The "Tripledemic" Arrives: Nantucket Faces Surge In Respiratory Illnesses

The shelves of over-the-counter medications at island pharmacies and the Stop & Shop are bare, school absences are spiking, the latest wastewater report shows the presence of COVID-19 at one of the highest levels since the pandemic began, and Nantucket Cottage Hospital is seeing unusually large numbers of confirmed flu cases. The “Tripledemic” has arrived on the island.

Nantucket health officials are now monitoring a surge in viral illnesses - including the flu, COVID-19, and RSV - just as the holiday season arrives.

The federal Centers for Disease Control last week classified Nantucket’s transmission rate for COVID-19 as “high,” making it the only county in Massachusetts at that level. The town of Nantucket’s latest wastewater sampling report from the Surfside Wastewater Treatment Facility shows the prevalence of COVID-19 in island sewage jumped significantly last week, and is now at one of the highest levels since the pandemic began.

At Nantucket Cottage Hospital, clinicians have noted a large uptick in the number of patients being diagnosed with the flu, while absences at the Nantucket Public Schools among students and teachers due to illnesses have been significant over the past week.

“Basically we are seeing another outbreak of COVID, just like we predicted would happen seasonally for the foreseeable future,” Nantucket Health Department Director Roberto Santamaria said. “Like I’ve been saying from the beginning, the new term will be ‘COVID and flu season’ rather than ‘cold and flu.’ We are seeing anecdotal evidence of high transmission, but reportable testing is down. The real outbreak I’m worried about is flu. We have almost three times the amount of confirmed flu than we do COVID.”

While graphs that were generated from the latest COVID-19 wastewater report for Nantucket look as if Nantucket is experiencing an unprecedented spike in the prevalence of the virus, Santamaria said it is the result of a change in the way the firm presents the data.

“They’re testing a new way of reporting the results,” Santamaria said. “They’re showing the relative spike of cases of where we were to where we are. To get a true perspective on the case load look at the previous report. Every other report is the old style.”

Even so, the effective virus concentration recorded in the latest report more than doubled from last week, and the island is higher than 97 percent of all communities that conduct COVID-19 wastewater sampling with the company Biobot.

Nantucket Cottage Hospital infection prevention manager Elizabeth Harris said the increase in viral respiratory illnesses matches what healthcare organizations are seeing around the country in what public health officials have called a "tripledemic."

"We’re seeing in an increase in respiratory illnesses like the rest of the country," Harris said. "It's unusual for us, and unusual for everywhere."

Still, Harris said the hospital's resources have not been overwhelmed by a surge of patients requiring hospitalizations.

The recent spikes in COVID-19 and influenza come on the heels of a surge in RSV cases, primarily among island children, that was noted in late November.

Earlier this month, the Nantucket Health and Human Services Department acknowledged the risings numbers for all three illnesses, and advised “that you maintain physical distances when in public, wear masks if you are feeling any symptoms, and limit your interaction with people outside of your household.”

The free COVID-19 testing program offered by the federal government resumed last Thursday, as the White House announced that every household in in the U.S. can order up to four tests at COVID.gov/tests to get rapid antigen tests in the mail.