are exactly sure what winter illness they had.

For months now health experts have warned of a potential “tripledemic,”an unscientific term that refers to an alarming rise inRSV,flu, and COVID-19 cases. December through March is usually the peak flu activity season but this year, across the country, influenza numbers are peaking early.

The City of St. Louis’ Department of Health just issued a Health Advisory to provide the status of winter respiratory viruses in the City. As of Dec 6, there have been 1,269 reports of Influenza (A) and 46 reports of Influenza (B) with a total of 1,315 influenza reports.

Influenza (A) accounted for 97% of total influenza reports while Influenza B accounted for 3%, according to the report. Of note was 600 new reported cases between November 20 and 26. 

The most concerning increase, according to the city report, was with older populations. New influenza cases for the 50-64 age group increased by 184% and the number of new cases in the 65 plus age group increased by 625% in the past two weeks.

As of Nov. 27, there were 1,779 cases of influenza A and 15 cases of influenza B in St. Louis County. Influenza A accounted for 99.2% of all influenza cases.  Overall, according to the St. Louis County Department of Public Health, influenza (A) has accounted for 98.2% of influenza cases for the 2022-2023 influenza season.

Last week, St. Louis Children’s Hospital reported that Flu and RSV cases have spiked exponentially in the last two weeks with a 300 percent jump in RSV and other respiratory illnesses from the same time last year.

Local experts aren’t surprised by the rising numbers.

“We’re not at a crisis level…yet” said Dr. Kanika Cunningham, St. Louis County’s newly appointed Public Health Officer. Cunningham is also a part-time physician with Family Care Health Center clinics.

“It’s concerning that we’re seeing more cases of influenza compared to this time last year,” Cunningham continued, adding: “And there are multiple reasons that explain this. There’s been a decrease in vaccination rates, we’re down from previous years. Other factors going on as well is that COVID pandemic fatigue has really set in. People are re-socializing; many are tired of isolating so, trying to get people to wear masks now as opposed to last year is a little different. Again, there are multiple factors in play compared to previous seasons.”

The White House and public health officials warned that the country will likely face another wave of COVID-19 infections as the weather gets colder and people travel and gather for the holidays. Yet, COVID-19 booster shot uptake remained low before Thanksgiving.

Dr. Rochelle Walensky, director of the Centers for Disease and Prevention (CDC), also noted alarming rates of flu vaccine fatigue or inaction. She recently cited a survey conducted by the National Foundation for Infectious Diseases that found that less than half of US citizens planned to get a flu shot this season even though seven in ten (70%) admitted knowing “it's the best way to protect against the flu.”

The CDc recently announced a growing number of US states (33) are experiencing “high” or “very high” respiratory virus activity with seasonal flu activity “elevating across the country.” In the week ending November 19, nearly 1 in 10 deaths nationwide (9.4%) was due to pneumonia, influenza or COVID-19- “well above the seasonal baseline of about 6%,” the agency noted. Additionally, the CDC estimates that there have been at least 6.2 million illnesses, 53,000 hospitalizations and 2,900 deaths from influenza this season.

Another “tripledemic” concern is that the flu and COVID-19 share very similar symptoms which makes it hard to tell which of the two one might have. Although onesymptom that seems unique to COVID is loss of taste or smell, both viruses can cause fevers, chills, headaches, cough, muscle soreness, fatigue, vomiting and shortness of breath.

RSV can infect anyone but is most dangerous in infants and the elderly. Symptoms are more similar to the common cold and tend to run their course with only mild intensity in adults and older children. However, with infants and the elderly, symptoms can be more severe, can include fevers and wheezing and may require hospitalization.

While RSV has hit children hard across the country, Dr. Cunningham said St. County is seeing a decrease in cases. “The rate of RSV cases is decreasing right now-which is a good thing-but the other two; influenza and COVID, those rates are going up.”

The best defense for all three illnesses are vaccinations, Cunningham stressed.

“There are respiratory navel swabs, rapid tests to detect whether it’s COVID-19 or influenza or RSV or other types of Rhinoviruses. The best remedy is to get tested.”

Sylvester Brown Jr. is The St. Louis American’s inaugural Deaconess Fellow.