Hamilton's respiratory virus season is better than last year's, but doctor says challenges remain

After months of relatively low transmission, Hamilton public health is reporting respiratory viruses are spreading more and more. This is to be expected given the time of year, doctors tell CBC Hamilton, and there are things people can do to help hospitals from being overwhelmed. 

"[Public health metrics] have been signalling that there's certainly COVID-19 transmitting out there in the community, and an increase from what we have seen even through these earlier fall months," Dr. Brendan Lew, Hamilton's associate medical officer of health said. 

As of Wednesday, public health reported it's tracking increased presence of COVID-19 in wastewater, and Respiratory Syncytial Virus (RSV) is spreading more too. This mirrors provincial trends, with an increasing number of patients being admitted to Ontario hospitals with respiratory virus symptoms, according to a provincial monitoring tool. 

"Certainly we know that when people are in close quarters and when they're spending more time indoors, those are the times and places where the risk of transmission for any respiratory virus, whether it's COVID-19 or influenza, is certainly higher," Lew said.

This season feels more like a typical respiratory virus season than we've had since the pandemic began, Dr. Angelo Mikrogianakis, chief of pediatrics at McMaster Children's Hospital, said. 

Typically, the effects of viruses "increase the demands on the hospital this time of year. [There are] more emergency department visits because more kids are sick," he said.

Last year at this time, pediatric hospitals were dealing with a surge of sick kids the likes of which some health-care providers said they had never seen. At McMaster, hospital leadership said this led to a reduction in the number of scheduled surgeries, and increasing staff burnout. 

Fortunately, Mikrogianakis said, "last year was unique" — the result of many children getting viruses like RSV for the first time. At the time, scientists pointed to that and other theories, including that COVID-19 might have affected people's immune systems. 

However, just because things are closer to the pre-pandemic norm, doesn't mean they're good, he said. "The emergency department is busier. Our wait times have increased, our daily volumes are bigger and our admissions to the hospital are up. And we're right at capacity, sometimes over capacity. But we are coping." 

That's in part because of lessons learned last year, he said. Now, the hospital has some more beds, and is treating children with stable vitals in a separate area from those requiring more intensive care.

One challenge, Mikrogianakis said, is the relative lack of health-care options in the community. "Most kids with viruses handle it pretty well," he said, and families can get care from their doctors outside a hospital setting, escalating if need be. But 55,000 to 60,000 people in Hamilton do not have a family doctor, and he said those lacking care at home or in their community have nowhere to go but the hospital. 

"When you have a sick child and you're struggling to figure out if everything's going to be OK and what you need to do, your worries are not about the system as a whole," he said. 

But ideally, people going to physicians and pharmacists first "helps us manage the system as a whole and keeps the high-level hospital services available for those children that need us the most."

Lew said if one hasn't, now is the time to get COVID-19 and flu shots, which are geared toward currently circulating XBB.1.5 sub-variants, and for which Hamiltonians older than six months are eligible.