The normal winter flu season is in full swing in Alabama, but this year COVID and RSV are joining the mix. The Centers for Disease Control and Prevention ranks the state among seven others with the highest rates for respiratory disease.

Alabama health officials say there has been a 3.2% increase in hospital admissions statewide for the three viral diseases, but there is no shortage of treatment facilities or hospital beds across the state.

But they warn that, with the workplace and schools opened after the holidays, the numbers could climb.

Based on recent patterns of influenza and COVID-related emergency room visits and hospitalizations in the state, it’s hard to tell if we’ve reached the peak of the illnesses, said Dr. Wes Stubblefield, district medical officer for the Northern and Northeastern Districts of the Alabama Department of Public Health.

Alabama hospitals are busy because it is the season for respiratory diseases, said Dr. Don Williamson, president and CEO of the Alabama Hospital Association.

Williamson said Friday that there were between 600 to 700 patients hospitalized with COVID or influenza. “It’s a little more COVID than we normally have, but the cases are milder,” Williamson said.

The number of patients hospitalized just for influenza is between 270 and 300 statewide. “These numbers are not outside the norm,” Williamson said.

“Some hospitals are full because they do not have full staffs, so they have less elasticity for treating the patients. And still the numbers are not anything like what we have seen,” Williamson said.

Since the pandemic began, cases have peaked each January. Hospitalizations rose to about 3,000 from COVID alone in January 2021 and 2022 before dropping to about 600 in 2023.

Stubblefield said the overall number of available beds in Alabama’s hospitals is not at a critical level as of the health department’s latest update on Jan. 6.

“We do have some adult medical, surgical bed and ICU bed shortages in some of our public health districts, but we don’t have a breakdown of how many of the patients in each hospital’s ICU are admitted for respiratory viruses,” he said.

“When these viruses are active, people are admitted to the ICU with complications which puts a strain on bed availability for other critical patients without these conditions,” he added.

 Identifying the Villains

All three diseases are highly contagious, and the best way to determine which one you have is to get tested.

The main difference between COVID-19 and influenza is the loss of taste or smell with COVID. Both viruses cause fevers, chills, headaches, cough, muscle soreness, fatigue, vomiting, diarrhea, shortness of breath, runny nose and sore throat.

RSV is more dangerous to people over the age of 60 and infants.

Most symptoms are similar to the common cold, but severe cases include wheezing and fevers.

If a baby is unusually tired, breathing rapidly or has bluish fingernails, get help immediately.

The CDC reports an estimated 58,000 to 80,000 children younger than 5 years are hospitalized due to RSV infection as of its latest report, on Jan. 6.

The CDC’s Respiratory Virus Hospitalization Surveillance Network comprises three networks that conduct population-based surveillance for laboratory-confirmed hospitalizations associated with COVID-19, RSV and influenza among children and adults.

Surveillance is conducted through a network of acute care hospitals in 12 states for RSV surveillance, 13 states for COVID-19 surveillance and 14 states for influenza surveillance.

The disease surveys cover more than 30 million people and include an estimated 8% to 10% of the U.S. population.

The CDC reported 29,000 COVID hospitalizations nationwide in the week before Christmas, compared to 39,000 for 2022. It also reported an average of 1,400 weekly deaths since Thanksgiving, which is less than half the fatalities at the same point last year. It reported the number of emergency room visits for respiratory diseases dropped 13.1%.

There have been 37 deaths in Alabama from all three of the viruses.