Health officials are advising the public to get vaccinations as respiratory illnesses spread

As the holiday season gets into full swing, public health officials are advising the public to stay up-to-date on their vaccinations for COVID-19, flu and RSV and to stay home if unwell, among other recommendations.

Regional wastewater data shows that infection rates are currently high, a trend that could continue in the coming weeks as more people gather indoors for the holidays.

Data from Stanford University’s WastewaterSCAN dashboard shows high to medium levels of respiratory syncytial virus (RSV) and norovirus, a gastrointestinal virus, across five out of six local sewersheds.

Influenza A, another common fall and winter virus, is also in high concentrations in some sewersheds, whose sewage is tested at regional wastewater treatment plants.

RSV is a highly infectious respiratory illness that is particularly concerning for infants, small children and the elderly, according to the U.S. Centers for Disease Control and Prevention.

Evidence of RSV has been high in the past 21 days at the Silicon Valley Clean Water plant in Redwood City, Palo Alto Regional Water Quality Control Plant, City of Sunnyvale Water Pollution Control Plant, San Jose-Santa Clara Regional Wastewater Facility and the South County Regional Wastewater Authority in Gilroy.

RSV concentrations are low in samplings taken from Stanford.

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Levels of influenza A, a variant of the flu virus, have been high in the Palo Alto, Sunnyvale and San Jose sewersheds in the last 21 days. Influenza A is at low concentrations in the Redwood City and Gilroy sewersheds, and at Stanford.

Emergency room visits related to influenza-like illnesses have increased 1.5% according to Santa Clara County Public Health influenza and RSV data dashboards.

The COVID-19 virus, SARS-CoV-2, is also still very much active throughout the county, with some serious cases. Hospital admissions show a seven-day average of 12 new admissions per day through Nov. 10, the latest data available. Twelve patients were admitted to the ICU, according to county data.

Dr. Jamila Champsi, chief of infectious diseases at Kaiser Permanente South San Francisco, said Kaiser Permanente Northern California is seeing increased cases of Influenza A and RSV.

“We are seeing cases of RSV in children under the age of 18, and influenza cases in those over the age of 50. We are not seeing an increase in hospital admissions or ICU admissions due to either illness. It is very likely we will see an increase in influenza, RSV, COVID-19, and other respiratory viruses due to travel and people gathering over the holidays,” she said.

Kaiser continues to recommend that people receive their COVID-19 vaccination and get a flu shot to protect themselves and others.

“COVID-19 and flu vaccines are available by walk-in at our clinics. We encourage our members to get their updated vaccinations through Kaiser Permanente. Visit kp.org for more information about clinic locations and hours. In addition, there is a RSV vaccine available for high-risk individuals including infants, pregnant women, and adults over the age of 60,” she said.

Wastewater concentrations of SARS-CoV-2 are high in the San Jose sewershed. They are at medium concentrations in Palo Alto and Stanford sewersheds, and are at low concentrations in Redwood City, Sunnyvale and Gilroy.

The rise in COVID-19 cases combined with influenza and RSV – a so-called “trifecta” of expected seasonal respiratory illness – prompted the Santa Clara County Public Health Department to require masking in all patient care areas in health care facilities such as hospitals, clinics and at assisted living, skilled nursing and memory care centers from Nov. 1 through March 31..

“The seasonal increase in circulation of multiple respiratory viruses causes a particular risk to populations more likely to experience severe disease and death if infected, including infants, older adults, and people with impaired immune systems,” the public health department said in a statement.

“The seasonal surges also risk overwhelming the existing health care system in the county, jeopardizing the capacity to provide care for these and other diseases.”

Dr. Kismet Baldwin-Santana, health officer of San Mateo County Health, added in a Nov. 30 press release: “Staying up to date with vaccinations for COVID-19, flu and RSV is the most effective tool for protection. Stay home if unwell, consider testing before gatherings and seek prompt treatment if needed.”

Gastrointestinal norovirus rates are high

Respiratory illnesses aren’t the only diseases plaguing local residents. Norovirus, which is highly contagious and can cause severe vomiting and diarrhea, is currently trending high in the Palo Alto, and Redwood City sewersheds. Norovirus is at medium concentrations in the San Jose, Sunnyvale and Gilroy sewersheds and at low concentrations in the Stanford samplings, according to the Wastewater SCAN data.

The virus is particularly dangerous for the elderly and can spread quickly in congregate-housing settings such as assisted-living and nursing homes. A person with norovirus can also still be contagious for up to two weeks after feeling better, increasing the likelihood of contamination to many people. The virus is spread through contact with contaminated surfaces and food, according to the CDC.

Advice from public health leaders

In a Nov. 30 statement, health officers from 12 Bay Area counties and the city of Berkeley released recommendations to help people stay healthy during the holidays:

Get vaccinated against COVID-19, flu and RSV

• These viruses pose the greatest risk to infants, older adults, and persons with certain health conditions. Getting recommended vaccines when pregnant protects pregnant people and their babies.

• One dose of this year’s updated COVID-19 vaccine is recommended for everyone ages six months and older, at least two months after their last dose. Children six months to 4 years old and immunocompromised persons who have never been vaccinated should get additional doses.

• People without insurance or whose insurance doesn’t cover the cost of vaccines can get the updated COVID-19 vaccine for free through the Bridge Access Program. Visit vaccines.gov to find a location.

• Everyone six months and older should get an annual flu vaccine. Children 8 years old and younger need two doses the first year they get the flu vaccine. 

• Adults 60 years and older can get vaccinated against RSV to prevent severe illness. Pregnant people should also get the RSV vaccine at 32 to 36 weeks of pregnancy to protect their newborn. RSV vaccines are available at many pharmacies and healthcare providers.

Sick? Stay home

• Stay home as much as possible until you have recovered, no matter which virus you have.

• People who need urgent or emergency medical care, including testing or treatment, should not hesitate to seek it.

Test if feeling ill

• Test right away. Symptoms of COVID-19 may be mild.

• Stock up on home-test kits. This fall, every household can get up to eight free COVID-19 tests from the U.S. government through covid.gov/tests.

Get treatment

• Medication for COVID-19 helps prevent hospitalization and is available to most adults and some teens with even mild symptoms.

• COVID-19 treatment works best when started right after symptoms begin, and within five days of symptom onset. Talk to a healthcare provider about treatment options or visit covid19.ca.gov/treatment.

• Antiviral treatment is available for those who test positive for flu who are at high risk for severe illness.

Wear a mask, improve ventilation

• Consider masking in indoor public places, especially if at higher risk for severe disease (over 65 years of age and/or persons with certain health conditions).

• Wear a well-fitting, high-quality mask such as a KF94, KN95 or N95.

• Improve ventilation indoors by turning on HVAC systems, filtering the air with a portable HEPA filter – the same kind that many use for wildfire smoke. Point fans out open windows, or open doors and windows when possible.