Flu surges in Virginia; COVID-19, RSV also on rise

Published 2:59 pm Friday, December 23, 2022

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Sentara Infectious Disease Specialist Dr. Bogdan Neughebauer reported during a virtual media update Friday, Dec. 16, that Virginia, in early December, was at the highest level measured for influenza, while COVID-19 and respiratory syncytial virus are also on the rise.


Neughebauer, who is also vice president and chief medical officer for Sentara, said that Virginia Department of Health data by Dec. 3 “shows that Virginia, as a state, is at a very high level for influenza-like illness. And this is really the highest level for influenza of all the different types of measures. Up to 10% of the current admissions and visits to (emergency departments) and urgent cares are related to influenza.

“One thing that you want to keep in mind is that the data is about two weeks behind because there is a lag in the number of recorded tests and the ones that are reported by VDH,” he added.

He then noted that the Centers for Disease Control and Prevention estimate that in the U.S., “we had about 27 million cases of influenza, and of those, about 13 million people presented to the emergency department for visits or presented to their primary care physicians.”

In tracking the activity of influenza, Neughebauer said he and other medical officials are looking at Australia as a mirror to the U.S., because with Australia being in the southern hemisphere, it tends to get flu infections much earlier than the U.S.

He said that Australia’s influenza season starts sometime in May and usually ends in October, but not this year.

“This year, interestingly, they had the first infections in March,” he said. “They spiked very fast in April and May, and then they dropped suddenly in July. So they started two months earlier and they finished about two or three months earlier. And we are seeing, I think, the same thing in the United States.”

In the U.S., flu season usually starts sometime in December, he noted, but this year it actually started in October.

“So if we had to plot the data, we hope that we’ll finish this infection sometime in January,” he said. “So while COVID is going up, we truly hope that the influenza cases will go down so we’re not going to have a situation where we have to fight two infections at the same time.”


Neughebauer said he has noticed a significant increase in the numbers of COVID-19 infections in the last few weeks.

“The percent positivity rate in Virginia has increased as well,” he said. “Based on the fact that this is very much consistent with what we’ve seen with the prior waves, we think that we are at the beginning of another wave.”

He stated that in Virginia, COVID infections usually occur in waves that appear either in early summer or late fall, and the current presentation is consistent with that.

“The good news is that the vast majority of these infections have been either mild or moderate,” he said. “They are not severe. Only a few cases require to be admitted, and really, only a small number of these cases are admitted in (intensive care units), and the number of deaths have decreased significantly in the last 6 months.”


Neughebauer also described what he and medical officials are seeing in terms of RSV and why it is so unique this year.

“We are seeing a perfect trifecta,” he said. “We have noticed in the last few months that we have an increased number of infections with influenza, COVID and the last one is RSV.

“RSV, or respiratory syncytial virus, is an infection that’s very common in children,” he continued. “It happens usually by the age of 2. However, many of these infections nowadays have been occurring in adults, and this is a very unique situation. 

“Furthermore, we have noticed a significant increase in the number of infections with RSV,” he emphasized. “In September and October, we had almost a 10-fold increase in the number of cases.”

He explained that what may have led to this situation is the fact that in the last two years, people have had a decreased immunity against RSV, mostly because of social distancing and wearing masks. 

“So while on a regular basis in the past we would be exposed to this virus, in the last two years, we did not have this opportunity,” he said. “So now most likely we are seeing higher numbers of infections because of that.”


Neughebauer said that most patients that develop flu, COVID-19 and RSV infections have more or less the same symptoms.

“They’re very much similar to any common cold,” he said. “You’re talking here about dry cough, fever, runny nose and some people may get headaches, some people may have shortness of breath, so these are the most common symptoms.”

He noted that in actuality, a vast majority of patients who acquire the infections do not even develop any symptoms to suggest that they are infected.

“If somebody, however, is at an extreme age, if they are very young or they’re elderly or if they have comorbidities, like heart conditions or diabetes, or if they do not have the best immune system, either because they take medications to suppress their immune system or they have conditions that depress the immune system, then those individuals would be at risk to develop more severe infections, and those individuals would, unfortunately, end up either in the emergency department or they have to be admitted for further treatment,” he said.


Neughebauer said that most of the infections in question have mild and moderate symptoms.

“Therefore, most people could treat them at home with oral over-the-counter medications,” he said. “Occasionally those symptoms can get worse, so in those cases the best thing to do is to call your primary care physicians or go to an urgent care if you do not have a primary care physician.

“If the symptoms are severe and you feel that it requires immediate attention, then please call 911 or please go to one of the emergency departments for further care,” he added.


For those that need to go to the emergency room, they should not experience longer wait times due to the activity of the flu, COVID-19 and RSV, and Neughebauer said this is because emergency departments have different tracks. He noted some have fast tracks where patients who have mild or moderate respiratory ailments are treated differently than people who present non-respiratory infections.

“We did not notice an increase in the wait time because of this situation,” he said. “I think that between the three infections, we have about the same number of patients.”


“The best way to prevent infections is washing hands, so washing your hands with water and soap would prevent transmission of many of these infections,” Neughebauer said. “Another thing that you can do — stay away from people who are sick. And with these infections, it’s rather easy to spot someone that’s coughing or sneezing.

“And then definitely try to stay healthy, drink plenty of fluids and, of course, enjoy your families.”