US Children’s Hospitals Overwhelmed by RSV Cases | Health News
Los Angeles, California – “It feels like this endless influx of high volume that keeps coming through our emergency department, or phone calls from outside hospitals that are also bursting at the seams,” Hui-wen Sato, an intensive care unit (ICU) nurse at Children’s Hospital in Los Angeles, reported a recent increase in RSV cases.
RSV or respiratory syncytial virus is a common virus that is spread mainly by direct contact or coughing. It usually causes mild symptoms, but it can be dangerous for young children and the elderly.
Across the United States, children’s hospitals are seeing an increase in RSV cases that is putting a severe strain on their capacity. As in early days Since the COVID-19 pandemic, some hospitals are building overflow tents to accommodate more beds.
Sato, who has worked as a pediatric nurse for 12 years, said she had never seen so many cases of RSV, telling Al Jazeera that this year was “extremely overwhelming”. Before the rise, its intense intensity was already under pressure due to lack of staff. ICU nurses can have a maximum of two patients, and while the unit physically has 24 beds, at times they have had to limit the number of occupied beds to 20 because there not enough staff.
Now, with RSV on the rise, Sato says it’s difficult to keep enough “wiggle room” for severe trauma patients coming through the emergency room. Previously, patients with respiratory diseases made up 50 to 60 percent of admissions, but this year, she estimated that they made up about 70 percent.
low morale, mental stress and the disease has forced many health workers to quit since the start of the pandemic.
“It’s started this real steady exodus of nurses from our hospital, but we’re hearing it’s happening everywhere,” Sato said. “The domino effect pandemicnurses leave, a [staffing] The scarcity and the biological reasons why there is such a huge increase in RSV is creating this perfect storm.”
Children’s Hospital and the American Academy of Pediatrics have called on the administration of US President Joe Biden to declare a state of emergency over RSV. But the administration has yet to do so, telling NBC News that “public health emergencies are determined based on nationwide data, scientific trends and insights from public health experts.”
On Sunday, the main expert on infectious diseases in the country, dr. Anthony Fauci, told CBS that children’s hospitals in some regions are overwhelmed: “When nurses and pediatric associations say this is really critical, it is.”
The rise in the virus this fall could be linked to a lack of contact between people kids who were isolated during the pandemic, experts told Al Jazeera. Daniel Rauch, chief of pediatric hospital medicine at Tufts Medicine, said preschoolers ages two to four are typically more resistant to RSV than infants, but this year it’s making them sicker than usual.
“There is a hypothesis that the children who are receiving it now, especially those of preschool age, are children who did not receive it last year and the year before during the pandemic, because they were isolated and were not around other sick children. , and they didn’t share those viruses,” Rauch told Al Jazeera.
The decline in pediatric hospital beds over the past 20 years is contributing to the current crisis, he said. American hospitals charge for the care they provide, and in general, hospitals are paid more for an adult in bed than for a child in bed, because adults are more likely to need billable procedures, while children often need only supportive care, such as putting on a ventilator or giving oxygen if they have a respiratory illness.
“A hospital operating on a very small margin has to decide: are we going to take care of children and potentially lose money on it? Or will we take care of adults and make more money for it – and that will support our care for everything else we do in the hospital? It’s unfortunately very simple math for many hospital administrators,” Rauch said.
“We’ve lost this capacity over the last few decades, and that’s because we don’t pay for pediatric care like we do adult care,” he added. “And this is what happens when you don’t value childcare.”
A final, unexpected factor is also contributing to the bed shortage, experts say: getting bigger mental health crisis among young people.
The pandemic has led to increased isolation and stress among children and teenagers, leading to higher rates of young people struggling with mental illnesses such as depression and substance use disorders — and those children may end up in intensive care units if they attempt suicide, Rauch said.
“Five years ago, I could handle this rush better because my beds were not full of children with behavioral problems… There are no psychiatric beds for them. They are just stuck in hospitals,” he said. “So my capacity is actually a lot less than it seems because I have all these kids with mental health issues that I can’t send anywhere else. A storm of combined events has made access to hospital care very difficult.”
Until there isn’t vaccine for RSV, the US pharmaceutical company Pfizer has announced that it will submit one for approval by the US Food and Drug Administration by the end of the year. The vaccine would be given to pregnant women who would then pass on the antibodies to their babies.
Janet Englund, a professor of pediatrics and infectious disease specialist at Seattle Children’s Hospital, told Al Jazeera that her hospital is also contributing to research into the development of an RSV vaccine. “The vaccine could be available for high-risk seniors by 2023 or 2024,” she said. Until then, Englund and other experts recommend wearing a mask or staying home when sick to protect others and reduce the burden on the health care system.
Sato says she’s constantly worried that she could accommodate one person too many, which means she would have to deny a bed especially to a sick child. She also feels moral distress about having to push her staff, “when all I want to do is support them – because as a nurse, I have to keep this going”.
She recommends that people wash their hands, postpone social gatherings if they are unwell and wear masks.
“We’re not asking people to mask up forever,” Sato said. “We’re just asking people to help the health system survive, and if they could just wear their masks this winter, so we don’t see burnt-out staff leaving and the whole system falling apart.”
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