State pediatric hospitals feel strain of RSV
Cases of respiratory virus are on the rise, and more kids are being seen in ERs.
Respiratory syncytial virus and other illnesses continue to stress children’s hospitals across California.
Nationally, hospitalization rates related to RSV are exceptionally high, according to Dr. Theodore Ruel, chief of UC San Francisco’s pediatric infectious diseases and global health division. The per capita rate this month was the highest since the 2018-19 cold and flu season, Ruel said at a recent campus town hall.
Children’s hospitals across California report being stretched thin.
The primary facility in Oakland “has been really hit hard with RSV,” Ruel said. UCSF Benioff Children’s Hospital there was “pushed and strained earlier in this recent rise than on the [San Francisco] campus, and they’re still seeing rising numbers.”
Santa Clara, Northern California’s most populous county, is reporting “an acute surge of patients … in both our inpatient pediatric ward and pediatric ICU,” said Dr. Vidya Mony, pediatric infectious-disease specialist and associate hospital epidemiologist at Santa Clara Valley Medical Center. “The predominant cause for these hospitalizations are secondary to respiratory viruses; specifically, RSV.”
RSV is taxing emergency-room capacity at Children’s Hospital Los Angeles, meaning the facility cannot always accommodate patients transferred from elsewhere. The hospital’s RSV positivity rate is 28%, a drop from the 37% reported earlier this month.
However, as of Nov. 15, L.A. County was reporting average daily occupancy of staffed pediatric hospital beds at 64%, up from 60% on Nov. 1. For pediatric ICU beds, average daily occupancy was 75%, up from 67%.
“These increases in pediatric bed occupancy are concerning, especially given the fact that we are still early in the typical respiratory virus season,” L.A. County Health Officer Dr. Muntu Davis said during a briefing. “These numbers do not translate to a dire situation at hospitals at this time, but we are already hearing anecdotally that hospitals and healthcare workers are feeling stress.”
The primary pediatric hospital in Orange County is observing a high volume of ER visits, according to the county’s Health Care Agency. At Children’s Hospital Orange County in Orange, roughly 450 patients have been seen in the ER each day over the last week and a half. On Nov. 1, just after Orange County declared a health emergency related to RSV, the hospital was reporting more than 400 pediatric patients a day in the ER.
“We need to continue being vigilant in preventing the rapid spread of winter viruses,” State Epidemiologist Dr. Erica Pan said in a statement. “As a pediatrician who specializes in infections, and a parent, it is concerning to see the rise in RSV and flu in babies, young children and our elderly population. It is crucial we are aware of prevention methods, but also how to care for our loved ones at home and what symptoms
to be aware of for parents to seek care for their children.”
Many who become infected with RSV can recuperate at home. Early symptoms in children can include a runny nose, reduced appetite and cough that may progress to wheezing. Infants younger than 6 months will almost always show irritability, decreased activity, decreased appetite or apnea (breathing that stops and starts).
Symptoms that can warrant medical attention include severe dehydration; difficulty breathing; fever, particularly in young children or exceeding 104 degrees; chest pain; and ear tugging or drainage. For babies, a warning sign is not having a wet diaper for eight to 10 hours straight.
Health officials say the spread of respiratory illnesses threatens to exacerbate the strain on healthcare systems this fall and winter. The flu is already more active than in years past, and the coronavirus may be rebounding after a lull.
While RSV, flu and COVID-19 — sometimes referred to as a “tripledemic” — have made headlines, they are not the only viral illnesses circulating. At UC San Francisco, others — including metapneumovirus, or MPV, and parainfluenza — are rising.
Given the risks posed by the respiratory virus season, officials say, it’s vital that Californians regularly wash hands, stay home when sick, cover the nose and mouth when coughing or sneezing and wear a mask in crowded or indoor settings.
“Just know that it’s a way to protect your family, to protect your community and protect the place where you work,” Ruel said of wearing a mask indoors.
While there’s no vaccine for RSV, updated boosters for COVID-19 and the f lu vaccine can provide some protection throughout the holiday season.
“COVID-19 is definitely on the rise again — wastewater, test positivity, reported case rates are all increasing,” Pan tweeted recently. “On top of an early RSV and f lu season, our hospitals are stretched. Get your booster and flu vaccine now!”