California is now reporting very high flu levels, according to the U.S. Centers for Disease Control and Prevention, as respiratory illnesses continue to rise across the country.
The CDC uses five general levels, from minimal to very high, to measure flu-like illness in the US and its territories. On Friday, the bureau’s color-coded map showed California and 10 other states, along with New York City, shaded purple, the worst of the three shades in the very high flu level.
Since early October, the CDC estimates there have been 78,000 flu hospitalizations and 4,500 deaths nationally.
The California Department of Public Health classifies all of Southern California as having high flu levels, while Central and Northern California are rated as moderate. Influenza is the reason for nearly 4% of hospitalizations per week at Kaiser’s facilities in Northern California, the highest in any of the previous four flu seasons.
In Los Angeles County, flu and COVID-19 cases are on the rise, and RSV — or respiratory syncytial virus — also remains at high levels.
“This triple threat…has a lot of potential to ensure that there is significant circulating disease and to put a strain on our healthcare system – both in terms of the number of beds available and the number of healthcare workers affected by disease, affecting the capacity of the hospital to care for patients,” Barbara Ferrer, LA County public health director, said in a recent briefing.
The flu positivity rate in LA County has hit 25%, a level not seen at this time of year for the past four years. “Obviously, we’re… off the charts,” Ferrer said.
“We are already seeing many people being hospitalized for flu-related illnesses and complications. So please, we urge people not to think of this as just ‘just the flu’. It’s not too late to get your seasonal flu shot,” she added.
California has recorded at least 36 flu-related deaths since early October, based on death certificate records. That figure is probably an undercount.
The positivity rate for RSV also remains high — about 15%, higher than in any of the previous four cold and flu years, which run from October to September.
There is some evidence that RSV activity has peaked in LA County in early November and is starting to decline. According to county data, the positivity rate was over 20% at the end of October. But it’s possible that the 15% rate is simply a result of more people being tested for the virus, Ferrer said.
“The current rate of positivity, even if it’s dropped, still exceeds the highest rate of positivity we’ve seen in the past five seasons,” Ferrer said. “So still an alarming number of people testing positive for RSV.”
At Children’s Hospital in Los Angeles, the RSV positivity rate is 23%. That has dropped significantly from November 1, when the rate was 38%. But the latest figure is still quite high and is about the same as last winter’s peak, which was 24%. CHLA’s emergency room is so busy that it is not always possible to transfer patients from other hospitals.
The positivity rate for flu in CHLA is 19%; before Thanksgiving it was 12%.
The RSV situation in Orange County remains the same as the week before, according to the Health Care Agency, where officials declared a public health emergency due to RSV and other viral illnesses straining children’s hospitals.
Increasing coronavirus-positive hospitalizations are exacerbating the RSV situation, as an increase in COVID-19 hospital patients means fewer hospital beds are available, the agency said.
At Kaiser hospitals in Northern California, about 2.2% of hospitalizations are related to RSV, up from 2.3% last week, according to the most recently available data. Those percentages are higher than in the five previous cold and flu seasons.
There have been at least 14 RSV-related deaths since early October, according to California death certificate records. The figure is probably an undercount.
“Given the high levels of RSV activity, caution is advised,” Ferrer said. “RSV often affects young children most severely and causes bronchiolitis [inflammation of the airways] and pneumonia. It is important to take precautions to avoid respiratory diseases. This often includes washing your hands, and for RSV in particular, wiping off frequently touched surfaces.”
In addition to wearing a mask, health experts say one of the easiest ways to reduce your risk of getting the flu or other viral illness is to avoid touching your face.
The CDC notes that people can become infected with the flu and RSV by touching contaminated surfaces, where some viruses can survive for days, and then their face.
“The one point I want to re-emphasize is…avoid touching your eyes, nose, and mouth,” said Dr. Ralph Gonzales, an associate dean of UC San Francisco, in a recent city hall on campus. “Very good studies have shown that if we can redouble our efforts to be vigilant about this, it will increase our chances of staying flu-free.”
Still, this simple-sounding advice may be easier said than done. Touching your face can be a spontaneous or even unconscious act that some studies indicate can help us deal with anxiety and discomfort, or be linked to negative or unsatisfactory feelings.
And it’s something that happens a lot. A 2015 study caught medical students in class touching their faces an average of 23 times per hour.
Here are some tips to train yourself not to touch your face.
- Be mindful when you touch your face and catch yourself doing it when – and preferably before – you do it.
- If you catch yourself touching your face, consider folding your hands or doing something else with them.
- Do you have an itch? Try to ignore it. If that bothers you, wash your hands, scratch them, and then wash your hands again. Or buy sterile wooden tongue depressors to use as an itch scratching tool.
Regular hand washing is also an important step to curbing the spread of viruses, officials say. If soap and water are not available, hand sanitizer can be used as a substitute.