This 1981 transmission electron micrograph (TEM) depicts the liberated, chain-like, ribonucleic acid (RNA) genome of the respiratory syncytial virus (RSV) pathogen. RSV is a negative-sense, enveloped RNA virus. The virion is variable in shape and size, with a diameter ranging between 120 and 300 nm, and is unstable in the environment surviving only a few hours on environmental surfaces. (Dr. Erskine Palmer/CDC via Bay City News)

Health experts in Sonoma County gave an update on Tuesday about the surge of respiratory illnesses plaguing the county and filling hospital beds.

Influenza and respiratory syncytial virus (RSV) cases are clogging hospitals across the state, especially children’s hospitals, according to the California Department of Public Health.

In Sonoma County the problem is growing, experts said at the community briefing. Add in COVID numbers that are staying about the same and residents face a trifecta of viral pathogens– some of which can infect a person at the same time.

Dr. Gary Green, infectious disease specialist for Sutter Health, provided some sobering information about what he described as an “extraordinary” amount of viruses moving through Sonoma County, with influenza making “footprints” everywhere, especially in Santa Rosa.

“Right now, out of hundreds and hundreds of flu swabs we’ve sent in, 43 percent are positive for influenza,” he said. “That’s an extraordinary number.”

Dr. Green said the baseline for the advent of flu season is usually around 10 percent positive swabs.

The numbers for RSV were even greater, he said.

“For the hundreds of swabs we’ve sent in for respiratory syncytial virus or RSV, [we’ve seen] 60 percent positive swabs, which is really an extraordinary number.”

Both Dr. Green and Dr. Jennifer Fish, a family medicine specialist at Santa Rosa Community Health, said that hospitals are near capacity but not being overwhelmed at this point, though when children are in need of hospitalization they are generally transferred to facilities out of county.

Manager of Communications for Sonoma County Paul Gullixson asked Dr. Green why flu season is so bad this year. Green pointed to COVID response fatigue combined with a contagious strain the previously wracked Australia’s winter this year. He also drew a comparison to the Influenza outbreak of 1918, which he said has a parallel to the COVID pandemic in that after the third year of dealing with the virus, people began taking less precautions.

“That’s what’s happening right now,” he said. “Kids are back at school. We’re all traveling for the holidays. People are mixing in their bubbles. And I think we can all expect viruses to bump this year and it’s going to be a rocky respiratory season this year– and it’s not due to one virus, its due to multiple.”

Dr. Fish said she’s experiencing a lot of fear and concern from the community because there are so many illnesses and so many people are sick, “especially children.”

“We’ve had multiple children from Sonoma County get hospitalized,” said Fish, adding that the strains that are circulating are stronger and circulating earlier in the season.

A Sonoma County resident who identified herself as Elizabeth F said she runs two large preschools in Santa Rosa and is concerned about the level of illness she’s seeing.

“I care for about 200 of our county’s 2 to 5 year olds,” she said. “These last few weeks have been the worst I’ve seen in about 30 years.”

Though many are sick, Dr. Fish advised residents to avoid taking at-risk adults or children to the ER simply to get diagnosed if their symptoms aren’t severe. Things to look for in children especially are difficulty breathing, a fever at 104 or higher that doesn’t respond to medication, and lethargy or having difficulty waking up. Dehydration is also something to closely monitor.

The current surge of RSV and the flu has created a situation in hospitals similar to that of COVID at its peak, the health experts said.

“I spoke with a physician who is working in Chico and the Childrens Hospital in Oakland,” said Dr. Fish. “They have nowhere to transfer kids and their beds are totally full. And so they’re basically running inpatient pediatric units in the ER, kids that need to be admitted, but they don’t have a place to send them to.”

Dr. Green said that the Sutter hospital in Santa Rosa has doubled its ER space, which has helped them remain within capacity, though a tent outside is also being used. Kaiser Permanente Santa Rosa has also erected a tent for overflow, according to County Health Officer Dr. Sundari Mase.

“With doubling our ER capacity, we’re able to see twice as many patients,” said Green. “What I really notice is, in addition to our ER being busier, but not over capacity, just the number of calls coming into primary care and pediatric offices has been really overwhelming.”

Vaccination is the single greatest predictor of a good outcome from catching the flu, said Dr. Green, adding that it makes him “a little bit sad” when patients refuse to get one. There is currently no vaccine available for RSV, but masking up and washing hands regularly are all strongly encouraged as the county fights the viruses.

To view the community update, go to the county’s Facebook page at facebook.com/CountyofSonoma.