Three waves of respiratory disease are overlapping this winter, driving patient numbers in hospitals to maximum levels, state officials said Thursday.

Respiratory syncytial virus — known as RSV — has sickened children and, increasingly, older adults. Oregon has simultaneously been slammed with a wave of influenza, as well as the latest omicron subvariants of COVID-19.

"Things will get worse before they get better," said Dr. Dean Sidelinger, state epidemiologist, who was joined by other medical professionals on a video press call Thursday.

Sidelinger said the trio of illnesses has pushed intensive care hospital bed demand to a level that "never happened during the darkest days" of the COVID-19 pandemic.

RSV-related cases in children showed a five-fold increase between Oct. 23 and Nov. 13. It peaked Nov. 19, but remains above rates of any previous peak. Seriously ill children will need long-term care to recover.

Sidelinger said there were no plans for a mandatory mask mandate, but urged people of all ages to wear masks indoors in crowded situations, such as stores or events.

Dr. Wendy Hasson, medical director of the pediatric intensive care unit of Randall Children's Hospital at Legacy Emanuel, said parents of small children should take additional steps, avoiding gatherings where infections can spread.

"Now is not the time to go to indoor places, birthday parties," she said. "Parents of very young babies (are) empowered to say 'no' to visitors." Hassan said.

Gov. Kate Brown on Wednesday authorized the deployment of volunteer teams to hospitals with staffing emergencies. She also asked for $25 million in state funds to pay for out-of-state nurses and medical staff training in intensive care of respiratory diseases.

Sidelinger said state efforts won't be hampered by the Jan. 9 change in administrations in Salem when Gov.-elect Tina Kotek is inaugurated.

Kotek has assigned staff to work with OHA on "continuity of care," said Sidelinger, who plans to stay on after Brown departs. Kotek has been critical of some policies of OHA Director Pat Allen, who has given his resignation, effective Jan. 9.

The flu season has proven severe as well, with cases doubling week over week for five consecutive weeks. Hospitals are now seeing a 30% positive test result for flu in patients, up from 1 percent a month ago. Hospitalizations for flu are especially rising among people 65 and older.

"The hospitalization rate in the elderly is up tenfold," Sidelinger said.

The trajectory for flu is expected to rise as holiday gatherings bring more people together in enclosed spaces where the virus can spread easily.

While COVID-19 has not dominated the health picture as it has in the past two holiday seasons, it is on the rise again. The current omicron subvariant has pushed COVID-19 hospitalizations from a daily average of 235 to 347 over the past month, a 48% increase. The number of COVID-19 patients in intensive care units around the state has risen from 27 to 35 over the same period. The latest weekly death toll was 28, though Sidelinger called mortality a "lagging indicator" and the sheer number of cases could drive that figure up later in the winter months.

"The COVID-19 pandemic is not over," Sidelinger said.

The current infections have hit children especially hard. Gravely ill children have to be sent to one of three specialized hospitalizes in the Portland area that have pediatric ICUs.

"We haven't seen anything like this before, this unprecedented surge of demand for care." said Dr. Ray Moreno, chief medical officer at Providence St. Vincent Medical Center.

Dr. Matthias Merkel, senior associate chief medical officer at OHSU, saw the situation on a personal level when he brought his daughter to OHSU's emergency room on a non-critical matter.

"I had to wait for 12 hours in my own emergency room because ambulance after ambulance arrived with children who needed immediate care," Merkel said.

Dec. 31 will mark the three-year anniversary of the reporting of the first COVID-19 cases in Wuhan, China.

The Johns Hopkins University Coronavirus Resource Center reports 647,560,719 cases worldwide since the beginning of the virus spread. COVID-19 has killed 6,648,433 around the world and 1,083,905 in the United States.

Johns Hopkins warned of the coming "tripledemic" in early November.

"We're dealing with the rise in RSV, the potential for a bad flu season, and another potential COVID surge, in the backdrop of a health care workforce that has been depleted over the last several years," said Brian Garibaldi, clinical lead for the Johns Hopkins Coronavirus Resource Center.

"That's one of our biggest concerns: Can we sustain ourselves through these surges, provide care for the patients who need it, but also maintain the level of workforce that we need to be able to care for all the other health care issues that are happening in people's lives?"

The Oregon Capital Bureau is a news partner of the Pamplin Media Group.