Respiratory illnesses are hitting hard, pressuring health care systems.

A vestige of the early days of Covid-19, the respiratory triage tent, is making a reappearance at Community Hospital of the Monterey Peninsula. It’s a proactive move, a spokesperson says, in case of a surge of patients from Covid-19, influenza or respiratory syncytial virus, known as RSV, which has already sickened a large number of children in California putting a strain on pediatric ICU beds across the state. With no such beds in Monterey County, numerous children have been flown by helicopter to other counties where beds are available.

Covid is already on an upswing in Monterey County: As of Dec. 5, the county logged 185 more cases than the week before, with the seven-day test positivity rate rising from 6.2 percent to 7.1 percent. The seven-day average case rate per 100,000 residents rose from 7.1 to 8.0. The state was reporting 34 Covid patients in three hospitals – CHOMP, Salinas Valley Memorial and Natividad. The number has been consistently rising since October.

At SVMH, health care providers are seeing two to three times the number of pediatric patients compared to past years. The pressure is being felt at all three hospitals, says Allen Radner, an infectious disease specialist who cares for patients at each. He says the sharp rise of RSV in children – who usually experience the virus before the age of 2 and develop an immunity – is due to a lack of exposure thanks to lockdowns and social distancing of the last two winter seasons. It’s also a bad year for the flu, which disproportionately affects older people.

There is no vaccine for RSV, but there are safe and effective vaccines for Covid and flu that are proven to prevent hospitalizations and death, Radner says, including the latest bivalent booster for Covid. Research shows that immunity from the Covid vaccines waned over time, warranting another vaccination, making a Covid booster much like getting an annual flu shot.

Monterey County reports a vaccination rate of 72.4 percent for the primary series of two shots. Only 54.7 percent of the population has received the primary series and one booster. Only 16.1 percent have received the newer bivalent vaccine. Andrea Zoodsma, director of community services for the Visiting Nurses Association of the Central Coast, says she was surprised to hear people say, “‘I’ve had enough Covid vaccine,’” when the bivalent became available. “We just try to educate them that we’re trying to get ahead of the game,” she says.

Since September, VNA has administered nearly 6,800 flu and Covid vaccines. Since receiving both at the same time is well-tolerated by most people, nurses often encourage people who come in for their annual flu vaccine to get a Covid vaccine as well.

Radner says it’s about more than just self-preservation. “We’re hoping people will be willing to do it so they protect their families and the people they interact with,” he says. Washing hands and wearing masks are a good idea too, he says. The Centers for Disease Control recommended on Dec. 4 that people return to wearing masks in public settings.