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As respiratory viruses strain US health care systems, Biden administration tells states how it's ready to help

MIAMI – Nearly 20,000 people in the United States were admitted to the hospital for flu last week, almost double the number of admissions from the week before, according to data updated Friday by the US Centers for Disease Control and Prevention.

The CDC estimates that there have been at least 8.7 million illnesses, 78,000 hospitalizations and 4,500 deaths from influenza this season.

In a letter to the nation's governors Friday, US Health and Human Services Secretary Xavier Becerra notes that flu and other respiratory viruses are "increasing strain" on the country's health care systems.

In a letter obtained exclusively by CNN, Becerra wrote that the Biden administration "stands ready to continue assisting you with resources, supplies, and personnel."

Last month, children's health leaders requested a formal emergency declaration from the federal government to support hospitals and communities amid an "alarming surge of pediatric respiratory illnesses, including respiratory syncytial virus (RSV) and influenza, along with the continuing children's mental health emergency."

The Biden administration has not declared a public emergency for RSV or flu, but the Becerra letter outlines ways the public health emergency declaration for Covid-19 can be applied to more broadly address challenges brought on by a confluence of Covid-19 and other respiratory and seasonal illnesses.

"The Administration has exercised regulatory flexibilities to help health care providers and suppliers continue to respond to COVID-19. These flexibilities -- while critical in addressing the COVID-19 pandemic -- can also help address many of the challenges you face during the spread of non-COVID-19 illnesses, including RSV and flu," the letter says. "They remain available to you and health care providers as you all make care available in response to flu, RSV, COVID-19, and other illnesses."

For example, if a hospital has staffing shortages that have been exacerbated by the Covid-19 pandemic, it may use a waiver that would allow increased surge capacity or easier patient transfers -- even if the patients need treatment for something other than Covid-19, such as flu or RSV.

The letter also highlights available funding, including $400 million from the US Centers for Disease Control and Prevention to prepare for and respond to public health threats each year, including flu and other respiratory diseases such as RSV, along with data, analysis and other planning resources put together by the federal government. It also notes that the federal government is monitoring the supply chain for critical drugs and devices and that federal health officials over the past month have been engaging with the nation's governors through a meeting hosted by the National Governors Association.

"As your federal partner, we stand ready to evaluate any request for federal medical assistance and support -- including requests for medical personnel and equipment -- working in close coordination with you and local jurisdictions to determine the needs and availability of matching resources," Becerra wrote.

Flu activity has been highest in the South, with hot spots spreading from El Paso to southwest Virginia. All but six states are experiencing "high" or "very high" respiratory virus levels, and seasonal flu activity remains "high and continues to increase," according to the CDC.

There have been nearly 17 flu hospitalizations for every 100,000 people this season, rates typically seen in December or January. The cumulative hospitalization rate hasn't been this high at this point in the season in more than a decade.

The latest surveillance data probably does not reflect the full effects of holiday gatherings, as it only captures through November 26, two days past Thanksgiving.

While flu continues to ramp up, RSV has shown signs of slowing nationwide, but test positivity rates are still higher than they've been in years, and cumulative hospitalization rates are about 10 times higher than typical for this point in the season. Less than two months in, the RSV hospitalization rate this season is already nearing the total RSV hospitalization rate from the entire 2018-19 season.

There is no vaccine for RSV, but health officials have urged people to get their flu shots and updated Covid-19 boosters heading into winter. With the holiday season -- and flu season -- underway, Dr. Anthony Fauci warned this week of the potential for an emergency situation.

"When you have very little wiggle room of intensive care beds, when you have like almost all the intensive care beds that are occupied, it's bad for the children who have RSV and need intensive care. But it also occupies all the beds, and children who have a number of other diseases that require intensive care or ICU, they don't have the bed for it," Fauci, director of the National Institute of Allergy and Infectious Diseases, said on CBS's "Face the Nation" on Sunday. "So if you get to that situation, that's approaching an emergency."

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