Doctors are warning of a potential ‘tripledemic’ as influenza and respiratory syncytial virus (RSV) cases surge alongside the continuing COVID pandemic.

Hospitals across the state are seeing more patients and longer wait times – some up to 9 or 10 hours – due mostly to RSV and flu cases.

Children’s of Alabama hospital reported they are at full capacity. Nationwide, an estimated 75% of pediatric hospital beds are full, according to data from the Department of Health and Human Services.

“We’re seeing a pretty steep upward surge in these viruses early on in the season, which does give everybody a little bit of pause that this may be a sort of long winter of a lot of illness,” said Dr. Claudette Poole, associate program director of pediatric infectious diseases with UAB and Children’s of Alabama, during a news conference today.

Doctors at the University of Alabama at Birmingham say that the wave of RSV and influenza is happening earlier than usual and they’re seeing a higher number of cases than in past years. A possible reason, they note, could be a “pandemic immunity gap.”

“If you haven’t been out and about in the last few years, you’ve been masking, you’ve been home…you haven’t been exposed to all the viruses that usually circulate in the winter,” said Dr. Jeanne Marrazzo, director of UAB’s Division of Infectious Diseases.

“So there is a theory that we as a society, as a community, maybe we’re more vulnerable right now, to the usual winter respiratory viruses we see. And that may be even more important for younger people, particularly kids.”

Multiple school districts this week shifted to remote learning for one or two days at a time because of a high number of influenza-related absences.

According to the Alabama Department of Public Health, “influenza-like illnesses are increasing in most parts of the state.” The agency said 15 influenza or influenza-like outbreaks were reported the week of Oct. 10 and rates are well above where they were at this time compared to the last two flu seasons.

While COVID-19 hospitalizations are trending downward, new variants appear to be emerging that are not as responsive to immunity protections.

Marrazo is urging Alabamians to still get vaccinated against COVID and to get boosted to help prevent severe disease.

“Vaccination with the current booster that we have now which is targeted to [Omicron subvariants] likely will help mitigate or help prevent the most severe outcomes of COVID, regardless of what lineages are coming down the line,” said Marrazo.

“I know that I said it might not work as well, but we think there still will be some effect for severe disease. And after all, that’s what we really, really care about.”

RSV, which causes mild cold symptoms but can be serious for young babies and the elderly, does not have a vaccine. The virus also doesn’t develop lasting immunity for those who have gotten it, so it’s possible to get concurrent infections.

Dr. Poole recommends parents keep their newborns away from crowded areas and to ‘cocoon’ them, allowing only a few trusted family members to hold the baby while viruses are circulating.

Schools, which pose a risk for spreading viruses due to the congregate setting, should also make sanitizers and tissues readily available, and parents should keep their kids home if they’re exhibiting symptoms.

Doctors are also encouraging flu vaccinations, which can be received from the ages of 6 months and older. Pregnant women are also advised to receive the shot as it will provide some protection to their babies until they are eligible to get the shot.

Along with the flu shot, which takes about two weeks to provide full protection, the CDC recommends the following preventative measures:

• Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
• Stay home when you are sick.
• Cover your mouth and nose with a tissue when coughing or sneezing.
• Wash your hands often.
• Avoid touching your eyes, nose or mouth.
• Practice other good health habits like cleaning and disinfecting frequently touched surfaces, getting plenty of sleep, being physically active, drinking plenty of fluids and eating nutritious food.