COEUR d’ALENE — The Panhandle Health District on Thursday reported its first influenza-related deaths of the flu season.

Three Kootenai County residents and one Bonner County resident, all over the age of 80, died of the respiratory illness.

“We are seeing an increase in flu activity in our area along with COVID-19, and RSV continues to circulate, but we are hopeful that RSV has plateaued,” said Jenna Dowell, clinical services division administrator for PHD, in a press release.

Kootenai Health on Thursday reported it had 33 COVID inpatients, with one in ICU; seven confirmed RSV patients in isolation and 11 confirmed influenza patients in isolation.

“In terms of capacity, we continue to have challenges," said Karen Cabell, chief physician. "The emergency department is seeing very high volumes of patients daily and the hospital is at 90-100% capacity on most days. Our teams are working tirelessly to care for the community and accommodate patients as quickly as possible.”

Coming into fall and winter, Idaho Department of Health and Welfare Director Dave Jeppesen was worried about the impact of COVID-19, influenza and RSV (respiratory syncytial virus) circulating at the same time.

Officials said the three respiratory diseases have created a “triple-demic."

“Unfortunately, we have seen our concerns turn into reality,” he said Thursday during a press conference.

Jeppesen said that since Thanksgiving, there has been a surge of people needing health care due to illness. He expects another surge following Christmas and New Year’s Day.

“Hospitals across the state are full and under a tremendous amount of stress,” Jeppesen said.

Idaho has averaged 45 reported influenza-related deaths each year for the last five seasons, with most reported deaths among people over 65 years of age.

Panhandle Health District has had 262 positive RSV tests reported to it so far for the 2022-23 illness season. Last year, it had 83 total cases.

The positivity rate for the flu in the health district is currently about 30%. In the past two years at the point, it was less than 3%.

Katherine Hoyer, Panhandle Health District spokeswoman, said it’s early in the flu season, which typically ranges from late September to late December.

“We are still climbing,” she wrote, adding, "which is concerning."

The state positivity rate for COVID-19, as of Thursday, was 8%. It was 15% for the Panhandle Health District, which covers the state's five northern counties, and 16.2% for Kootenai County.

There were 21 people hospitalized with COVID-19 in the PHD, with 153 new cases in the past week.

Statewide hospitalizations of COVID-19 patients was at 105, according to the Idaho Division of Public Health website, with 1,329 new cases in the past week.

Statewide, 11,587 people have tested for RSV, with 1,896 showing positive, 16.4%.

RSV, for which there is no vaccine, primarily affects children under 2 years old and older adults with chronic heart and lung conditions and weakened immune systems.

For those with preexisting lung diseases, "this can be lethal," said Dr. Jim Souza, chief physician executive at St. Luke’s Health System in Boise. “For the kids, it can be a severe acute illness.”

The Centers for Disease Control and Prevention on Wednesday estimated that nationally so far in the 2022-23 season there have been at least 13 million illnesses, 120,000 hospitalizations and 7,300 deaths from influenza.

Dr. Kathryn Turner, deputy state epidemiologist, said respiratory illness looks very different this winter in Idaho compared with the last two.

“Until this current respiratory disease season hospitals have not had to contend with both high numbers of confirmed COVID-19 patients and high number of confirmed influenza patents while at the same time we have high levels of RSV circulating in the community," she said.

Souza said the number of patients being treated there for respiratory diseases is up, with patients coming from Alaska, California and Oregon.

St. Luke’s has about 50 influenza patients and around 30-50 COVID-19 patients.

He said Idahoans should expect to find busy, crowded emergency departments.

Dr. Christine Hahn, state epidemiologist, said the symptoms of flu, COVID-19 and RSV are similar.

“Only testing can tell the difference between these viruses for sure,” she said.

Health officials said people should get flu shots, COVID-19 boosters, avoid crowds and be cautious at holiday gatherings by wearing a mask.

“We don’t want your holiday gift-giving to be the gift of sickness,” said Elke Shaw-Tulloch, state health official and administrator for the Division of Public Health.