Overcrowded US children’s hospitals due to RSV cases

• Children’s hospitals around the U.S. are overwhelmed by RSV cases.
• Some hospitals are building overflow tents.
• RSV spreads by direct touch or coughing.

Hui-wen Sato, an ICU nurse at a Los Angeles children’s hospital, said a recent rise of RSV cases “feels like an ongoing, large-volume invasion.”

RSV spreads by direct touch or coughing. It causes modest symptoms but is harmful to youngsters and the elderly.

Children’s hospitals around the U.S. are overwhelmed by RSV cases. Some hospitals are building overflow tents as they did during the COVID-19 pandemic.

Sato, a pediatric nurse for 12 years, said this year’s RSV cases are “exceptionally overwhelming.” Her ICU was understaffed before the spike. The ICU has 24 beds, however often only 20 are filled because there aren’t enough nurses.

With the RSV rise, Sato says it’s hard to keep enough “wiggle room” for trauma patients. In the past, respiratory ailment patients constituted about 50 to 60% of admissions; this year, she estimates 70%.

Since the pandemic began, low morale, emotional stress, and illness have caused many healthcare personnel to quit.

“Nurses are leaving our hospital, but we’re hearing it everywhere,” Sato added. The pandemic, nurses fleeing, a [staffing] shortage, and RSV’s biological causes are creating a perfect storm.

Children’s hospitals and the American Academy of Pediatrics want President Biden to declare an RSV emergency. The government has not done so, saying NBC News that “public health emergencies are established based on nationwide data, science trends, and public health experts’ opinion.”

Dr. Anthony Fauci, the country’s top infectious disease expert, told CBS that some children’s hospitals are overcrowded. “If nurses and pediatric groups say it’s important, it is.”

The virus’s surge this fall may be linked to children’s isolation during the pandemic, researchers told Al Jazeera. Preschoolers are usually more resistant to RSV than infants, but this year they’re sicker than usual.

“There’s a concept that the kids getting it now, especially that preschool age group, are the kids who didn’t have it last year and the year before in the epidemic because they were isolated and weren’t around other sick kids,” Rauch told Al Jazeera.

In the last 20 years, pediatric hospital beds have declined, he noted. US hospitals charge for the care they provide, and in general, hospitals are paid more for an adult in a bed than for a child in a bed. Adults are more likely to need procedures that can be billed for, while children often only need supportive care, such as being placed on a ventilator or given oxygen.

A hospital with a slim margin must decide whether to treat children and lose money. For many hospital administrators, that’s straightforward math, Rauch said.

We’ve lost this capacity in recent decades because we don’t pay for pediatric care like adult care, he said. “This is what happens when children aren’t valued.”

The escalating mental health crises among young people is another unexpected issue, experts say.

The pandemic has increased isolation and stress among children and teens, resulting in higher rates of mental diseases such as depression and substance use disorder. Children who try suicide often wind up in ICUs, Rauch added.

“Five years ago, I could have handled this spike better because my beds weren’t full with behavioral health kids… No psychiatric beds. He stated they were hospitalized. My capacity is lower than it seems because I can’t send kids with mental health difficulties elsewhere. Combined occurrences have made access to inpatient care challenging.

Pfizer will submit an RSV vaccine to the FDA by the end of the year. Vaccinated pregnant women would pass antibodies to their babies.

Seattle Children’s Facility professor and infectious disease specialist Janet Englund said her hospital was also researching an RSV vaccine. The vaccination may be offered to high-risk seniors by 2023 or 2024. To protect people and alleviate strain on the healthcare system, Englund and other specialists recommend wearing a mask or staying home while sick.

Sato worries she’ll admit one person too many, denying a bed to a sick youngster. As a charge nurse, she must push her team “when all I want to do is encourage them.”

She encourages washing hands, postponing social events if sick, and wearing masks.

Sato: “We won’t make people mask forever.” “We’re asking citizens to assist the healthcare system stay afloat by wearing masks this winter to prevent burnt-out staff and system collapse.”

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