COVID and flu cases are up in Fresno. What does that mean for the summer ahead?

New cases of COVID-19 have trickled higher over the past two weeks in Fresno County, stirring a minor reversal after several months of week-to-week declines in infections.

At the same time, Fresno County has experienced an increase in influenza cases typically seen in the winter months.

Both viruses are creating modest concern – but not alarm – among local health officials as Fresno and the central San Joaquin Valley move toward the warm summer months. That’s when the lure of air-conditioned spaces makes for a higher risk of transmission, Fresno County interim health officer Dr. Rais Vohra said.

Two weeks ago, in the week ending April 23, Fresno County had 296 laboratory-confirmed cases of coronavirus, the smallest number of weekly cases since last summer. Cases have since climbed modestly, to 315 cases in the week ending April 30, and 588 this past week.

But compared to thousands of cases that were reported each week throughout January and February when hospitals were profoundly burdened by coronavirus patients, COVID-19 now is causing relatively few problems for the health care system, Vohra said.

“That’s why even though they’re ticking up, they’re still so low that right now we feel comfortable with how things are looking,” Vohra said. “We don’t want to sound a false alarm that we’re entering into a surge.”

So a return to mandatory face masks, social distancing and other virus-prevention measures seems unlikely to return anytime soon.

Vohra added that threats to hospital capacity during COVID-19 surges each of the past two winters were the driving factors behind many of the unpopular social and economic limitations and mandates.

That included indoor mask rules, capacity limitations on businesses, restrictions on indoor gatherings and more – measures aimed at limiting the spread of the virus and minimizing the flow of sick coronavirus patients into hospitals, their emergency rooms and intensive-care units.

“We’re not to the point, even with these small upticks, where hospitals are being impacted,” he added. “This just requires further observation and monitoring.”

Summer’s viral opportunity

While a surge does not appear to be on the horizon in Fresno County, even as cases from new COVID-19 variants increase in other parts of the U.S. and around the world, Vohra suggested that it’s still too early for the public to let down their guard.

“You have to keep in mind that there’s a hidden number of COVID patients that are still circulating among us, and that the numbers are looking more rosy than perhaps they should,” he said.

Vohra added that he was notified Friday that the relatively new BA.2.12.1 variant – estimated to represent about 20% to 30% of new cases in California – has been detected in Fresno County. Because of the lack of testing going on now among the public, it’s like “the tip of an iceberg” in terms of even more cases that haven’t been detected or reported.

“We recognize that we’re not catching every person with a home test kit that turns positive, so that works against our efforts to get a good grip on what’s going on,” he said.

The summer presents a different kind of challenge to keeping the coronavirus in check, as the Valley’s hot weather sends people in search of air conditioned places, whether at home or in malls, stores, movie theaters and other businesses.

“That actually works against us … because respiratory illnesses love indoor crowding,” Vohra said. “As it gets warmer and as you seek out air conditioned areas, you may be putting yourself at increased risk because everybody else is doing the same thing.”

Influenza makes a comeback

While the COVID-19 front is relatively calm, Vohra said his team at the Fresno County Department of Public Health was preparing to issue a health alert for a different respiratory disease: the flu.

“The flu seems to be coming back,” Vohra said Friday. “We are seeing a big uptick in the number of symptomatic people that are coming in for care in the (hospital) emergency departments and now showing up in the hospitals.”

Since March and April, Fresno County has seen a five-fold increase in the rolling seven-day average of visits to hospital emergency rooms by patients with flu symptoms. “Those numbers were very nicely going down since our January surge with the omicron (variant of COVID-19),” Vohra said. “And now that number has come back up. That is a concern.”

Besides the timing of the increase in influenza cases in the summer instead of in the usual winter flu season, what’s unusual “is that it seems to be attacking mostly young people, under age 17, a lot more than the middle aged,” Vohra said.

He suggested that if a person has gotten sick and tested negative for COVID-19 but still feels sick, they should consider getting tested for influenza as well.

Whether COVID or the flu, Vohra advised that people who are sick stay at home and avoid going out in public, where they could potentially spread either virus. He said face masks can help prevent transmission, too.

“Although it’s really unpopular, I really think that masking is still a great idea in light of the fact that the flu is coming back (and) in light of the fact that we’re probably not seeing all of of the COVID because of home testing,” he said. “All of that should remind us all that masking was always a great idea and is still a great idea.”