RSV Cases Fill up Pediatric Hospital Beds Across the Country
A record number of RSV (respiratory syncytial virus) infections in infants and young children has overwhelmed children’s hospitals across the country over the past two months. RSV cases usually peak in winter months, but this year’s early and dramatic surge has many doctors alarmed.
“We are not out of the woods yet when it comes to RSV,” said Dr. Melanie Kitagawa, a pediatrician at the University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado. “In October and November we saw the perfect storm of conditions for RSV spread, and now in December many children’s hospitals have had to take unprecedented measures to have enough beds, staff, and resources to provide care.”
In November, RSV hospitalization rates among children four and under soared to over four times higher than average seasonal peak levels, according to a CDC report. Several children’s hospitals declared emergency modes, and some had to resort to putting young patients in unconventional spaces like libraries or conference rooms.
“Many ERs and urgent cares have also been completely overwhelmed with visits from infants and toddlers struggling to breathe,” said Dr. Grace Lee, chief medical officer for practice innovation and pediatric infectious diseases physician at Lucile Packard Children’s Hospital Stanford. “Wait times of 6 hours or more have become very common.”
Experts believe lockdowns and COVID precautions over the past three years limited viral exposures and immunity building opportunities among young children. Now as society has reopened, viruses like RSV are spreading rapidly through an immunologically naive and vulnerable population.
New Omicron Subvariants Spread Over Holidays
As RSV continues to strain children’s hospitals, two new highly transmissible Omicron subvariants of COVID-19 have emerged right before peak holiday travel and gathering season. The new strains, BQ.1.1 and XBB, accounted for 44% and 27% of recent COVID cases respectively.
“This essentially means 70% of current U.S. COVID cases are caused by brand new subvariants that weren’t even significant worries two months ago,” explained Dr. David Hooper, chief of infectious diseases at Massachusetts General Hospital.
The subvariants have mutations that enable significant immune evasion, meaning even those recently boosted or previously infected are at risk. So far infections still appear mostly mild or asymptomatic in healthy vaccinated individuals due to residual immunity. But the elderly, immunocompromised, or unvaccinated remain vulnerable to severe disease or hospitalization.
“I strongly advise getting a new updated bivalent booster shot if it’s been more than two months since your last vaccine or infection,” said Dr. Hooper. “We need to utilize all the tools we have to reduce spread of these highly contagious new variants and protect our vulnerable populations.”
Beyond boosting, experts emphasize the importance of responsible behavior during the upcoming holidays. This includes avoiding crowded poorly ventilated indoor spaces when possible, wearing high quality masks in public areas, and staying home if feeling even mildly sick.
“I know people are fed up with being cautious after three long years of the pandemic,” said Dr. Kitagawa. “But these new variants have potential to unravel all the progress we’ve made if we let our guard down over the holidays. We all need to pull together responsibly for health care workers facing yet another viral surge.”
| Month | Average Weekly RSV Hospital Admissions per 100,000 children < 2 years old |
|---|---|
| September 2022 | 1.1 |
| October 2022 | 2.9 |
| November 2022 | 6.6 |
CDC RSV surveillance data comparing 2022 weekly rates of RSV hospital admissions to prior seasonal peaks
Long Term Health Impacts Remain Unknown
While death rates in children remain low, there is still much unknown about potential long term health consequences from these overwhelming pediatric infections.
“I am very concerned about impacts to lung and neurological development in young children with severe RSV or other respiratory infections,” said Dr. Lee. “We know inflammation early in life can disrupt delicate developmental processes with lifetime effects.”
Research indicates early childhood respiratory infections correlate with higher rates of chronic diseases like asthma later on. And some studies have linked infant RSV hospitalization with lower IQ scores or added learning disabilities in school age children.
“The brain and lungs undergo so much crucial development in the first years of life,” said Dr. Lee. “An intense inflammatory infection at the wrong time could shift trajectories with negative effects that don’t appear until years later.”
More research is still urgently needed in this area. In the meantime doctors strongly advise prevention measures to avoid infection through the holidays. Beyond protection against individual viruses like RSV or COVID, limiting overall spread of any and all wintertime bugs will help keep pediatric hospital volumes at manageable levels.
“This fall we have seen how fragile our medical infrastructure can be when multiple routine childhood viruses converge into one giant pediatric pandemic,” summarized Dr. Kitagawa. “We all must work together – both health care providers and families – to ‘flatten the curve’ of all these viruses so our children’s hospitals don’t drown this winter.”
Outlook Over Coming Months
Children’s hospitals face difficult months ahead with new COVID variants spreading rapidly even while RSV admissions remain extremely high. Cases of flu and other common winter bugs have also started rising worryingly early this season.
“Frankly I think January through March 2023 could be the toughest months yet of the entire pandemic for children’s health care nationwide,” predicted Dr. Lee. “We are still recovering from the RSV surge while facing more unpredictability from new COVID variants and early flu – all as hospital staff reach burnout.”
In this time of ongoing uncertainty, doctors emphasize staying up to date with the latest public health guidance around viruses. They also advise being prepared should anyone in your family become ill.
“Make contingency care plans in case your childcare facilities close or you need to miss work to care for sick family members,” advised Dr. Kitagawa. “Have basic medications, fever reducers, fluids and comfort measures ready at home to treat viral symptoms.”
Experts remain hopeful that warm spring weather will finally provide lasting relief from this year’s unrelenting pediatric viral onslaught. But until then hospitals brace for difficult months ahead while public health officials closely track spread of new variants.
“We’ve made it through other peaks before and just need to support each other responsibly for a few more months,” said Dr. Lee. “If we all do our part – get boosted, wear masks, stay home when sick – we can prevent health care and society overall from crumbling under the weight of these viruses.”
To err is human, but AI does it too. Whilst factual data is used in the production of these articles, the content is written entirely by AI. Double check any facts you intend to rely on with another source.
