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As respiratory viruses such as respiratory syncytial virus (RSV) rise among young children in the United States, many children’s hospitals are being overwhelmed by a deluge of patients filling emergency rooms and hospital beds.
“There’s no room anywhere,” said Dr. Sage Myers, a pediatric emergency room physician at Children’s Hospital of Philadelphia, TODAY.
The Children’s Hospital of Philadelphia (also known as CHOP) is the oldest children’s hospital in the country and one of the largest with 594 beds. The hospital has been busy or overwhelmed for three weeks, and unprecedented patient numbers are causing wait times and capacity issues far beyond what staff could have imagined.
“I’ve worked in pediatric emergency medicine at CHOP for over 15 years now, and this is definitely the most patients I’ve ever seen come into the ER and the busiest our hospitals have ever had,” Myers said.
Last week, Myers took to Twitter to share what she saw in the pediatric ER. Her comments went viral.
“We’re seeing a lot of respiratory viruses floating around right now that started much earlier than we usually see,” Myers said, adding that RSV is more of a late fall or winter virus, but cases started to rise in the summer.
RSV cases have skyrocketed in Philadelphia since September, according to data from the City of Philadelphia Department of Health. Weekly RSV hospitalization rates nationwide have reached levels typically observed in December, according to data from the US Centers for Disease Control and Prevention.
The surge in RSV coincides with an early flu season, Myers said, and activity is already picking up at full force in parts of the South. Last week, the US reported its highest rate of flu hospitalizations for this time of year in a decade, with young children among the hardest-hit groups, TODAY previously reported.
Rhinovirus and enterovirus, common viruses that cause respiratory illness, are also circulating at higher levels than usual, Myers said, and neither has COVID-19 gone away.
Children’s immunity to these viruses may have waned over the past two years due to lack of exposure during the pandemic, which could explain why these seasonal respiratory viruses are hitting harder and earlier than expected, TODAY previously reported.
Experts have warned of a possible “triple disease” of RSV, flu and COVID-19 this winter, which could strain healthcare systems and strain medical resources.
Most children who get RSV will recover on their own, but Myers said she sees more and more children showing up to emergency rooms struggling to breathe. Children hospitalized with RSV usually need supportive measures such as fluids and oxygen, but some need longer care or need to be put on a ventilator. Some children may develop complications such as pneumonia or bronchiolitis.
“Younger children are generally more likely to struggle with respiratory diseases, particularly RSV, partly because we build up immunity over time… so the older you are, the more immunity you have and the easier it is to fight it. ‘ Myers said.
“There just aren’t any beds available.”
The sheer volume of sick children in the ER and hospital patients is causing delays and bottlenecks in care, Myers said. “We have children’s wait times in the ER that are far longer than we ever thought possible, even though we are doing everything we can to see children quickly.”
So many children come into CHOP’s emergency department at once that there is a wait time for patients to be checked in and triaged when patients first come in, Myers said. Waiting times in the doctor’s actual waiting room are also long, and even children who have to be admitted to the hospital have to wait until the space becomes available.
“There just aren’t any beds available, and a lot of kids are sitting in the ER waiting…which reduces the space we have to see new kids,” Myers said. This includes children who come to the emergency room for RSV or other reasons. “Obviously we’re also still seeing all the kids with appendicitis and broken arms and things like that,” Myers said.
This isn’t just a problem in the Philadelphia area, Myers said, and CHOP has been inundated with requests to transfer patients from hospitals in other states all the way to Virginia. “It’s not typical at all … They’re reaching out as far as they can to find places to send their kids to,” Myers added.
A growing problem for already burdened hospitals
What is happening at CHOP is just a snapshot of what is happening in many children’s hospitals across the country. The crisis follows many community hospitals across the US closing pediatric departments to accommodate the influx of adult patients due to COVID-19.
“Very few children became ill … as a result, some hospitals closed their pediatric wards altogether … and less space was made available in the community to care for children,” Myers said.
Lack of medical staff and burnout exacerbate the problem. “We (at CHOP) are fortunate that we can still operate our full bed capacity,” Myers said. “There are hospitals that might have a bed open, but they can’t use it because they don’t have enough staff to be able to do that safely.”
A severe flu season could make things a lot worse, Myers warned, stressing that “flu is more likely to kill children than RSV.”
It’s unclear how the winter will play out, but Myers said she anticipates “it’s just going to be longer and longer waiting for kids. … There is literally no other place to send them to.”
How parents can help protect children
“Children, in general, are amazingly resilient. …Most of the time they will recover,” Myers said. But it’s important for parents to learn to distinguish between a mild case that can be treated at home and a case that requires additional care or a visit to the emergency room.
“Pediatricians can be a huge help,” Myers said, adding that parents shouldn’t hesitate to call in if their child is sick.
Signs of serious illness include difficulty breathing or wheezing, and discoloration of the skin or lips.
Parents can also protect their children by making sure they are up to date on their vaccines, Myers said. Every child as young as 6 months should get their seasonal flu shot and their primary COVID-19 vaccine series, and children as young as 5 should get a COVID-19 booster, experts told TODAY. Some children may need two flu shots.
“The more that we can contain the spread of the flu and the fewer children that can get sick, the better,” Myers said.
Adults should also get vaccinated, Myers added, because they’re less likely to become infected and transmit the virus to children. Vaccinations are “a good priority if you want to avoid spending hours in waiting rooms,” Myers said.
This article was originally published on TODAY.com
