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Tripledemic's sequel likely won’t be as bad for Oregon, expert says

New waves of COVID, RSV and the flu are headed this way, but a top expert forecasts less of an impact on most Oregonians and the state’s hospitals compared to 12 months ago
December 7, 2023

Last fall some called it the “tripledemic,” a combination of rising levels of COVID-19, RSV and the flu that hit Oregonians hard and filled hospital emergency rooms and pediatric intensive care units.

Now, new waves of all three respiratory illnesses are again headed Oregon’s way, a top state forecaster says. But despite some warnings of a potential repeat on the national level, the impact on most Oregonians and the state’s hospitals is unlikely to be quite as bad as last year, judging by an interview with Peter Graven, a health economist at Oregon Health & Science University.

The director of the university’s Office of Advanced Analytics, Graven issued frequent COVID-19 forecasts throughout the pandemic to assist with hospital planning. Now, he does them less frequently, but issued another on Wednesday.

The report shows trends similar to last years, but if anything less of an impact in flu, and roughly equivalent levels of COVID-19. Respiratory syncytial virus (known as RSV), it appears to be on much the same trajectory as last year, Graven projects.

Many Oregonians remain particularly vulnerable to COVID-19 and its ill effects, including the elderly and some people with autoimmune disease, among other groups. 

But many other Oregonians enjoy heightened immunity to COVID-19 right now, Graven said. He also cites increased hospital preparedness, and the timing of when the three waves hit as reasons he is not expecting a repeat of last year..

One difference: last year, the peaks of COVID-19, RSV and the flu all hit hospitals within a “couple of weeks,” Graven said.

The result? Several declared a crisis, legally allowing them to provide reduced levels of care for patients while they tapped hundreds of state-funded temporary nurses that had been authorized by then-Gov. Kate Brown.

This year, the peaks of the three viruses will be spread out over a longer period of time, meaning less of a strain on hospitals and providers’ ability to provide quality care. 

Meanwhile, hospitals generally seem better prepared to treat patients and better staffed.

“We definitely were at some bare minimums for staffing last year,” Graven said. “As an economist, I can say that the price for (temporary) nurses has gone down, which is a signal that in general places are (better) staffed than they were last year. It's still the case that we're in a shortage, but not the same as last year.”

The virus headed for the biggest peak is RSV, even though experts had expedited less prevalence this year than last.

As for influenza, “To me it looks like flu may even be more mild than usual,” he said.

COVID-19 levels are expected to rise this month as well, but Graven says he’s not expecting it to cause the same problems.

One reason:  numerous variants of COVID are all coexisting, with no new aggressive variant arising to challenge immunity built against them in the past, he said.

The other? Oregon saw an unexpected wave in the late summer that likely helped build immunity, Graven said.

One interesting aspect: levels of COVID-19 detected in wastewater are not seeing the same jumps as seen in California and Washington state.

Graven does not expect that to continue. But overall, when it comes to COVID, he suspects Oregon will see “a more moderate winter when compared to last year,” he said.

You can reach Nick Budnick at [email protected] or at @NickBudnick on