Hospitals in NYC brace for combined onslaught of flu, RSV and COVID as a winter surge gets underway

Hospitals in the city are struggling — and bracing for things to get worse — as they deal with a rise in RSV and flu cases combined with a recent boost in COVID-19 numbers ahead of an expected winter surge

Waves of the flu, COVID and RSV, or respiratory syncytial virus, a common and highly contagious virus that has been hitting young children hard this year. are stretching hospital resources thin — but it could be just the beginning.

With a typical season peaking in January and February, doctors warn of a tough winter ahead.

RSV peaked in November and is now waning, data show, but now, flu is rampant and doctors expect a spike in COVID after the holiday season.

“It just gets worse and worse every day,” Ramon Rodriguez, CEO of Wyckoff Heights Medical Center in Brooklyn, said. “We’ve been experiencing an enormous influx of patients who have respiratory illnesses over the last month.”

COVID cases are increasing rapidly in the city, jumping more than 40% over the past two weeks. The city logged 3,659 cases a day over the past week on average, according to the city’s COVID data tracker. Two weeks ago, the number was 2,529.

Hospitalizations have not kept pace with total case numbers, but hospital officials say they are worried about the upcoming holiday season.

“I’m worried about COVID and flu spiking at the same time, with the holidays coming up,” Dr. Bernard Camins, professor of infectious disease at the Icahn School of Medicine at Mount Sinai, said.

One of the factors making this winter season especially challenging is the return to prepandemic standards. Masking and social distancing tamped down the spread of not only COVID, but other infectious diseases. Now, people are extra vulnerable to flu and RSV.

“It’s a certain irony,” Wyckoff ‘s Rodriguez said. “What’s happened is that because we were taking precautions and wearing masks, people, children especially, didn’t get immunity from some of these illnesses. And so it’s really hitting us full force now.”

The pediatric emergency department at Brooklyn’s Maimonides Medical Center is struggling. The department doesn’t have enough staff or beds to meet the increased demand, according to its director, Dr. Alex Arroyo, who said he’s seen a 60% or 70% patient increase in the past two months. A normal day is usually between 80 and 100 patients a day. Now, it’s as many as 170 patients a day.

“It may get worse before it gets better,” Arroyo said. “We’re all very hesitant and leery about heading into January and February, which are usually our busiest months, when we’re already hitting peak volumes in October and November. What January and February brings — I’m a little concerned and scared.”

Wait times have tripled and even quadrupled in his department. Children have had to be placed on adult floors for a lack of beds. Nurses and doctors — many, including Arroyo — who have kids who are also falling sick and need extra care are short on staff.

“This is not just obviously a Maimonides issue,” Arroyo said. “This is statewide, this is citywide, this is all over the place, and the volume that we’ve seen from pediatrics across the board, across the country is frightening.”

It’s often chalked up to the “tripledemic,” or surges in flu, COVID, and RSV, all at the same time.

Dr. Jennifer Lighter, pediatric infectious disease specialist at Manhattan’s Hassenfeld Children’s Hospital at NYU Langone, said it’s a little more complex than that — while all three viruses are circulating now, they aren’t peaking at the same time.

“I think that’s really simplifying what’s going on,” Lighter said. “With most respiratory viruses, there’s usually one that rises for six weeks and then it comes down. ... I suspect we’re going to actually see a rise in influenza admissions over the next month or so. And then, possibly after that, we would really see more of an upswing of COVID.”