'Quad-Demic’ Of Illnesses Straining VA Emergency Rooms

VIRGINIA — Public health officials are warning that a “quad-demic” — a contagious combination of COVID-19, influenza, RSV and the nasty stomach bug norovirus — is putting pressure on Virginia emergency rooms and hospitals.

The level of influenza in the Commonwealth is high and rising, the Virginia Department of Health said Monday, with two pediatric deaths caused by influenza. One death occurred in a young school-aged child (5–12 years old) in Virginia’s Eastern Region and one in a teenage child (13–17 years old) in the Central Region of Virginia.

Respiratory viruses are at high or very high levels across most of the country, according to the latest surveillance report from the U.S. Centers for Disease Control and Prevention. The agency said in an update Friday that nationally, wastewater surveillance shows viral activity is high for influenza A and moderate for RSV.

COVID-19 levels are low, but coupled with norovirus, offer a quadruple threat.

Norovirus data from public health laboratories from around the country tallied by the CDC shows that Midwest states from Kansas to Michigan are the hardest hit by the highly contagious stomach bug, whose symptoms include vomiting and diarrhea. Norovirus positivity test levels in all regions of the country are as high or higher than last season’s peak nationwide.

Here’s the situation in Virginia:

State health officials said they have received reports of 18 COVID-19, RSV or influenza-related deaths in the past six weeks.

Influenza activity: High and continuing to rise, with 7 percent of all emergency room visits associated with the flu, and two pediatric deaths confirmed as of Jan. 27, according to Virginia health officials.

RSV activity: Very high, with 0.4 percent of all emergency department visits associated with RSV as of Jan. 25, according to Virginia health officials.

COVID-19 activity: Infection rates are stable, with 1.1 percent of all emergency room visits in the state tied to COVID, according to Virginia health officials.

Norovirus: Minimal activity reported by the CDC. The state does not track norovirus cases.

Dr. James Campbell, infectious disease pediatrician at the University of Maryland Children's Hospital, told WMAR that the highly contagious norovirus typically causes a day or two of vomiting and diarrhea.

"It tends to come mostly in the winter. It’s primarily because—probably—people are in closed spaces, so they have more contact with each other,” Campbell said.

In its most recent update on respiratory viruses, the CDC said COVID predictions for the next two weeks suggest that emergency department visits will remain at a lower level compared to prior winter seasons. Influenza predictions suggest that emergency department visits will be high and will increase in most states.