Three forms of respiratory illness, including a new variant of COVID-19 are increasing in prominence since the Christmas holiday prompting Kent Hospital to require all visitors to mask as of Friday January 5, and placing a strain on the hospital because of an increase in patients and a reduction in staff.

While not at the number of infections seen during the pandemic, Dr. Thomas Wold, Kent’s Chief Medical officer described the situation as an “endemic.” Kent is seeing JN.1, a subvariant of COVID-19 as well as patients with the flu and Respiratory Syncytial Virus or RSV.

“Respiratory illnesses are becoming more active,” Wold said. The good news is that while these illnesses “are ramping up,” Wold said, the JN.1 variant of Covid is not as virulent as the Omicron variant and can be treated with the antiviral drug Paxlovid. As of Friday, the Centers for Disease Control and Prevention reported JH.1 represented about 62% of the Covid cases nationwide. It’s about 44% at Kent, Wold said.

As is the case at this time of year, Wold attributed the uptick in respiratory illnesses to the gathering of family and friends, some from across the country and around the world, during the holiday season. What’s different this year, he said, is the level of hospital staff infections which is on par with the general population. This has put a strain on the remaining staff.

Conditions aren’t limited to Kent.

Rhode Island Department of Health (DOH) Public Information Officer Joseph Wendelken, said last week statewide Covid trends have been rising.

Wendelken said a higher rate of COVID-19 and respiratory illnesses were expected to occur around this time of year. However, he noted that overall the number of Covid cases is lower than at this time last year.

“This is a seasonal pattern that we’ve seen now with Covid-19 over the past few years,” Wendelken said. “We don’t anticipate the numbers being any different from last time.”

In regards to the flu, however, Wendelken said that the state is in a high tier of flu activity, having had 158 hospitalizations statewide and one death. The hospitalization numbers, according to the DOH’s website, mark the highest level within the past few years.

“It’s a real reminder that the flu is a serious virus, and people should get vaccinated if they aren’t,” Wendleken said. “Both for the flu and for Covid, that’s one of the best things we can do to prevent severe illness.”

About 15% of Rhode Islanders, which is consistent with the national trend, have received the most recent Covid-19 vaccine, although Wendelkin said that the number varies greatly by age, with 42% of Rhode Island’s 65+ population having already taken it.

“Everyone masking is back,” Wold said of the Kent policy, “we want to do whatever we can to reduce risk. He said the hospital, as Wendleken reported statewide, has seen a big jump in flu in recent weeks that “hasn’t shown signs of cresting.”

He identified immune deficient patients such as those battling cancer and other diseases as well as the elderly, especially over 80 years old as particularly vulnerable to respiratory illnesses.

“Flu and Covid vaccinations are really important,” he stressed. He said it’s not too late to get either of the vaccinations.

As for when people should consider visiting an emergency care center, the CDC recommends people should seek emergency medical attention if they have difficulty breathing; persistent pain or pressure in the chest; new confusion; inability to wake or stay awake or pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone. The CDC points out that flu and Covid symptoms can be remarkably similar and that tests are needed to make a determination.

Wold said the need to use oxygen is a defining reason to visit an emergency room.

In a release issued Friday, the state DOH pointed out that during respiratory virus season, hospital emergency departments are often more crowded. Children and adults in emergency departments with less serious health issues may experience long wait times. “If you or your child does not need emergency medical care, do not go to the emergency department. Long waits in the emergency department are frustrating, and they expose you and your family to new sicknesses.”

It goes on to say “many health issues can be treated more quickly and effectively by a primary care provider or in an urgent care facility or health center.” Listed are back pain, sprains, minor cuts, colds, sore throat, low-grade fevers, and most cases of norovirus (also known as the stomach flu).

 According to the CDC, people infected with RSV usually show symptoms within 4 to 6 days after getting infected. Symptoms of RSV infection usually include: runny nose, decrease in appetite, coughing, sneezing, fever and wheezing.  Additionally,  symptoms usually appear in stages and not all at once. In very young infants with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties.  Almost all children will have had an RSV infection by their second birthday. Antiviral medication is not routinely recommended to fight infection. Most RSV infections go away on their own in a week or two. However, RSV can cause severe illness in some people.

According to the CDC, RSV can cause more severe infections such as bronchiolitis, an inflammation of the small airways in the lung, and pneumonia, an infection of the lungs. It is the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age.

The good news from the CDC is that healthy adults and infants infected with RSV do not usually need to be hospitalized. But some people with RSV infection, especially older adults and infants younger than 6 months of age, may need to be hospitalized if they are having trouble breathing or are dehydrated.

In the release issued by the Department of Health, Interim Director of Health Utpala Bandy, MD, MPH states, “Now is the time for all of us to take some basic prevention measures to stay healthy. Those prevention measures – such as getting vaccinated and avoiding contact with people who are sick – are critical for anyone who is at greater risk for severe illness.”