From the Valley to the state capital, Massachusetts health systems are buckling under a flu explosion that has already claimed more than 30 lives this season, statewide. At hospitals like Cooley Dickinson in Northampton, a perfect storm of holiday travel, low vaccination rates and an H3N2 strain that partially evades this year’s vaccine has left emergency departments struggling to manage a surge of patients reporting unusually harsh symptoms.
“We anticipated that the flu was going to hit hard this year and it’s peaking earlier than we anticipated, so it is putting strain on the hospital and emergency services,” said Dr. Cyrus Yau of Cooley Dickinson Hospital.
The flu, or influenza, is a viral infection of the respiratory system impacting the nose, throat and lungs. In North America, flu season usually takes place between October and May, causing symptoms associated with the common cold — such as a fever, muscle aches, fatigue and chills — and potentially leading to death.
Yau is the Medical Director and Division Chief of the Hospitalist Program, while also serving as the Interim Chair for Pediatrics at Cooley Dickinson. He said in December, the hospital had approximately 1,500 confirmed flu cases and just about a week into January, there had been approximately 400 cases.
“We’ve seen a huge surge in flu cases this season,” he said.
According to Centers for Disease Control and Prevention (CDC) statistics, Massachusetts is one of approximately 18 states experiencing very high flu activity.
Yau said the increase in flu cases is taking its toll on Cooley Dickinson emergency and hospital services, which are nearing patient capacity. He said the hospital has had to make adjustments to manage the influx of patients, opening new rooms and bringing in new beds.
With the increased cases, Yau said that anecdotally, patients are reporting harsher symptoms and wanting to stay admitted in the hospital longer to recover.
“They [patients] definitely feel like this season, when they are getting the flu, they are having a harder time breathing and getting chest pains,” Yau said.
Cooley Dickinson is not the only medical provider facing the strains of higher flu cases, with more severe symptoms being reported.
The Massachusetts Department of Public Health (DPH) is reporting “very high and rising levels of influenza activity” statewide, with nearly 9,000 emergency department visits per day last week, about one-quarter of them related to acute respiratory illness. Hospitals in some regions, such as Cooley Dickinson, have reported capacity levels exceeding 90%, largely driven by influenza.
Two Boston children under the age of 2 have died from flu-related illness this season, marking the city’s first pediatric influenza deaths since 2013, according to the DPH. Statewide, there has been a total of four pediatric, flu-related deaths this season.
Dr. Seth Gemme, chair of emergency medicine for Baystate Health in Springfield, said it is a similar story for Baystate emergency rooms, and higher volumes of patients are leading to higher waiting times.
“We are seeing a high volume of high flu-positive cases but the symptoms are also more severe,” Gemme said.
Gemme oversees emergency medicine for Baystate hospitals with locations from Greenfield to Springfield. Last year, he said the flu season peaked in February, much later than this year. While it appears the flu season is peaking now, the current surge is not over.
Both Gemme and Yau recommend if someone is experiencing flu symptoms and are unsure if they contracted the flu, they should contact a primary care provider to receive guidance based on their symptoms.
Though, if they are experiencing severe symptoms such as chest pains, shortness of breath and trouble breathing or difficulty eating and drinking, people should go to an emergency room.
“The ERs [emergency rooms] are very busy and very full, and that makes us need to prioritize certain patients,” Yau said.
Gemme said the best preventative measure is to reduce coming into close contact with many people and large gatherings.
Gemme and Yau recommend getting the flu vaccine, and the DPH urges residents 6 months and older to get vaccinated.
According to the DPH’s vaccination dashboard, as of Jan. 3, approximately 35.3% of Franklin County residents have been vaccinated against the flu, while in Worcester County, that number stands at 30.9%. Regarding COVID-19, 15.4% of residents in Franklin County residents have been vaccinated and 9.6% in Worcester County.
Both doctors recommended frequent hand washing, especially after using the restroom and before meals, and noting that masking can reduce the likelihood of getting sick. Avoiding touching the face is also recommended.
Yau said people who have contracted the flu should still get vaccinated once recovered since they can still contract different strains of the virus. Gemme said since the flu season is long lasting, patients should still consider getting the vaccination whether or not they have come down with the flu this year.
Yau explained one of the reasons the flu season is so bad is because this year’s vaccine was developed before a mutation occurred. The mutation, known as the H3N2 subtype K strain, has become predominant compared to other strains.
According to the CDC national statistics, during the week of Dec. 14, Influenza A made up approximately 94% of positive flu tests it gathered from public health institutions. A large portion of those tests were subtyped, revealing approximately 92% were strain H3N2, meaning the strain is making up the large majority of confirmed flu cases.
While that mutation makes the vaccine a potential mismatch for the H3N2, Yau said the good news is that available data show the vaccine still reduces the chance of getting sick and the severity of illness against this strain.
Gemme recommends anyone with a chronic illness such as diabetes, asthma or emphysema to get a vaccine, to reduce the risk of comorbidity — having two or more diseases or medical conditions at the same time.
On Tuesday, Boston Public Health Commissioner Dr. Bisola Ojikutu said compared to last flu season in Boston, there have already been twice as many pediatric flu hospitalizations. She said vaccination rates are only slightly lower than last year, but remain “overall low.”
Yau said as a pediatrician, he has observed and heard anecdotally there have been more pediatric cases of the flu, but there have also been more cases in general.
According to State House News Service, public health officials stress that most flu infections in children remain mild but urged parents and caregivers to seek immediate medical attention if children develop warning signs of severe illness. Those include trouble breathing, persistently high fever, extreme lethargy, confusion or signs of dehydration such as markedly decreased urination.
Yau said besides the strain mutation, it is difficult to explain why flu cases are so bad this year. He also noted that flu rates are much higher compared to COVID-19 and other respiratory illnesses such as the common cold and RSV, and sometimes, when one virus is more prevalent the other is less.
“I would certainly recommend getting vaccinated,” Yau said. “Anecdotally, those vaccinated seem to be experiencing less severe symptoms.”
Material from State House News Service was used in this article.