Local experts expect post-Thanksgiving jump in COVID-19, flu and RSV infections

As people abandon pandemic-era precautions and hold multigenerational gatherings with extended family and friends, the risk of spreading respiratory illness increases.|

As Sonoma County residents prepare for Thanksgiving travel and gatherings, local infectious disease experts warn of a bump — if not an explosion — in respiratory viral illnesses, including influenza, COVID-19 and respiratory syncytial virus.

Cases of the flu and RSV are already surging, and COVID-19 is once again on the rise, according to local public health data.

Thanksgiving gatherings and travel will almost certainly accelerate transmission of all three illnesses, said Dr. Gary Green, an infectious disease expert with Sutter Santa Rosa Regional Hospital.

“As people get together, if we don't take precautions, I really think we're going to see either a bump in cases or an explosion of cases,” Green said.

Green said people have essentially let their guard down, abandoning many pandemic-era precautions such as social distancing and masking. This year’s Thanksgiving gatherings are likely to once again be multigenerational and include visits from extended family and friends.

“In the early part of the pandemic, the families that got hit the most were those that were multigenerational, and in one household, because some people still had to go to work,” Green said. “I think we're going to recreate that setting. With the holidays, we're going to have multigenerational gatherings under one roof.”

The flu, which for a few years was held at bay by pandemic-era public health precautions, has returned with a vengeance. According to the latest public health data, on Nov. 18 there were 30 Sonoma County residents hospitalized for the flu, compared with 18 for COVID-19.

Because many hospital patients are still prescreened for COVID-19, the 18 figure likely includes a share of people who sought hospital care for something other than COVID-19 but ended up testing positive for the virus. In contrast, those who test positive for influenza are likely seeking care for a respiratory illness.

Dr. Siamack Nemazie, assistant physician in chief for hospital operations at Kaiser Santa Rosa Medical Center, said emergency department visits for respiratory illnesses have been increasing significantly for the past two to three weeks. To a lesser degree, hospitalizations also have been on the rise.

“We’re all facing impacts from an increasing number of patients coming in with the flu, RSV and, right now to a lesser degree, with COVID-19,” Nemazie said. “We were so good with our preventive measures for the last three years that we really haven’t had a big RSV season … and definitely minimal to none in terms of the flu season.”

Nemazie said influenza and RSV infections are “clearly catching up to us now,” with the elimination of mask mandates and people traveling and moving about in their communities more than they have at any other point in the pandemic.

Dr. John Swartzberg, an infectious disease expert at UC Berkeley said he also feared a significant uptick in flu, RSV and COVID-19 this holiday season. Swartzberg recommended people should take the following precautions for Thanksgiving gatherings:

  • Ensure that everyone attending the gathering is symptom free.
  • Between now and Thanksgiving, reduce your chances of infection by limiting your exposure to others, wearing a mask indoors in public and wash your hands frequently.
  • Take a rapid antigen test before shortly before attending the gathering.

Swartzberg said people should make sure there’s good ventilation by opening windows and, when possible, using a HEPA filter. Swartzberg said it might be a good idea to do a rapid test on Tuesday and then test again a couple of hours before gathering with others. That should reduce the threat of possible false negatives.

“If both of those are negative, the chances of you transmitting the virus are really small,” he said.

Dr. Sundari Mase, the county’s health officer, said Sonoma County has historically had low flu vaccination rates, at only about 30%. As with the COVID-19 vaccine and booster, the flu vaccine greatly reduces the chances of severe illness, she said.

Mase said flu hospitalizations have been on the rise for the past three weeks. She recommended that local residents get vaccinated for the flu as soon as possible, as well as get inoculated with the new COVID-19 booster.

“I'm still advising masking for my family, for my friends and for the community,” she said. “In Sonoma County, it’s a high recommendation if you think you’re vulnerable. This is a time for you to take your own precautions.”

You can reach Staff Writer Martin Espinoza at 707-521-5213 or On Twitter @pressreno.

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