Philadelphia area hospitals are preparing for potential post-holiday ‘tridemic’ cases

Philadelphia-area hospitals are bracing for a potential post-holiday spike in seasonal illness after a bitterly cold holiday week forced family and friends to gather indoors — often without masks.

Cases of RSV, influenza, and COVID-19 — a highly contagious trio of viruses dubbed the “tridemic” or “tripledemic” — had leveled off or decreased over the past two weeks in the Philadelphia area, according to data from the Centers for Disease Control and Prevention. That’s a welcome break for hospitals that have been overwhelmed by cases of seasonal illnesses, which can be serious for young children, older adults, and people with compromised immune systems.

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While cases of flu-like illness declined for the third consecutive week as of Dec. 24, according to the most recent CDC data, transmission remained high in Pennsylvania and New Jersey.

“I’m concerned about close-quarters gatherings, if people are not masking, that we will see a continued bump,” said Martin Topiel, chief infection control officer at Virtua Health in New Jersey.

The CDC has urged people to wear masks on public transit and in indoor spaces as seasonal illnesses continue to spread.

Virtua hospitals have about half the flu patients they did two weeks ago, Topiel said. RSV has “been a bit of a rollercoaster” for the New Jersey hospital system, he said.

Flu and RSV cases have similarly decreased over the past few weeks at the Hospital of the University of Pennsylvania and Temple University Hospital.

Leading up to Christmas with temperatures in the single digits, COVID cases had plateaued and hospitalizations declined in Pennsylvania. Cases and hospitalizations continued to rise in New Jersey, but remained below holiday-week illness levels from past years, according to the Inquirer’s COVID tracker.

It’s too soon to say how holiday gatherings may affect those trends, said Jennifer Reardon, a Temple spokesperson.

Still, hospitals are preparing to manage an uptick of cases “should the need arise,” said Neil Fishman, the chief medical officer at HUP.

During the COVID pandemic, hospitals adapted to better respond to outbreaks, for instance improving their protocol for triaging patients so the very sickest were treated first, Virtua’s Topiel said. Still, the triple threat of RSV, flu, and COVID has strained staffing resources.

“Our health care staff has been through so much, tirelessly,” he said. “That’s the part we have to figure out how to sustain — how to have health care workers available.”

At the height of the pandemic, hospitals across the country shut down nonemergency services to divert staff to overcrowded emergency departments, intensive care units, and makeshift COVID tents.

Virtua hasn’t had to reassign workers, said Topiel, but he is concerned about the pressure emergency staff are under. The system will look for ways to build up its pipeline of hospital workers in the new year.

In the meantime, doctors are urging people to get their COVID and flu vaccines to protect against severe illness, wear masks when gathering inside, and stay home if they feel sick.