In response to the recent surge in hospitalizations from COVID-19 and the flu, the Maryland Department of Health has issued recommendations for hospitals and doctor's offices to intensify efforts to curb the spread of illness. One of the key measures suggested is the mandatory use of masks in all patient care areas.

Despite the escalating circulation of what pediatrician Dr. Monique Soileau-Burke referred to as a "tossed salad" of respiratory viruses, doctor's and hospital leaders have expressed that they are not currently overwhelmed by the influx of sick patients, unlike in previous years.

At Adventist HealthCare's emergency departments in Montgomery and Prince George's counties, the number of patients with respiratory illnesses has steadily increased since just before Thanksgiving, as noted by Dr. Patsy McNeil, senior vice president and chief medical officer of Adventist. However, this trend was not unexpected, according to McNeil and her colleagues.

The state's health department has set a threshold of 10 hospitalizations per 100,000 residents as the trigger for implementing "broad facility-wide source control" measures. During the week ending on December 23, the hospitalization rate reached 16.7 per 100,000 residents. However, it dropped to 8.1 during the week of Christmas, the most recent data available.

Several hospitals in Maryland, such as Luminis Health Anne Arundel Medical Center and those operated by LifeBridge Health, have reinstated universal mask mandates for everyone on their premises, including patients, visitors, and employees. Other hospitals, like the University of Maryland Medical Center in Baltimore, are considering following suit.

Currently, the bulk of hospitalizations for respiratory illnesses are driven by COVID-19 and the flu. Hospitalizations for respiratory syncytial virus have already peaked for the season, with the number of hospitalizations dropping from 228 to 104 in recent weeks.

Dr. Gregory Schrank, an epidemiologist at the University of Maryland Medical Center, expects it will take a few more weeks for the circulation of influenza and COVID-19 to decline. He noted that in a typical respiratory season, children tend to fall sick before older adults, suggesting that there may be a decline in pediatric hospitalizations before adult hospitalizations decrease. However, with the COVID-19 pandemic impacting the usual patterns, it remains uncertain how this season will unfold.

As of January 2, there were 545 COVID-19 patients occupying hospital beds in Maryland, a notable increase from the 425 hospitalized on Christmas. Nonetheless, the current figures remain significantly lower than the nearly 800 beds occupied during the same period last year.

State data indicates a slight decrease in flu hospitalizations towards the end of last year, dropping from 391 in the week before Christmas to 370 during the final week of the year.

Luminis Health has reported a welcome decline in patients with respiratory illnesses, witnessing a decrease from around 35 patients after Thanksgiving to approximately 26 patients last Friday. Additionally, the hospital system has seen fewer patients requiring admission to the intensive care unit or ventilation.

Health experts emphasize that vaccination against the flu, COVID-19, and respiratory syncytial virus is a crucial step in avoiding hospitalization, especially in the ICU. However, as of the latest available data, only about a quarter of Marylanders have received their flu shots.

Vaccine hesitancy and fatigue have become prevalent issues in recent years, with an increasing number of parents seeking exemptions from getting their children vaccinated. The Centers for Disease Control and Prevention reported a significant rise in exemption rates from 0.4% to 3% nationwide, with some states exceeding 5%.

Dr. Soileau-Burke has observed that while some parents readily vaccinate their children against the flu, they are less enthusiastic about getting them vaccinated against COVID-19, despite the CDC's assertion that it provides protection against the highly transmissible Omicron subvariant.

In conclusion, Maryland hospitals are bracing themselves for a surge in respiratory illnesses as COVID-19 and flu hospitalizations continue to rise. Implementation of infection control measures, including universal masking, remains crucial in mitigating the spread of these illnesses. Vaccination against flu, COVID-19, and respiratory syncytial virus is strongly encouraged to prevent severe illness and reduce the strain on healthcare facilities.