Children’s hospitals are reporting an early surge in respiratory viruses, largely respiratory syncytial virus or RSV, overwhelming their emergency rooms and filling pediatric beds near capacity across the country.
Doctors are seeing an alarming rise in RSV cases, a common respiratory illness, earlier than previous years and particularly among young infants experiencing severe breathing problems. An increase in RSV cases, coupled with an uptick in other respiratory diseases, such as rhinovirus, enterovirus, and adenovirus, have pushed children’s hospitals plagued with staffing shortages to their limits in the past several weeks.
“Right now we’re at about 80% capacity in our hospital. Two weeks ago we were at 100%. We had more kids admitted during the month of September than ever recorded here,” said Dr. Charlotte Boney, pediatrician-in-chief at Baystate Children’s Hospital in Springfield, Massachusetts. “We ran out of beds a few times in September, and all of New England had that problem. So when the beds were full in Boston, we took a few kids because we still had a bed. Those kids from eastern Massachusetts were transferred all the way out here.”
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Roughly a third of admitted patients at Baystate Children’s Hospital have respiratory illnesses, the majority of whom are infants two and under. Typically hospitals would see RSV cases rise beginning in late October, but this year case numbers across the country started to steadily go up in September. The number of positive RSV tests nationwide increased over 3 times between Sept. 3 to Oct. 15, according to surveillance data from the Centers for Disease Control and Prevention.
Baystate Children’s Hospital is seeing more children come into the pediatric emergency room, surpassing patient volumes it would typically see during the winter. In the last six weeks, roughly 140 to 170 children are coming in each day, a number that Boney called “unprecedented” compared to the 100 to 110 children they would see a day in the winter when RSV is peaking.
“We’ve seen more kids admitted to our hospital in the last eight weeks with non-COVID respiratory disease than we ever saw during the first two and a half years of COVID,” said Boney.
Hospitals around the country, including in Maryland, Washington, Michigan, and Washington, D.C., are reporting similar capacity issues with higher rates of respiratory illnesses than this time last year.
Dr. Russell Migita, a clinical leader of Emergency Services at Seattle Children’s in Seattle, Washington, said they are seeing “double the number of patients” they would normally see in October.
“At any given day, for most of the day, we are at about 200% of our physical capacity in the Emergency Department,” said Migita. “Over half of the patients currently in the ED have symptoms attributable to a respiratory virus. RSV is on the rise, and last week 30% of respiratory viral tests in Seattle Children’s ED were positive for RSV. In the past, when we’ve reached 30-40% positivity, we are at peak, which typically lasts for 2 months. ”
Dr. Jason Custer, chief of critical care at the University of Maryland Children’s Hospital in Baltimore, said they are “staying at or near capacity.”
Dr. Anita Patel, an attending in pediatric critical care at Children’s National Hospital in Washington, D.C., noted that while it is not new that children under 2 account for the most cases during viral seasons, case numbers going up earlier this year with “no end in sight to this current surge” has stood out.
Roughly three-fourths of all pediatric hospital beds are full nationwide, according to data from the Department of Health and Human Services.
Doctors suggested that the surge in cases this year may be contributed to the fact that children may not have gotten RSV in recent years because of COVID health precautions in place, such as masking and social distancing, which have largely subsided now. Typically, “virtually all” children get infected with RSV by the time they are two years old, per the CDC.
“So now the thought is we’ve been sort of protected from not just COVID but all these other respiratory viruses for two years, and now they’re sort of back with a vengeance. And they’re really making little kids who have never been exposed to these viruses before very sick,” said Boney.
RSV, which is spread through contact with an infected person or touching contaminated surfaces, presents itself as a cold-like illness in most cases, though it can cause severe illnesses such as bronchitis and pneumonia, especially for children younger than 5 with underlying conditions like a weakened immune system.
Parents are advised to monitor their child’s symptoms and reach out to their pediatrician to keep them informed of their child’s status. If a child starts experiencing more severe symptoms, such as difficulty breathing or eating and drinking, parents should seek urgent or emergency care.
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“Kids under two when they are working hard to breathe, you suddenly start to see them using their belly to breathe. If you’re seeing that belly breathing or even their ribs sort of going in and out, those are two really concrete reasons to go to the ER right away,” said Patel.
Doctors who spoke to the Washington Examiner recommended parents keep their children up to date on their flu and COVID-19 vaccines to avoid infections in the winter.
