RSV surge spreading to Chicago-area children’s hospitals
Children with the respiratory disease RSV are filling Chicago-area children’s hospitals, leading to longer emergency room waits, occasionally delayed surgeries, and difficulty transferring pediatric patients between hospitals.
RSV, which stands for respiratory syncytial virus, can cause a runny nose, cough and fever, and in most people it is mild and clears up within a week or two. But sometimes it can be more serious, especially in babies, causing pneumonia and inflammation of the small airways in the lungs. Each year, about 1% to 2% of babies younger than 6 months who get RSV may need hospitalization, according to the Centers for Disease Control and Prevention.
RSV often spikes during the late fall and winter, but this year it arrived early and is making some older children sick. It comes on top early swelling of other respiratory diseases which kept children’s hospitals in the Chicago area overcrowded for months.
“We are in a major crisis and we absolutely need everyone on deck for our kids!!!,” Dr. Frank Belmonte, chief medical officer at Advocate Children’s Hospital, tweeted Thursday in response to a tweet about similar spikes in other countries. parts of the country.
In Chicago, the percentage of emergency room visits by children younger than 5 due to RSV is about 10 times higher now than at the same time in 2019, according to data from the Chicago Department of Public Health.
“We are coming out of a pandemic where many children were not exposed because we were socially isolated and we are trying to protect ourselves,” said Dr. Marcelo Malakooti, assistant chief medical officer at Lurie Children’s Hospital. “There was this preponderance of kids who may not have been exposed to the virus before and this was maybe the first time.”
Some doctors have compared this rise in RSV to what adult hospitals faced in March 2020.
The University of Chicago Medicine Comer Children’s Hospital has been full for 53 days in a row. As of Sept. 1, Comer was able to accept more than 670 sick children transferred from other hospitals, but had to turn away about 500 other transfer requests because it had no more beds available, Comer leaders said in an emailed to all Chicago Medical Staff and Faculty October 27.
In recent years, many community hospitals in the Chicago area have closed their pediatric inpatient unitswhich means that when they get very sick children, they often have to transfer them to another place.
“Unfortunately, some of these children were transferred to hospitals as far away as St. Louis,” Comer leaders said in an email to all employees, about the children it could not accept from other hospitals.
Comer is also seeing about 150% more patients in its emergency department than it saw this time last year. In just one month, from September to October of this year, Comer saw the number of patients visiting the emergency room increase by about 32%.
“It’s very difficult,” said Dr. John Cunningham, chief physician at Comer. He noted that in the past many children with severe cases of RSV were 1 or 2 years old. Now the hospital accepts children aged 4 and 5. “Kids have been plugged up for the last few years (and) now they’re getting RSV late.”
Lurie Children’s Hospital is also operating at full capacity, meaning all of its beds are mostly full, Malakooti said. So far, Lurie has had two deaths from RSV this season, he said. Each year in the US, about 100 to 300 children under the age of 5 die from RSV.
Lurie had to turn down more transfer requests from other hospitals than usual.
Both Comer and Lurie have postponed some operations to stay open. Hospitals have also had to admit some children to emergency rooms, which means keeping them in emergency beds until beds open up elsewhere in the hospital.
“It’s clearly overburdening the pediatric health care system,” Malakooti said.
RSV rates are also high in other parts of the country, with some hospitals in other states allegedly they’re setting up tents outside their EMS, doubling up kids in rooms and considering calling in the National Guard for backup.
Doctors at Lurie and Comer say they didn’t need to take any of those steps at this point. They are, however, trying to get creative.
The University of Chicago Medicine is asking medical staff who normally care for adults to volunteer for overtime shifts working with children at Comer.
In the late afternoon and evening, Comer tries to use part of his fourth floor as a “fast track” area for children who arrive at the Emergency Department with minor illnesses, in order to reduce the pressure on the Emergency Department. It also transfers some older pediatric patients to adult beds at the University of Chicago Medical Center.
Comer is also considering converting some of its regular beds to intensive care beds.
Despite the high number of children with RSV, Malakooti said cases have not yet peaked and the situation could get worse before it gets better.
Children’s hospitals are also preparing for the flu season, which some predict will be the worst in years. The risk of flu infection remained low in Chicago during the week ending Oct. 22, although it is on the rise, according to the Chicago Department of Public Health.
Pediatricians are urging parents to make sure their children get a flu shot. Doctors say parents should keep their children home if they are sick, make sure they wash their hands, call pediatricians if their children are sick and bring them to the emergency room if it’s an emergency.
“We’re very concerned and we’re preparing for it as best we can,” Cunningham said.
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