Should You Gather for Thanksgiving as Respiratory Viruses Surge? What to Think About

Some health experts fear a post-Thanksgiving surge could make the already-challenging situation even worse

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Chicago-area hospitals are filling up in the lead-up to the Thanksgiving holiday as cases of a number of respiratory viruses rise, so health experts say it's important to think about some things before gathering this week.

Hospitals are already reporting a concerning rate of pediatric hospitalizations, with intensive care unit bed capacity dropping well into the single digits. Some health experts fear a post-Thanksgiving surge could make the situation even worse.

"It's only November and RSV has already come and hit us hard. And there's other viruses that don't make the news as much that are also surging right now just because it's respiratory virus season," said Dr. Allison Arwady, commissioner for the Chicago Department of Public Health. "If we see a significant surge, and we will see some surge no doubt about it, of flu and of COVID, on top of that, particularly for kids, you know, we may run out of good hospital capacity."

So what should you think about if you're planning to gather this week?

"If you're not feeling well, that is you know, first and foremost, stay home," Karen Ayala, executive director for the DuPage County Health Department, told NBC Chicago. "Don't really need to know why or what disease it is, but particularly respiratory diseases. If you're not feeling well today, chances are you won't be feeling well on Thursday. And even if you're feeling better, you'll probably still be symptomatic. So making that decision early on and being able to share that with your potential hosts or your potential visitors would be really very important."

While COVID tests remain critical to preventing the spread of COVID, they won't help stop the spread of RSV or the flu.

"I tell parents all the time, coughs and snot - those are contagious," said Dr. Carly Senescu, pediatric hospitalist at Edward-Elmhurst Health. "So if your kid is coughing, that's contagious. If your kid is blowing their nose, licking a toy, sharing it with someone, that's all contagious. So whether or not they have a high enough viral load to pass it on is a little bit not as structured as it is for COVID. So I would say it's the same thing. Stay home when you're sick. Stay masked if you have symptoms."

Health officials are also urging people to get both their flu and bivalent COVID booster shots.

There are some measures that can make a gathering safer, experts said.

"If you are someone who is worried, if you have a young child in particular and you're worried about RSV, definitely be washing your hands," Arwady said. "If the kids are able to put a mask on ... if you're having cold-like symptoms, please put a mask on. ... It's about keeping your germs to yourself, regardless of whether it's COVID. But also, it's about keeping kids home, if they're really not feeling well. The number one rule, stay home when you're sick, still applies. And then anything that you can do around ventilation. So having windows open a little bit even at Thanksgiving, if you're going somewhere warmer for Thanksgiving, doing it outside. These are all things that limit the risk not just for COVID, but for all of the other respiratory viruses."

Ventilation was also a large piece of advice from Ayala.

"Ventilation and airflow is one that we've found over the last three years [being] terribly effective in reducing or increasing the risk of disease transmission [and] respiratory viral transmission. So if you're going to be somewhere and you can open windows or open the doors or go outside to have a conversation, [you should]. Fortunately, it sounds like the weather's going to be pretty moderate, for this weekend," Ayala said.

Experts also urge parents to protect those particularly at-risk for viruses like RSV and flu, particularly young children.

"I think that what we're going to see is people being much more in tune with making sure that their company who comes over, their visitors who come over are, you know, if they're coughing a lot, maybe it's time to shorten the visit. If you have a new baby at home, maybe asking people to mask, not letting people pick up the baby or kiss the baby's face," Ayala said.

DuPage County's health department on Tuesday revealed that it has had days where there are no available beds for seriously ill children.

"Hospitals and clinics are seeing a dramatic increase in the number of people who are ill with respiratory diseases like influenza (flu), respiratory syncytial virus (RSV), and COVID-19," the DuPage County Health Department said in a statement Tuesday. "Children are being especially impacted, with more children with severe illness seeking care at hospitals with some waiting hours to be seen. Some even need to be transferred to another healthcare facility."

The county fears that conditions will only worsen after the holiday.

"RSV is not a new virus. Influenza is not a new virus. But we're seeing both earlier and more severe cases of illness," Ayala told NBC Chicago. "And yes, we are concerned because... we're going to be getting together, we're going to be spending more time indoors versus outdoors. It all leads us to be concerned that this will get worse before it gets better."

At the same time, Advocate Aurora Health said all of its facilities have implemented a "limited-visitor policy" as they work to "reduce the spread of COVID, flu and other seasonal illnesses."

A spokesperson for the hospital told NBC Chicago the move was "due to the substantial increase in influenza activity."

Advocate Children’s Hospital in Park Ridge is one of many area pediatric hospitals dealing with unprecedented demand.

“I have never seen pediatric medicine like this in my practice, in my career,” Dr. John Howard, the site director for the pediatric emergency room, told NBC Chicago Tuesday.

The wait time for the emergency room is surging as well, to as much as 10 hours. Advocate Children’s also opened up a new “Fast Track” area on Nov. 7, to accommodate patients with less acuity, who may be able to go home the same day.

“Portions of the waiting room have been repurposed to create patient beds where they weren’t any,” said Howard.

As of Friday, the Centers for Disease Control and Prevention said "seasonal influenza activity is elevated across the country," with levels reported to be high in Illinois.

The Illinois Department of Public Health told NBC Chicago Tuesday that pediatric ICU bed availability was down to just 5% statewide.

"We’re being kind of overwhelmed by the RSV cases. We’re probably at about three to five times our usual normal cases," said Dr. LaMar Hasbrouck, chief operating officer of the Cook County Department of Public Health.

But flu cases are also spiking at many hospitals and some experts believe the current flu strain is hitting children and seniors harder than previous strains.

According to IDPH, the current flu strain circulating most in the state is H3, with some cases being found to be H3N2. A similar trend is being reported national.

Dr. Jose Romero, director the CDC's National Center for Immunization and Respiratory Disease, reportedly said the strain has historically be associated with more severe flu seasons for children and seniors.

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