Soaring RSV Cases Continue to Overwhelm Hospitals
Twenty-five states and Washington, D.C. are reporting at least 75% of their pediatric hospital beds are full.
U.S. hospitals are struggling to keep up with the continued increase in respiratory illnesses among children, most commonly RSV.
Respiratory syncytial virus, often referred to as RSV, is a respiratory illness common among babies and children. The most common symptoms include a runny nose, coughing, sneezing, fever, and a decrease in appetite. More severe symptoms include difficulty breathing and dehydration which may require hospitalization.
While the illness largely circulates in the winter months, pediatricians and other health providers say the surge is happening much earlier than usual. Across the country, 25 states and Washington, D.C. are reporting at least 75% of their pediatric hospital beds are full, largely with children with respiratory illnesses, reports NBC News.
According to data from the Centers for Disease Control and Prevention (CDC), there were 8,597 cases of RSV detected the week of Nov. 5. New CDC data also shows the hospitalization rate for RSV among people 65 and older is about 10 times higher than it was pre-pandemic. Midwestern states, including Minnesota, Nebraska, Missouri, and Wisconsin, are seeing the highest positivity rates.
MassGeneral Hospital for Children has postponed some elective pediatric procedures to free up space for sick patients. Because the pediatric intensive care unit is so full, the hospital is transferring some pediatric patients to its general care unit. In October, the hospital saw 2,000 positive RSV tests. Only halfway through November, the hospital has seen 1,800.
Lori Pugsley, nursing director for the hospital’s inpatient pediatric units, calls it a pediatric crisis. In the 33 years she has worked at the Boston hospital, Pugsley said she has never seen the surge of RSV begin in October.
About an hour north in New Hampshire, there were no pediatric intensive care unit beds available as of Monday, according to WMUR. In addition to an earlier peak and greater numbers, this year’s strain of RSV is more severe, according to Dr. Dan Hale, pediatric medical director at Portsmouth Regional Hospital.
“These kids are getting really sick, under six months. Those are the ones ending up in the hospital, in the ICU, sometimes on a ventilator,” he said. “We’re seeing more children now than we did during the coronavirus peak epidemic.”
Officials at Portsmouth Regional and Exeter Hospital said they are able to treat some patients in the emergency department and send them home, but for babies and young children who are very sick, it can take several hours for a pediatric ICU bed to open up at any New England hospital.
“We’re a Mass. General program at Exeter, so we prefer to utilize the PICU at MGH,” said Exeter Hospital’s Dr. Derek Trapasso. “Having said that, we’ve sent patients all over New England. It could be up to Dartmouth, to Maine. We sent one to Hasbro Children’s Hospital in Rhode Island.”
California Confirms First Pediatric Death Due to Flu, RSV
Across the country, California saw a rise in RSV infections in October — two months earlier than usual, according to the California Department of Public Health. The health department also issued a statewide advisory Saturday, saying hospitalizations from respiratory viruses in the coming months would continue to strain hospitals. On Monday, the state also reported its first death of a child under five due to the flu and RSV.
In the San Francisco Bay Area, hospitals are inundated. Back in October, Dr. April Zaat, a pediatric hospitalist at UCSF Benioff Children’s Hospital Oakland, told ABC 7 that the pediatric ICU was full as well as the respiratory unit. At the time, there were also five to seven kids in the emergency room waiting for beds.
“A lot of them have respiratory illnesses. Like rhinovirus, enteroviruses. Sort of a potpourri if you will of respiratory viruses that are causing virus in kids,” she said. “RSV is the main player.”
While RSV is most common among children under the age of two, and premature babies or babies six months or younger are at the highest risk, hospitals are seeing higher numbers of older children contracting the virus. Dr. David Cornfield, Chief of Pediatric Pulmonary Medicine at Lucile Packard Children’s Hospital at Stanford, said COVID is to blame.
“Given the isolation that we have all experienced due to COVID, many children that are in their second year or third year of life have not yet seen RSV infection,” he said. “So, those older children that are getting RSV for the first time are more severely affected as well.”
Hospitals are also seeing an increase in patients because parents don’t know what symptoms to look for, which often results in packed emergency rooms. Most RSV symptoms can be managed at home with fever-reducing medicine and ensuring hydration, said Dr. Anna Duran, with the University of New Mexico’s Children’s Hospital in Albuquerque, which reached capacity in its pediatric unit on Monday.
Parents are advised to call their pediatricians if their children have ordinary cold and flu symptoms. If their child is having difficulty breathing, pulling in their chest, flared nostrils, or blue around their nose and mouth, they should seek medical care immediately.
“We do want to encourage you to seek emergency care, should you see signs of respiratory distress,” Duran continued. “[That means] your child is working harder to breathe or they are breathing fast. Also, signs of dehydration, which include your child does not have tears when they cry.”
Since RSV can live on surfaces for up to three days, doctors say regularly washing surfaces and hands is key to preventing its spread, as is staying home when sick, wearing a mask, and getting vaccinated and boosted for the flu and COVID.
“COVID has impacted the seasonal patterns of all these respiratory infections,” Tina Tan, a pediatric infectious-diseases specialist at the Ann and Robert H. Lurie Children’s Hospital of Chicago, told The Washington Post. “Whether the pattern will go back to the way it was pre-COVID, I don’t think anyone really knows, but it does make it more complicated to provide the care that people need when you have three viruses that can cause serious diseases surging at the same time.”
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