A wave of the highly contagious respiratory syncytial virus is sweeping across the United States — sending greater numbers of babies and toddlers to the hospital, recent data show.

The onset of RSV comes as the country heads into the wider fall-and-winter respiratory virus season, also typically marked by increased circulation of ailments such as COVID-19 and the flu. But RSV, the leading cause of infant hospitalization nationwide, presents particular risk for the youngest babies, a major reason health experts recommend pregnant women either get vaccinated near their delivery date or immunize their newborns.

“This is the perfect time to get your vaccine for RSV if you have never gotten one,” the Los Angeles County Department of Public Health said in a statement to The Times.

RSV can spread through coughs or sneezes but also by touching a contaminated surface, such as a door handle, and then touching your face before washing your hands, health officials warn.

For the week ending Oct. 11, about 1.2% of emergency room visits nationwide among infants younger than 1 were due to RSV — up from 0.4% a month earlier, according to data posted by PopHIVE, a project led by the Yale School of Public Health.

“An RSV wave is starting to take hold,” epidemiologists Katelyn Jetelina and Hannah Totte wrote in the blog Your Local Epidemiologist.

RSV can be dangerous for infants, older adults and people with certain medical conditions, according to the U.S. Centers for Disease Control and Prevention. RSV can cause pneumonia, as well as a severe inflammation of the lungs’ small airways, known as bronchiolitis, the California Department of Public Health said.

“The issue with kids is that their airways are so small that when it causes inflammation in the airways, it’s just very hard to breathe,” said Dr. Peter Chin-Hong, a UC San Francisco infectious diseases expert. “So they come in with wheezing … and that’s why they get into trouble.”

Nationally, RSV kills up to 300 children under age 5 annually, and can send up to 80,000 to the hospital. Among seniors age 65 and older, the virus can cause up to 10,000 deaths in a typical year and as many as 160,000 hospitalizations, according to the CDC.

“I think it’s been kind of invisible, mainly because until recently … people wouldn’t test — we couldn’t test for RSV until the age of molecular diagnostics,” Chin-Hong said. “So it has been kind of an invisible epidemic.”

RSV is “kind of a bronze medalist of respiratory viruses, with COVID and influenza No. 1 and No. 2, duking it out, and RSV is No. 3 for older adults,” he added. In general, RSV is the first to emerge during the fall-and-winter virus season, followed by flu then COVID, Chin-Hong said.

Before immunizations became available, about 2% to 3% of young infants were hospitalized for RSV annually, according to the CDC. Most children who are hospitalized for acute respiratory disease caused by RSV were previously healthy, according to a study published by the journal Pediatrics.

They may require oxygen or intravenous fluid or even be put on a ventilator to help them breathe, according to the CDC.

Unlike the flu and COVID-19, there are no antiviral drugs to treat RSV once infection sets in.

For now, the combined activity of respiratory illness from RSV, flu and COVID-19 is considered “very low” in California, state health officials said.

But “we are starting to see the beginnings of respiratory virus season,” the L.A. County Department of Public Health said.

Health officials in Santa Clara County, Northern California’s most populous, are already reporting “medium” levels of RSV in the wastewater of San José, Palo Alto and Sunnyvale.

Now is exactly the time to get vaccinated if you haven’t already — “especially before respiratory virus activity potentially increases later,” said Dr. Regina Chinsio-Kwong, the Orange County health officer.

RSV immunizations are recommended for pregnant women between 32 and 36 weeks of gestational age — about one to two months before their estimated delivery date — as well as for everyone age 75 and up and those age 50 to 74 with underlying medical conditions such as diabetes, cancer, kidney disease, weakened immune systems, asthma or heart disease. Vaccines are also recommended for individuals who live in a nursing home or long-term-care facility.

If a pregnant woman wasn’t vaccinated against RSV, officials recommend her infant get immunized.

RSV vaccinations are fairly new, being introduced in 2023. There are now three brands — Pfizer’s Abrysvo and GSK’s Arexvy were licensed in May 2023, and Moderna’s mResvia in June 2024. All three can be used for older adults, but only the Pfizer vaccine is available for pregnant women.

Infants were also able to get immunized starting that year through monoclonal antibodies, which aren’t technically vaccines but function similarly in this case.

Older adults who already received an RSV vaccination generally don’t need to get another one.

The arrival of those vaccines followed a particularly brutal 2022-23 respiratory virus season when California was slammed by a hospital-straining “tripledemic” of RSV, flu and COVID.

Unlike the RSV shots, flu and COVID vaccinations are generally recommended ahead of every fall-and-winter virus respiratory season. Older adults, those age 65 and up, can get the COVID vaccination every six months, according to the California Department of Public Health.

People can get the RSV, flu and COVID vaccinations all during the same visit to a healthcare provider, Chinsio-Kwong said.

“Receiving all eligible vaccines at once is considered best practice, as it helps avoid missed opportunities due to scheduling challenges,” she said.

Studies have shown the RSV immunizations are effective.

During last year’s respiratory virus season, there were significant reductions in the RSV hospitalization rate for babies, data show. Data also show RSV vaccines were effective in preventing symptomatic illness in older adults.

Chin-Hong said he suggests “everyone should get it” if they are 75 or older, and for those between age 50 and 74 with heart or lung disease or are very immune compromised, “I think the juice is worth the squeeze.”

Annual routine flu vaccines are recommended for everyone who is at least 6 months old.

As for COVID, a vaccine can be given to anyone who wants one. The California Department of Public Health specifically recommends the shots for everyone age 65 and up, babies age 6 months to 23 months, children and teenagers who have never been vaccinated, and people with certain health risk factors and those in close contact with them.

The California Department of Public Health also recommends pregnant women get the COVID vaccination.

After concerns earlier this season about how difficult it might be to get COVID vaccinations, pharmacists and California health officials now say securing the shots is relatively easy.

The controversy arose in the late summer amid confusing guidance coming from agencies overseen by Health and Human Services Secretary Robert F. Kennedy Jr., who has disparaged vaccinations.

There was a period during which the Food and Drug Administration had belatedly approved COVID-19 vaccines only for those age 65 and up and younger people with underlying health conditions. An unprecedented delay in the CDC issuing its own recommendations had the effect of snarling vaccinations for many.

In some states, that meant people were being turned away from getting the COVID vaccine at their local pharmacy, including seniors, even as a late summer surge was raging. And at one point, the powerful CDC Advisory Committee on Immunization Practices nearly recommended the COVID vaccine be available by prescription only.

On Oct. 6, acting CDC Director Jim O’Neill officially lifted the agency’s recommendation that adults under age 65 get the updated COVID-19 vaccine, saying instead that doing so should be based on “individual-based decision-making” in consultation with health professionals.

Now, “patients can go into the pharmacy” and can have conversations on whether to get the COVID-19 vaccine with a professional, Allison Hill, a director of professional affairs for the American Pharmacists Assn., said during a recent webinar.

California also recently clarified state law to make sure that pharmacists can independently administer the COVID vaccine, according to Dr. Erica Pan, director of the state Department of Public Health.

Californians renewing their public health plans or who plan to sign up for the first time will be in for sticker shock when open enrollment begins on Saturday. Monthly premiums for federally subsidized plans available on the Covered California exchange — often referred to as Obamacare — will soar by 97% on average for 2026.

The skyrocketing premiums come as a result of a conflict at the center of the current federal government shutdown, which began on Oct. 1: a budgetary impasse between the Republican majority and Democrats over whether to preserve enhanced, Biden-era tax credits that expanded healthcare eligibility to millions more Americans and kept monthly insurance costs affordable for existing policyholders. About 1.7 million of the 1.9 million Californians currently on a Covered California plan benefit from the tax credits.

Open enrollment for the coming year runs from Nov. 1 until Jan. 31. It’s traditionally the period when members compare options and make changes to existing plans and when new members opt in.

Only this time, the government shutdown has stirred uncertainty about the fate of the subsidies, first introduced during the COVID-19 pandemic and which have been keeping policy costs low, but will expire at the end of the year if lawmakers in Washington don’t act to extend them.

Californians window shopping on the exchange’s consumer homepage will have to make some tough decisions, said Covered California Executive Director Jessica Altman. The loss of the tax credits to subsidize premiums only adds to what can already be a complicated, time-consuming and frustrating process.

Even if the subsidies remained intact, premiums for plans offered by Covered California were set to rise by roughly 10% for 2026, due to spikes in drug prices and other medical services, Altman said.

Without the subsidies, Covered California said its members who receive financial assistance will see their monthly premiums jump by an additional $125 a month, on average, for 2026.

The organization projects that the cost increases will lead many Californians to simply go without coverage.

“Californians are going to be facing a double whammy: premiums going up and tax credits going away,” Altman said. “We estimate that as many as 400,000 of our current enrollees will disenroll and effectively be priced out of the health insurance that they have today. That is a devastating outcome.”

Indeed, the premium spike threatens to lock out the very Americans that the 2010 Affordable Care Act — President Obama’s signature domestic policy win — was intended to help, said Altman. That includes people who earn too much to qualify for Medicaid but who either make too little to afford a private plan or don’t work for an employer that pays a portion of the premiums.

That’s a broad swath of Californians — including many bartenders and hairdressers, small business owners and their employees, farmers and farm workers, freelancers, ride-share drivers, and those working multiple part-time gigs to make ends meet. The policy change will also affect Californians who use the healthcare system more frequently because they have ongoing conditions that are costly to treat.

By raising the tax-credit eligibility threshold to include Americans earning more than 400% of the federal poverty level, the Biden-era subsidies at the heart of the budget stalemate have brought an estimated 160,000 additional middle-income Californians into the system, Covered California said. The enhanced subsidies save members about $2.5 billion a year overall in out-of-pocket premium expenses, according to the exchange.

California lawmakers have tried to provide some relief from rising Covered California premiums by recently allocating an additional $190 million in state-level tax credits in next year’s budget for individuals who earn up to 150% of the federal poverty level. That would keep monthly premiums consistent with 2025 levels for a person making up to $23,475 a year, or a family of four bringing in $48,225 a year, and provide partial relief for individuals and households making slightly more.

Altman said the state tax credits will help. But it may not be enough. Forecasts from the Urban Institute, a nonprofit research group and think tank, also show a significant drop-off of roughly 400,000 enrolled members in Covered California.

The national outlook is even worse. The Congressional Budget Office warned Congress nearly a year ago that if the enhanced premium subsidies were allowed to expire, the ranks of the uninsured would swell by 2.2 million nationwide in 2026 alone — and by an average of 3.8 million Americans each year from 2026 to 2034.

Organizations that provide affordable Obamacare plans are preparing for Californians to get squeezed out of the system if the expanded subsidies disappear.

L.A. Care, the county’s largest publicly operated health plan, offers Covered California policies for 230,000 mostly lower-income people. About 90% of the Covered California consumers they work with receive subsidies to offset their out-of-pocket healthcare insurance costs, said Martha Santana-Chin, L.A. Care’s CEO. “Unless something drastic happens … a lot of those people are going to fall off of their coverage,” Santana-Chin said.

That outcome would ripple far and wide, she said — thanks to two factors: human behavior and basic economics.

If more and more people choose to go uninsured, more and more people will resort to visiting hospital emergency rooms for non-emergency care, disrupting and overwhelming the healthcare system.

Healthcare providers will be forced to address the cost of treating rising numbers of uninsured people by raising the prices they bill to insurers for patients who have private plans. That means Californians who are not Covered California members and don’t receive other federal healthcare aid will eventually see their premiums spike too, as private insurers pass any added costs down to their customers.

But right now, with the subsidies set to end soon and recent changes to Medicaid eligibility requirements threatening to knock some of the lowest-income Californians off of that system, both Altman and Santana-Chin said their main concern is for those who don’t have alternatives.

In particular, they are concerned about people of color, who are disproportionately represented among low-income Californians, according to the Public Policy Institute of California. Any hike in out-of-pocket insurance costs next year could blow the budget of a family barely getting by.

“$100, $150, $200 — that’s meaningful to people living on fixed incomes,” Altman said. “Where is that money coming from when you’re living paycheck to paycheck?”

A controversial plan to kill one owl species to save another cleared a major hurdle.

The full Senate on Wednesday struck down a GOP effort to prevent the cull of up to 450,000 barred owls in the Pacific Northwest over three decades, ending a saga that created strange political bedfellows.

It’s a major win for environmentalists and federal wildlife officials who want to protect northern spotted owls that have been crowded out by their larger, more aggressive cousins. In recent weeks they got an unlikely ally in loggers who said scuttling the U.S. Fish and Wildlife Service plan could hinder timber sales.

But it’s a blow to an equally unusual alliance that includes right-wing politicians and animal rights advocates who argue the cull is too expensive and inhumane. The Trump administration leaned on Republican lawmakers to get out of the way, scrambling partisan lines.

Sen. John Kennedy, a conservative from Louisiana, sought to nix the owl-killing plan via the Congressional Review Act, which can be used to overturn recent rules by federal agencies.

Kennedy said Interior Secretary Doug Burgum, whose portfolio includes timber production, recently called him and told him to abandon the resolution. This month logging advocates said that stopping the cull would jeopardize timber production goals set by the Trump administration.

But Kennedy was not persuaded.

“The secretary needed to call somebody who cared what he thought, because I think he’s wrong,” Kennedy said on the Senate floor. “I think he and the other members of the administrative state at the Department of the Interior decided to play God.”

Flanked by pictures of owls and bumbling cartoon hunter Elmer Fudd, Kennedy praised barred owls for their “soulful eyes” and “incredibly soft” feathers. But he acknowledged they’re better hunters than spotted owls. Barred owls, which moved over from eastern North America, are outcompeting spotted owls for food and shelter in their native territory.

Ultimately the resolution failed 72 to 25, with three lawmakers not voting. Nearly all those who voted in favor of the resolution were Republican, but even more Republicans voted against it. The Fish and Wildlife Service approved the barred owl cull last year under the Biden Administration.

“I feel a lot of relief because this was one of the most major threats to the long-term, continued existence of the northern spotted owl in many years,” said Tom Wheeler, executive director of the Environmental Protection Information Center. “We’ve passed this hurdle, which isn’t to say there aren’t other hurdles or road bumps up ahead, but this feels good.”

Wheeler described the failed effort as a “nuclear threat” — if the resolution had passed, the Fish and Wildlife Service would have been blocked from pursuing any similar rule, unless explicitly authorized by Congress.

Now Wheeler said he and his allies will continue to push for the owl cull to be carried out, and for federal funding to support it.

Animal welfare advocates like Wayne Pacelle, president of Animal Wellness Action and Center for a Humane Economy, are dismayed.

“What this means is that not only are barred owls at extreme risk of large-scale shooting, but spotted owls and old-growth forests are at risk from chainsaws,” Pacelle said of the failed resolution.

Pacelle’s camp vowed to continue the fight. A lawsuit challenging the hunt they filed against the federal government last fall is moving forward. And they’ll try to ensure money doesn’t flow to the program.

In May, federal officials canceled three related grants in California totaling more than $1.1 million, including one study that would have included lethally removing barred owls from more than 192,000 acres in Mendocino and Sonoma counties.

However, there are other projects to kill barred owls in the Golden State, according to Peter Tira, a spokesperson for the California Department of Fish and Wildlife.

One $4.3-million grant issued by the state agency will support barred owl removal in the northwestern part of the state, along with other research. Another grant issued by NASA to a university involves killing barred owls in California as well as creating a tool to prioritize areas where the raptors need to be managed.

It’s not clear how or if the government shutdown, now stretching into its 31st day, is affecting the projects, Tira said in an email.