HCA Healthcare’s chief epidemiologist shares updates on flu, RSV and COVID-19

Preventing the spread of viruses – like the flu, respiratory syncytial virus (RSV) and COVID-19 – is a high priority for HCA Healthcare, for the safety of our patients, those who care for them and the communities where we live and serve. As we approach the busy holiday season, the spread of these viruses is expected to grow which may leave you with questions about these infectious diseases.

HCA Healthcare’s chief epidemiologist, Dr. Kenneth Sands, focuses on keeping patients and our colleagues safe from infection across HCA Healthcare’s 183 hospitals and more than 2,300 sites of care. We sat down with Dr. Sands to discuss the triple threat posed by the seasonal flu, RSV and COVID-19, and what people can do to stay healthy in the coming months.

Q. How long is flu season and what are we seeing so far?

Dr. Sands: Flu season typically starts each October and could end as late as May. While we are starting to see flu activity increase, we don’t typically see cases peak until the period of time between December and February.

Q: Is it too late to get the flu vaccine?

Dr. Sands: There is still time to get protection from the flu. It can take up to two weeks after vaccination for antibodies that protect against the flu to develop in your body – meaning if you get vaccinated this week, you will have a layer of protection for your Christmas, Hanukkah, Kwanzaa and New Year’s celebrations.

I would urge everyone to consider getting the flu vaccine. It is safe and effective. Each year the flu vaccine is customized to address the most anticipated strains among the population so it can best protect people from becoming very sick if you do get infected.

The CDC shares current recommendations for who should receive the flu vaccine.

Q: What is RSV?

Dr. Sands: Respiratory syncytial virus, or RSV, is a common respiratory virus that in most cases causes mild, cold-like symptoms. However, RSV can be serious for infants and older adults. Right now, we are seeing increases in RSV activity indicating the 2023-2024 RSV season is now in full swing, particularly in the southern U.S. where rates of RSV infection are highest.

Q: Do I need to get the RSV vaccine?

Dr. Sands: This year for the first time, there are vaccines that can help prevent severe illness from RSV. Two different manufacturers now make a vaccine that can be given to those who are at least 60 years old as they are at a greater risk for complications from RSV, especially if they have some underlying health conditions. The recommendation from the Centers for Disease Control and Prevention (CDC) is for these patients to discuss with their physician whether to receive the vaccine.

One of these vaccines is also approved for women who are 32-36 weeks pregnant, who will then pass on protection to their newborn child. Finally, there is now an antibody that acts as a “passive vaccine” that can be given directly to newborns. The CDC recommends that these two immunizations to protect newborns be administered during RSV season, which typically goes from September through January for most of the country.

For others who are less likely to develop RSV, everyday preventative action – like staying home when you are sick, covering coughs and sneezes with a tissue, washing your hands and frequently cleaning touched surfaces like doorknobs and cell phones – can reduce the likelihood of spreading RSV.

It is important that you feel comfortable with your decision, so I recommend having a conversation with your primary care provider to make the best decision for you and your family.

Q: The first COVID-19 case was confirmed nearly four years ago in the United States, and we are still seeing new cases in our communities. Do you think COVID-19 is now endemic in the United States?

Dr. Sands: Viruses, including SARS-CoV-2, which causes COVID-19, can be expected to evolve in ways that allow them to infect more people successfully. One of the ways this might happen is that the virus becomes more contagious, infecting larger numbers of people but then weakening, making them less sick. That way, people can still circulate in society and the virus is more likely to continue spreading.

While there is some suggestion that COVID-19 is moving in this direction, it is difficult to define when something can be labeled endemic. We are now seeing the virus in circulation on a more permanent basis, with levels of activity that fluctuate within a smaller, more stable range. It is unlikely that we will completely eradicate COVID-19, so I would not be surprised to see it labeled as endemic in the future.

Q: Should people be worried about getting COVID-19 and the flu simultaneously?

Dr. Sands: It is true that people can be infected with multiple viruses at the same time, and distinguishing between COVID-19 and the flu, for example, may pose challenges due to their similar symptoms. Fortunately, we have tests for both viruses that help us diagnose the right infection and treat it effectively.

Across HCA Healthcare, patients are very rarely identified as having two infections at the same time. As is the case with many viruses, vaccination is a critical aspect of prevention and lessening of severe symptoms of both diseases.

Q: HCA Healthcare created a flu, RSV and COVID-19 predictive model. What does this look like?

Dr. Sands: HCA Healthcare is tracking the seasonal flu, RSV and COVID-19 together in a model that we put in place at the end of the last respiratory season, about 6 months before the CDC started reporting national data using a similar model. The system allows us to simultaneously monitor all three respiratory infections, providing a more comprehensive understanding of the overall impact on our facilities.

Q: What advice do you have for a happy and healthy holiday season?

Dr. Sands: This holiday season, the best thing you can do for yourself and your family is to be up-to-date on your vaccines. Other best practices like social distancing, masking and good hygiene practices will be valuable tools in our collective arsenal as we continue to fight viruses and keep society healthy. I encourage everyone to monitor COVID-19, RSV and flu transmission levels in your state to help determine whether or not to wear a mask when gathering this holiday season. And, of course, stay home and isolate yourself if you are not feeling well. I know we cherish being around family this time of year, but it is not worth your loved one’s health.