As respiratory illness ramps up, Berkshire Health Systems prepares to mask | Local News

For Stephanie Nesbitt, the symptoms started a few days before Christmas with a sore throat and some sneezing.

A day later, her symptoms worsened, and she took two rapid tests for COVID-19. Both came back negative. By Christmas, Nesbitt was feeling even worse, so she scheduled an appointment to be seen at Berkshire Health Urgent Care the following day.

Sound familiar? Respiratory illness tends to spike in winter. And this season is no exception: You or someone you know is likely suffering just like Nesbitt.

The Centers for Disease Control and Prevention data shows respiratory illnesses were on the rise in December throughout southern New England and New York. Levels were low in Vermont and Maine but very high in New Hampshire.

At Berkshire Health Systems’ three facilities in North Adams, Pittsfield and Great Barrington, there were six to eight COVID admissions across all three hospitals as of Monday.

Dr. James Lederer, chief medical officer and chief quality officer for Berkshire Health Systems, said the uptick of RSV — or Respiratory Syncytial Virus, a common and highly contagious virus that primarily affects the respiratory system — that began in November is probably more significant than COVID or influenza, although influenza has been on the rise in the past two weeks as well across the state. 

“In winter, we tend to usually see influenza start to spike somewhere in January,” he said.

In anticipation of the expected rise in respiratory illness, Berkshire Health Systems is enacting masking protocols starting Thursday. Health officials are beginning reviews of virus activity on a weekly basis to determine masking requirements.

“We’re watching our staffing absences,” Lederer told The Eagle. “We’re watching the respiratory dashboard. We’re watching the wastewater [for the virus that causes COVID-19]. We’re watching our COVID admissions and our Emergency Department admissions.”

The masking protocol is based on three levels of severity, according to the Berkshire Health Systems masking protocol memo. A green level means respiratory viruses are low and masking is voluntary unless someone is symptomatic when in a BHS facility. Yellow signifies moderate virus activity and would require masking for all staff when in direct contact with patients, masking for those with symptoms and voluntary masking for all others. It would also limit visitation to those over 18 years of age. A red level means virus activity is high and masking is required for health care professionals, patients and visitors, with additional limits on visitor access and universal testing of all inpatients at BHS hospitals.

In that memo, Lederer also advocated masking, regular hand washing and social distancing to prevent the spread of COVID, RSV and influenza.

He also advises vaccinations.

In the last six months in Berkshire County, 20.2 percent of residents have received a COVID-19 vaccination and 32.4 percent have received the influenza vaccination, according to the Massachusetts Department of Public Health’s online dashboard.

RSV can pose significant risk to very young children, whose airways are so small that any inflammation will compromise their breathing, or in adults, particularly older adults, who may have “underlying co-morbid illness, particularly respiratory illness,” Lederer said.

What about pneumonia?

“Pneumonia is just a more severe manifestation of any viral illness,” he said. “So I can have RSV, where I have the runny nose, the slight sore throat, the cough, but it can also end up being more severe where I have significant cough, shortness of breath, wheezing, chest congestion.”

By the time Nesbitt got to Urgent Care, “I was very miserable. Lots of head congestion, pain in my face, even like my teeth were hurting, headache. I felt like my head was being squeezed.”

Nesbitt donned a mask before going in, decided against taking one of the two open seats in the waiting room and headed back to her car to wait. It took an hour.

“I kind of think that made my lungs worse, because I waited in the car and it was really cold,” she said. “I can’t imagine how long the people who just walked in had to wait.”

She was tested for both flu and strep throat. Both tests came back negative. Her diagnosis was a sinus infection for which she was prescribed antibiotics.

But by Monday, she was feeling worse. Her congestion had descended to her chest. She’d begun wheezing and had developed a productive cough complete with phlegm. She was also experiencing fatigue and mild body aches.

“I’m making a follow-up appointment with my primary care doctor, just to make sure we’re treating the right thing,” she said.