One day after the news of COVID-19 hospitalizations more than doubling in Pierce County in a week, local and area health officials ramped up calls for indoor masking amid ever-growing respiratory illness caseloads.

COVID-19, flu and respiratory syncytial virus are surging in Pierce County as well as the region. A joint statement released Friday from representatives of hospitals and health departments statewide recommended universal masking amid the current surge.

“As health officers and health care leaders working to improve the health of Washington residents, we recommend that everyone wear a high-quality, well-fitting mask when around others in indoor spaces to protect against both acquiring and spreading these infections to others,” the statement read.

Face masks are no longer mandated by the state in most settings outside of health care and have become few and far between in social settings as more people gather for holiday parties, family gatherings and other social events.

In their statement, health care officials also emphasized getting vaccinated for flu and receiving the updated COVID bivalent booster.

“In addition to RSV and influenza, new COVID-19 variants are taking hold and immunity from past vaccination is waning for many people who have not yet received an updated booster shot. The surge in these viruses is resulting in many illnesses,” they added.

According to the Centers for Disease Control and Prevention, flu-related hospitalizations on a national scale are running higher this year than during every previous season since 2011. The very young and those 65 and older are at the highest current rate of hospitalization for flu illnesses nationwide, according to data.

Dr. Karthikeyan Muthuswamy is associate medical director for the emergency department at St. Clare Hospital in Lakewood, and chief of staff and president of medical staff for Virginia Mason Franciscan Health.

Muthuswamy told The News Tribune on Friday that with so much illness in the community, it “is very difficult to distinguish between the flu, COVID and RSV. When you show up to my ER, they all look the same. And for the most part, their outcomes are at this point the same.”

“We’re seeing a ton of people coming in” with influenza-like illnesses. he added.

Statewide, winter 2019 going to 2020, he said peak visits across Washington to ERs of patients with influenza-like illness hit 8 percent.

“This time this year, the peak was 15 percent,” he said. “So literally double the percentage of patients,” with influenza-like illness (ILI).

“It is in a way worse now than it has ever been in the past,” he added.

The state trend reflects what’s happening locally, he noted.

“In Pierce County, it’s about 12 to 14 percent visits for ILI, this flu season, whereas two years ago, it was about 5 percent was the peak.”

Muthuswamy doesn’t think the relaxed mask standard is the lone reason for the now-overwhelmed medical facilities.

“Americans didn’t really wear masks before COVID existed and our flu seasons were bad, but never this bad in recent history,” he said.

He recommends wearing masks now, “just because there are so many people who are getting sick and we know masks work.”

“We know this because flu disappeared for two years, like when we were in the middle of COVID pandemic, flu didn’t exist,” he said. “I saw maybe one flu case, the whole flu season in a year. That’s ridiculous. Now I’m seeing about six flu cases per shift.”

He thinks the causes behind the current respiratory surge are more complex, to be determined ultimately a few years from now after the data is researched and reviewed.

“The working idea is because we were so good at containing ILIs when we were going through COVID, a lot of us weren’t exposed to flu. Most importantly, kids weren’t exposed to the flu at school. So now everybody’s back in school. Everybody’s mixing again. And our bodies haven’t seen the flu in awhile. So we’re more likely to get sick,” he said.

“It’s almost like we’re seeing COVID for the first time. … Same thing with the flu. Our bodies haven’t really seen it for two years. So everybody’s getting sick.”

Muthuswamy added, “That’s the working theory. We’re not going to be able to prove that for a few years.”

He said the same applies to RSV.

“Now all these kids haven’t had exposure to RSV. We don’t have a vaccine for RSV, yet, unfortunately. So RSV is rearing its ugly head again. And RSV is a very dangerous disease. Arguably, for kids under 2, it’s more dangerous than COVID,” Muthuswamy said.

Pediatric medical centers such as MultiCare’s Mary Bridge Children’s Hospital in Tacoma have been in the thick of dealing with RSV and other respiratory infections. U.S. Rep. Kim Schrier, who is also a pediatrician, visited the hospital Friday, drawing attention to RSV’s impact and her efforts in seeking federal emergency action to aid in the RSV surge.

In a letter she sent to President Joe Biden and Health and Human Services Secretary Xavier Beccera in November, she wrote: “The combination of a presidential emergency declaration … and a secretarial public health emergency declaration would best address pediatric capacity issues from this RSV surge and allow for better patient care.”

Muthuswamy told The News Tribune his best guess is the current influenza-like illness surge is going to be around for awhile, based on previous disease patterns.

“My prediction is this is going to be bad through January. My concern is if it drops pretty quickly … that almost always carries with it a second peak in February. If it drops a little bit and stays flat. It’s going to stay flat throughout the rest of the season and then drop off … based on history of what we’ve seen with ILIs.”

Dr. John Lynch, an infectious diseases specialist and medical director of infection prevention and control at Harborview Medical Center, said in a statement Thursday, Dec. 8 that flu cases normally wouldn’t start to ramp up until the end of December, but this season’s wave emerged in late November.

All that makes it critical for people to take extra health precautions now, he added.

“It’s multiple layers: getting vaccinated, getting boosted, staying home when you’re feeling sick, getting tested for COVID and connecting to care, if that’s helpful for you,” said Lynch. “Stay at home when you’re sick and stay away from other folks.”

For more information

VMFH guide to determining levels of care:

MultiCare where to seek care guide:

This story was originally published December 10, 2022 7:05 AM.

Debbie Cockrell has been with The News Tribune since 2009. She reports on business and development, local and regional issues.