Kansas health experts watch for COVID-19, flu and RSV trifecta as holiday season approaches

TOPEKA — Doctors and public health researchers expect a spike in COVID-19 infections during the holiday months to complicate the medical response to the increasing spread of influenza and the complex influenza virus.

The trifecta of COVID-19, influenza, and respiratory syncytial virus, or RSV, could lead to escalating health problems and hospitalizations this winter as precautions such as vaccination, masking and isolation wane in 2022. During the winter of 2021-2022, Kansas experienced a spike in the Delta and Omicron variants of COVID-19.

“We’re just crossing our fingers,” said Dana Hawkinson, director of infection control at the University of Kansas Health System.

Hawkinson said there is a two- to four-week lag between infection and hospitalization for COVID-19 and urged Kansas residents to get vaccinated and boosted to protect themselves from the most dangerous aspects of the virus.

Since COVID-19 hit Kansas in March 2020, the state has documented nearly 900,000 cases. The actual number is believed to be higher as testing for the virus has decreased. Eighteen counties in Kansas have reported more than 10,000 cases of COVID-19, with 171,000 cases in Johnson County and 164,000 cases in Sedgwick County contributing to more than a third of the state total.

The latest report from the Kansas Department of Health and Environment showed that 9,657 deaths in Kansas were linked to COVID-19 during the pandemic. Kansas figures include 2,613 deaths in 2022.

Dana Hawkinson, a physician at the University of Kansas Health System, said the flu season, combined with COVID-19 and a challenging flu virus, can make it difficult for hospitals to keep up with the growing number of patients. (Kansas Reflector screenshot from the KU Health System Facebook channel)

Risks of re-infection

Nathan Bahr, an associate professor of infectious diseases at the University of Kansas Medical Center, said there is reason to be concerned about research findings that show that people who are infected repeatedly with COVID-19 are more susceptible to erosion of organ function. He compared it to someone who repeatedly injured their leg and ended up with a fracture.

“The more times this happens, the greater the risk of losing function,” he said.

Washington University in St. Louis said an analysis of the medical records of 5.4 million Veterans Administration patients suggested that people who contracted COVID-19 more than once were twice as likely to have a heart attack in compared to those who caught the virus once. In addition, the researchers said the risks to kidney, lung and gastrointestinal health were greater among those repeatedly infected.

Amber Schmidtke, department of natural sciences and mathematics at Saint Mary’s University in Leavenworth, said the U.S. Centers for Disease Control and Prevention places Kansas in the second-highest category out of five for flu cases that do not require hospitalization . Flu-like symptoms included in the CDC analysis are fever, cough and sore throat.

The CDC produced a color-coded map that placed Kansas in the “high” tier and Missouri in the “moderate” range for the flu. Flu-like symptoms are highest in the states of South Carolina, Alabama, Tennessee and Virginia.

“The intensity is so high this year, especially in the South, that the CDC had to add a new color to the very high category,” Schmidtke said on the KU Health System broadcast.

She recommended that people get both a flu shot and a COVID-19 booster. However, there is no RSV vaccine available in the United States.

Amber Schmidtke, chair of the department of life sciences at Saint Mary's University in Leavenworth, said the CDC reports that Kansas has a high incidence of flu-like symptoms among non-hospitalized people, while Missouri has a moderate level of fever, cough and sore throat symptoms.  (Kansas Reflector screenshot from the KU Health System Facebook channel)
Amber Schmidtke of Saint Mary’s University in Leavenworth said the CDC reports that Kansas has a high incidence of flu-like symptoms among non-hospitalized people, while Missouri is in the moderate range. (Kansas Reflector screenshot from the KU Health System Facebook channel)

Examination of sewage water

Mark Johnson, a professor of microbiology at the University of Missouri and a researcher in Missouri’s wastewater program tracking the changing nature of COVID-19, said the ability to detect emerging strains of the virus has been refined over the past two years. The holiday season is a good time for the spread and evolution of the virus among people in closed spaces, he said.

“Last year and the year before was just now when we started seeing pedigrees. We started to see the numbers go up,” Johnson said.

He said the influx of Delta and the emergence of Omicron had led to a “tough winter”.

“Fortunately,” Johnson said, “we’re getting a lot of new options, and none of them do what Delta did or what Omicron did. With Delta, it was really amazing because we could see it moving across the state.”

Asked if the heavy rain led to misleading conclusions about the concentration of COVID-19 in sewage samples, Johnson said the decision was to also test for the presence of caffeine. The numbers are comparable to the routine presence of the coffee component, he said.

His research partner in the COVID-19 testing, Chung-Ho Lin of the University of Missouri College of Agriculture, said sanitation is an important resource for assessing community health.

“Effluent never lies,” Lynn said. “Give us 15 milliliters of water and we can tell you a lot of stories.”

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