The rapid spread of the virus has led to record levels of pediatric hospitalizations and daily emergency room visits in Orange County, prompting authorities to declare a health emergency.
The county, like the rest of California, faces a virus triple whammy: the continued circulation of the coronavirus, Seasonal rise in influenza increasing the spread of respiratory syncytial virus, or RSVis a dangerous respiratory disease for small children.
Children’s hospitals can quickly become strained when the virus surges, with relatively few beds available to begin with. For example, Orange County has only two hospitals that specialize in children’s care, and both are “operating beyond their capacity to provide pediatric care. [patients] with respiratory illness,” county health officer Dr. Regina Chinsio Kwon said on Tuesday.
Qingxio Kwon’s issuance of a state of emergency declaration late Monday will allow the government to require hospitals that normally do not treat children to “take care of children when and where they are needed.” This flexibility could come in handy in the months ahead, when many officials expect both the coronavirus and the flu to become more active.
“I worry about what the future holds,” said Qingshio Kwon. If flu and RSV cases spiked at the same time, “we’re in trouble. And usually these two viruses affect our young children. There are only so many beds that we have to do.”
Children’s Health of Orange County, which operates a primary hospital in Orange and a smaller facility in Mission Viejo, said Melanie Patterson, vice president of patient care, said it had “unprecedented numbers” in both its inpatient wards and emergency rooms. Not the amount you see. Care Services and Chief Nursing Officer.
CHOC Hospital in Orange sees more than 400 pediatric patients in the emergency room each day. About 15% of children seen in the ER are hospitalized.
285 patients were admitted to the 334-bed CHOC hospital on Tuesday Orange. A year ago she was 188.
“It’s a huge surge for us,” Patterson said.
CHOC’s 54-bed Mission Viejo hospital admitted 43 patients on Tuesday, up from 28 on the same day a year ago.
Other California hospitals are also reporting worsening early-season RSV surges. Kaiser of Orange County He is a pediatric infectious disease specialist at Permanente, Dr. Daisy Dodd, who said the health system could continue to meet demand, but that “the influx is substantial and much faster than normal.”
So far, Los Angeles County Public Health officials say they have not seen a significant increase in pediatric hospital bed occupancy.
Still, individual hospitals report being extremely busy. Dr. James Stein, chief medical officer of Children’s Hospital Los Angeles, said in a statement that the facility can accept children from the emergency room. However, because ERs are very busy and have very limited capacity available, CHLA cannot always accept transfers from other hospitals.
LA hospitals are seeing an increase in RSV-positive children, with the prevalence rising to 38% from 31% the week before. Both numbers are above her peak of 24% last winter, according to Marisa Gulkoft, the hospital’s executive director for quality and safety.
Dr. Christina Ghaly, director of the LA County Department of Health Services, said many hospitals don’t have many pediatric beds and even a small increase can have a big impact.
For example, if a hospital has 12 pediatric ICU beds and 6 are already occupied, say, “You can reach 100% capacity very quickly just by admitting 6 patients. And Depending on their turnover rate and length of stay in hospital, we can see how quickly they get into trouble.”
“Thankfully, we haven’t had any serious issues so far, but we understand how quickly things can change,” she told the county board of supervisors on Tuesday.
Although highly contagious, RSV is more of a nuisance than a serious threat to otherwise generally healthy adults and older children. But babies are especially vulnerable because the virus attacks and inflames the very small airways that lead to the lungs.
Profuse mucus production can block airways. Adults and older children can cough easily, but babies may need extra help breathing. Newborns and infants in the first year of life, especially those younger than 6 months, are most at risk.
Premature babies, babies with underlying heart or chronic lung disease, and children with weakened immune systems are at increased risk, as are older adults.
Certain warning signs that your baby needs urgent medical attention include:
- Your chest is drawn inward, your nostrils are widened, and you breathe faster than normal
- Dehydration to the point of not crying
- No wet diapers within 7-8 hours
- refuse to feed
- Blue around the mouth due to lack of oxygen
Warning signs in children 3 or 4 years old may include wheezing and rapid breathing. Critically ill children may need oxygen and other support in the hospital to help them breathe.
“It’s not just the little ones. We have five- and six-year-olds in the hospital right now,” Dodd said.
Each year, an estimated 58,000 children under the age of 5 years are hospitalized with RSV nationwide, resulting in 100 to 500 deaths. There are an estimated 177,000 hospitalizations and 14,000 deaths annually among people aged 65 and over.
“The best way to protect ourselves and our children from respiratory illness remains the same as we have done throughout the pandemic: wear a mask when indoors and with others. , stay at home when you’re sick,” said Chingshio-Kwon.
RSV is particularly hard hit in many parts of the country. This is probably because transmission has been relatively stagnant over the past two years and many young children have little immunity to the virus. Dr. Ashish Jha, his COVID-19 response coordinator at the White House, estimated last week that about 90% of children will catch RSV at least once by the age of two. But “because of the pandemic, a lot of him is getting RSV at once because sort of a canonical pattern has been disrupted,” he said.
The percentage of RSV-positive respiratory specimens in LA County is also at its highest level in five years. About 12% of his specimens were positive for RSV, up from about 6% last October to 7%, where he had less than 1% in three Octobers before that.
Seven percent of children under the age of five are associated with RSV or acute bronchiolitis (swelling of the airways usually caused by RSV). This is higher than at any point in the last three years.
“As with influenza, it is not possible to predict whether this is an early peak or the beginning of a severe season. ,” said Ferrer.
“The triple whammy of all three viruses circulating at the same time could strain an already overburdened healthcare system,” San Diego County health officials wrote. in a statement Late last week.
County Public Health Officer Dr. Wilma Wooten said: “We don’t have a vaccine against RSV, but we do have enough vaccines against the flu and his COVID-19.”
In both cases, the vaccines “take two weeks to be fully effective, so both vaccines should be given as soon as possible,” Wooten said.
