Busy hospitals still can handle RSV outbreaks

Children’s hospitals across the United States are over capacity as intensive care units and medical floors are filled with children battling multiple severe winter viruses.

Kids are coming down with respiratory syncytial virus, or RSV, an easy-to-contract upper respiratory infection that impacts the breathing of younger children in particular. While RSV continues to spread, the seasonal flu has also picked up steam, which has led to a severe crunch at pediatric medical facilities around the country and the region, including Cohen Children’s Medical Center in New Hyde Park.

At our hospital, patient volume is up 44% when compared to the pre-pandemic period of October and November 2019. About 300 kids daily are being seen in our emergency department and about 20% of those children are admitted for monitoring and care.

The headlines are certainly startling, but it doesn’t mean hospitals can’t handle the increase or that parents should avoid bringing their child to the hospital if it’s necessary to get immediate care.

Historically, hospitals have seen similar winter increases in virus cases. But this year’s influx might seem new because during the height of COVID-19, other viruses weren’t spread due to people being isolated, schools being closed, and masks being worn.

RSV, for example, was the most common cause of hospitalization of infants and children from the 1980s through 2019, and now it’s back after two years away.

It’s possible that we’re seeing a few more severe cases today because many babies don’t have the natural antibodies from previous infections — most children have RSV by the time they turn two years of age. It spreads that easily.

Even without the antibodies, most RSV cases are not severe enough to send a child to a hospital, or worse, to have them admitted to an intensive care unit. But it’s important for parents to make an educated decision based on their child’s symptoms.

Is your child running a high fever? How is their breathing? Is it increasing in frequency? Are there preexisting conditions that may impact your child’s breathing, such as asthma, or heart or neurologic disease?

These are important questions to consider.

Seek medical attention immediately if you notice that your child is breathing rapidly or their breathing has slowed markedly, or even stops briefly.

But if the breathing is relatively normal, with mild wheezing, and the fever drops after treatment with acetaminophen or ibuprofen, it makes sense to contact your pediatrician instead of coming to the hospital.

Many of the most severe cases are found in babies less than a year old, although it’s possible to have older children hospitalized. Most of those older kids have preexisting conditions such as chronic asthma.

In the meantime, the best course of action remains the same: For RSV, like most common illnesses, keep your child home if they don’t feel well.

And while we don’t know how bad the flu outbreak will be this season, the flu shot has been effective in making cases milder. The flu shot is safe, and children should receive it.

The more children — and adults — are vaccinated, the closer we get to slowing the spread of that virus.

That will also lead us to a healthier and happier holiday season.

 n THIS GUEST ESSAY reflects the views of Dr. Charles Schleien, senior vice president and chair of Pediatric Services at Northwell Health and chair of pediatrics at the Barbara & Donald Zucker School of Medicine at Hofstra/Northwell.