CHEO was operating at 134 percent capacity for inpatients as of Tuesday, while the intensive care unit was at 129 percent. The emergency department had 254 visits on Tuesday, despite being designed to handle 150 patients a day. Adrian Wyld/The Canadian Press
Children’s hospitals across Canada are seeing an unusual increase in sick children needing medical attention for a variety of viruses, and experts fear the problem will become more severe as cases of COVID-19 rise and the season begins. flu
Some hospitals are reporting an alarming increase in pediatric hospital admissions for respiratory syncytial virus (RSV), a common disease that can lead to serious outcomes in a small percentage of those infected.
“This is an early increase,” Chuck Hui, chief of infectious diseases, immunology and allergy at CHEO, a major pediatric hospital and research center in Ottawa, said Wednesday. “We’re seeing a significant number, an increase in the number of RSV cases and also a significant increase in RSV hospitalizations.”
The Public Health Agency of Canada’s most recent respiratory virus report confirms that RSV rates this year are above expected levels.
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So far this month, CHEO has admitted 10 times the average number of RSV patients it was seeing before the pandemic. The increase adds to serious capacity issues, fueling concerns about how this and other health care facilities will be able to meet the needs of pediatric patients this cold and flu season.
CHEO was operating at 134 percent capacity for inpatients as of Tuesday, while the intensive care unit was at 129 percent. The emergency department had 254 visits on Tuesday, despite being designed to see 150 patients a day.
“We are now dealing here at CHEO and at children’s hospitals across the country with an unprecedented increase in demand,” Alex Munter, CHEO’s president and CEO, said during the briefing. “Neither CHEO nor any of our organizations was built for this type of demand.”
The period from May to September has been the busiest in CHEO’s nearly 50-year history, Munter said.
He said a lack of beds and staff has forced the hospital to cancel a handful of planned operations in recent days, including heart, brain and spine surgeries. Postponed and canceled surgeries are a significant problem in pediatric facilities across Canada, with more than half of children and adolescents waiting beyond the recommended window for surgical procedures.
At McMaster Children’s Hospital in Hamilton, fewer than 10 children have RSV, but the emergency department is seeing “an unusually high seasonal increase in viral illnesses,” president Bruce Squires said in a statement.
Hospital officials are concerned about capacity in the coming months and worry that the extreme pressure on health care staff “is not sustainable if we see a significant increase in disease,” Mr. Squires in the statement.
Joan Robinson, a pediatric infectious disease physician at the Stollery Children’s Hospital in Edmonton, said all of these trends could make for a very difficult fall and winter.
“If we get flu, RSV and COVID admissions at the same time, we could end up with very busy emergency departments and maybe not as many pediatric beds,” Dr. Robinson said.
According to CHEO, the increase in hospital admissions for RSV is likely because a cohort of children who previously had little exposure are now being introduced to it (and other viruses) at the same time. And higher viral loads often lead to more severe cases. Because so many are infected, it could increase the chance that a child will catch it from a few others, exposing them to a higher viral load.
Dr Robinson said most parents should not be too alarmed by RSV this season. It is a common virus that tends to infect all children by the time they are 2 years old. The most severe results are usually seen in a small number of children during their first encounter with the virus, he said. About 70% of children under the age of 2 will have cold-like symptoms when infected with RSV, but about 30% will develop bronchiolitis. Of those, about 1 to 2 percent will require hospital admission, Dr. Robinson said.
Melissa Langevin, associate medical director of emergency medicine at CHEO, said there are some key signs parents and caregivers should watch for and seek medical attention if they appear:
- pauses in breathing and/or fever in a child under 2 months
- signs of difficulty breathing, including pulling into the rib cage or neck.
- a significant reduction in fluid intake
- unusual sleepiness in a child without fever
Parents should use nasal aspirators or “mucus suckers” on babies younger than 6 months to clear their noses and help them breathe, Dr. Langevin said. RSV usually lasts about a week and hits on days four and five, he said, and is often accompanied by a cough. Children under 6 should not take over-the-counter cough and cold medicines.