"Tripledemic" in U.S. could bring deluge of patients to hospitals

Threat of "tripledemic" looms over holidays

The U.S. could very well face what has been dubbed a "tripledemic" this winter, with cases of COVID-19, the flu and a virus called respiratory syncytial virus (RSV) surging at the same time. 

Cases of RSV are rising quickly in young children, who typically contract the virus by the time they're 3, but were shielded from it and other viruses during pandemic lockdown periods. 

"Pediatric ICUs around the country, many parts of it, are full," said CBS News medical contributor Dr. David Agus. Most hospitalizations now are related to influenza and RSV, not COVID-19, he added.  

The threat of a "tripledemic" is not new, according to Dr. Michael Mina, chief science officer at eMed and the nation's leading epidemiologist.

"Public health officials have been bracing for this possibility since early in the pandemic," he said in a statement to CBS MoneyWatch. 

Americans' weakened immunity — a result of hunkering down and limiting exposure to others during the COVID-19 pandemic — is the reason for the simultaneous surge in cases of three different viruses. 

"The recent surges are fully expected ramifications of a new virus that caused massive swings in human behavior. We know that immunity is working exactly as it was supposed to, and in this case, it means that we drained population-level immunity by not having exposures," Dr. Mina said. 

Dr. Mina urged hospitals to prepare now by stockpiling supplies and identifying ways to increase capacity by adding new beds. 

The simultaneous increase in cases of three distinct viruses comes as more professionals are leaving the health care field for work that pays better or is less physically and emotionally draining, which could further threaten the nation's strained health care system.

"I'm concerned that hospitals, health care providers are going to be overwhelmed," said CBS News medical contributor and Kaiser Health News editor-at-large Dr. Celine Gounder. "We're looking at very high rates of both flu and RSV, so probably something around like 35,000 hospitalizations per week just from those two conditions."

Of course, COVID-19 is still around, too. "Are we going to be prepared, are we going to have the beds? I'm really concerned about that," Gounder said. 

Unmanned hospital beds

A vaccine is now available for RSV, a common respiratory virus that causes cold-like symptoms but which can be serious in infants and older adults, according to the Centers for Disease Control and Prevention. 

Lately, a spike in RSV cases among very young children has overwhelmed pediatric hospitals. Little kids are especially susceptible to developing severe symptoms because their immune systems are undeveloped and their airways are smaller than those of adults, making it harder to breathe when inflamed. 

The health care system is also grappling with a reduced labor force following an exodus of health care workers from the field during the pandemic, largely due to burnout. That means that even more work falls on the laps of the nurses, doctors and administrative and support staff who remain in the industry. 

Some 330,000 medical professionals dropped out of the labor force in 2021 according to health care commercial intelligence company Definitive Healthcare. 

"It's an even more difficult situation, [with] even more understaffing, so then even more people get burned out and leave," Gounder said.

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Seeking better balance

Some of the physicians, nurse practitioners, physician assistants and other providers left their jobs to retire early, while others decided to seek out administrative work and stop seeing patients.

"So it's all different kinds of ways of reducing that burnout of having a better work-life balance which, frankly, over the last couple of years, it's been really hard on people," Gounder said. 

Gounder said she's already seeing the impact of limited staff on patients seeking care at Bellevue Hospital in New York City.

"Patients are sitting in the emergency room for a day or two waiting for a bed, because it's not just about having the physical bed — you need to have the doctors, the nurses, the other staff to man that bed," she said. 

"The whole system is really clogged up right now," she added. 

Workers across diverse fields left jobs in search of better wages and working conditions during the so-called "Great Resignation."

There's no clear-cut solution or obvious way to lure more professionals back to the medical field, and though higher wages wouldn't hurt, better pay alone won't fix the issue, according to Gounder. 

"I think people are valuing their time in a whole different way now, and I do think it would require really rethinking the business model of health care, really changing how we structure health care, how we deliver it, who provides it," she said. "I'm somewhat skeptical that we're going to make those changes." 

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