The State of the State: Pediatric Hospital Capacity for the Season-Revised Severe Coronavirus (RSV) in the United States
RSV typically causes mild illness, but it can prove particularly dangerous to young children whose small lungs cannot cough forcefully enough to clear mucus. Nearly all children contract the virus before the age of 2. There is a sudden surge of sick children at the same time as hospitals have been overwhelmed in recent weeks. In the United States, hospitalizations for kids 4 and younger spiked to 61 per 100,000 in mid-November, according to data from the CDC. The rate peaked at 26 young children per 100,000 for the RSV season. And some hospitals are now short on pediatric beds. Because Covid largely spared children from severe illness, some hospitals pivoted, opening spaces designated for kids up to adults. Some of those beds never went back.
Respiratory infections are usually at their peak in the winter, but this year’s season has begun earlier and the numbers are high.
I have been doing it for a long time. I’ve been at Connecticut Children’s for twenty years, and I’ve never seen this level of surge forRSV in our hospital,” said the hospital’s vice president and physician in chief.
The hospitals across the nation reached 80% capacity last week, which is a 8 percentage-point jump in two weeks. That is the highest level since the Omicron surge in January. This week, hospital capacity has improved slightly.
When Amber Sizemore and her Family went Out of State to Celebrate her Birthday, Raegan discovered she had been exposed to toxins and a fluid injection
If parents notice symptoms of an illness, such as a cold or flue, they can be taken care of at home.
“It is good for you to contact your provider and talk through symptoms,” she said. If a child has breathing issues, is unable to drink or eat, or throws up all the time, it would be important for them to be seen by a doctor so that they can get help.
When Amber Sizemore and her family went out of state to celebrate her birthday last week, she had hoped her toddler daughter, Raegan, would try swimming. But the 15-month-old, normally energetic and adventurous, wasn’t herself on Saturday.
Sizemore said that they have been great here and took good care of her, but the scariest part was that she may have exposed herself if I had not been aware of it. I am glad I did not wait.
The UH Rainbow Babies & Children of Cleveland knew immediately that Raegan needed to be admitted, her mom said. She needed oxygen.
Connecticut Children’s Hospital is Peaking at the Right Time for RSVs? An Empirical Analysis of an RSV Case in Connecticut
Doctors recommend that children be taught to cough and sneeze into their tissue rather than their hands. Also try to keep frequently touched surfaces clean.
The US Department of Health and Human Services does not specify the reason for hospitalization, but about three-quarters of pediatric hospital beds available nationwide are being used now. By comparison, pediatric hospital beds were about two-thirds full on an average day over the past two years.
With so many patients, UH Rainbow Babies had to divert for a couple of days in October so it wouldn’t have to take emergency admissions. It is taking patients again, but it is still slammed with RSV cases.
There has been such such a dramatic increase in cases in Connecticut that Connecticut Children’s Hospital has been coordinating with the governor and public health commissioner to determine whether it should bring the National Guard in to expand its capacity to care for these young patients.
“I don’t know how but she slept with those ice packs on top of her,” Zoey Green said, holding an exhausted Lindy at the hospital. She said that they were trying to keep her hydrated so she didn’t have to go back on an IV.
“We are very full, and our census numbers are pretty high as we work through kind of figuring out how to accommodate all of the sick kiddos in the community,” she said.
Staff at UH Rainbow Babies are hoping that things don’t get much worse. “I mean, I hope we’re peaking right now, because if we’re not, then holy hell,” said Dr. Amy Edwards, associate medical director for pediatric infection control.
How you feel when you’re sick and how you can keep yourself safe in the presence of a baby, a child, and a stranger
The typicalRSV season seemed to change when everyone stayed home in 2020 and 2021, to prevent the spread of the coronaviruses. Case counts were low, and that created an “immunity gap.”
It’s generally such a mild illness that adults often don’t realize they have it, or they think it’s nothing more than a cold or allergies and go on to interact with others.
“It’s not a fatiguing virus the way influenza or Covid is, so you really do feel fine,” Edwards said. “And then what happens is, your neighbor has that beautiful baby, and you bring over a casserole, and you kiss that little baby because you feel fine. You don’t get sick. And unfortunately, you pass it on to them, and sometimes they end up at the hospital.”
“Hand hygiene is the single most important thing that we can do to keep ourselves and others safe,” said Davis, of the children’s hospital in Grand Rapids. She tells people to never touch their faces unless they recently washed their hands.
When kids or grownups are sick, they need to do one thing and one thing only, she said: “Stay home when you are sick so you won’t spread whatever respiratory illness you have.”
“I would like other parents to know they shouldn’t watch their child’s cough lightly and take symptoms seriously,” she said. If we hadn’t gotten Raegan help, this would have been a lot worse.
Flu and other influenza epidemics in the United States – the granddaddy of them all, and why this year will be the new normal
Influenza activity continues to increase in the US – the number of flu illnesses, hospitalizations and deaths so far this season nearly doubled in the past week. According to the CDC’s estimates, at least 1.6 million illnesses, more than 12,000 hospitalizations and 700 deaths from flu have been reported this season. About one in 11 tests for flu were positive last week.
A new report from the US Centers for Disease Control and Prevention says that at least 13 million illnesses, 130,000 hospitalizations, and 7,300 flu deaths have been reported so far this season.
As of Friday, seventeen states have less than one in five available beds. Rhode Island, Arizona, Maine, Minnesota, Delaware, and Washington DC are all full.
COVID-19 restrictions make us more vulnerable to these viruses. What’s behind the current surge in the Northern Hemisphere, and what will the new normal be?
“These viruses are coming back, and they’re coming back with a vengeance,” says Scott Hensley, an immunologist at the University of Pennsylvania in Philadelphia. It is possible that this year will be the granddaddy of them all when it comes to flu.
Older children and adults who have previously been exposed to infections are at risk of waning immunity. In the absence of exposure to a virus, antibody levels decline. John Tregoning, an immunelogist at Imperial College London, says that it’s normal to get exposed to a small amount of virus in a year. But “that kind of asymptomatic boosting maybe hasn’t happened in the last few years”.
Another open question is how these viruses compete and interfere with one another. Infection with one virus can raise a strong innate immune response that might prevent infection with another virus. The decline in the first wave of flu last year happened after the surge began. Perhaps Omicron infection provided some short-lived protection against flu. Maybe the Omicron surge convinced people to keep their distance.
Taking a Chance on Flu: The Overflow Health Care Workflow During the Covid-19 Pandemic in El Paso, South Carolina
Pitzer expects that next year’s peaks and valleys might look much more like those that occurred before the pandemic. She isn’t placing any bets. But she says: “I do expect that this winter is probably going to be the last unusual winter.”
According to Walgreens data, flu hotspots spread from El Paso to southwest Virginia.
The entire country is being affected, but rates of flu may be less intense in some parts of the country. He urged people who live in high risk households to put on their masks in public places. Those with adults over the age of 65, pregnant women, people with a pre-existing condition such as heart disease, diabetes or lung disease and anyone who is immune-compromised would be included in high-risk households.
Across the country, overflow health care workers are struggling to catch their breath as hospitals fill with sick patients battling a trifecta of respiratory illnesses – Covid-19, RSV and the flu.
“We have not had to reconfigure conference room space to care for patients even during the Covid pandemic,” said Longhurst, who explained that UC San Diego Health has experienced an equal number of Covid patients as patients with other respiratory viruses. These are not normal times.
The situation is so overwhelming at UC San Diego Health, the hospital had to create space to triage patients by setting up tents in parking lots and using other unconventional spaces. The hallways in the emergency department are also full of temporary beds for patients who were admitted but are awaiting hospital beds.
The Rise and Fall of the RSV and Covid Viruses and their Influence on Prevention and Detection at a California State University Medical Center
Smith said that the decline inRSV has been rapid. The rise of Covid has been slower and a little bit later but then is superimposed by a very rapid rise in flu.
“The most powerful factor by far is probably the vaccines, but the other one is the cumulative number of infections we have all had which is now called natural immunity,” said Dr. Edward Jones-Lopez, an infectious disease specialist at Keck Medicine of the University of Southern California.
Despite all the evidence of safety and efficacy there is still a third of the country where people are not getting vaccinations.
The vaccines for the flu and Covid are available, but not for the RSV. Testing is needed to determine which of the three Viruses has the same symptoms and which one should be treated.
“I’ve seen one case of three infections occurring at the same time,” said Jones-Lopez. There are more than one independent virus that can cause different diseases, and you have a better chance of being affected by them if you have many infections.
Smith of Cedars-Sinai Medical Center advises people with an illness that causes them to be susceptible to infections, to wear a mask. “It’s the best protection that we have for anyone else who is concerned about transmission.”