Los Angeles, California – “It feels like this endless mass influx that keeps going through our emergency departments, or a call from an outside hospital bursting at the seams,” Hui-wen Sato, Intensive Care Unit (ICU) Nursing The Los Angeles Children’s Hospital said of the recent spike in RSV cases.
RSV, or respiratory syncytial virus, is a common virus spread primarily through direct contact and coughing. It usually causes mild symptoms but can be dangerous for young children and the elderly.
Children’s hospitals across the United States are experiencing a surge in RSV cases, severely straining hospital capacity. Similar to the early days of 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 RSV cases and told Al Jazeera she feels “very overwhelmed” this year. Before she surged, her ICU was already under pressure due to understaffing. Her ICU nurses can accommodate a maximum of two patients, and although the unit physically has 24 beds for her, she limits the number of full beds to 20 because there are not enough staff. Sometimes I had to.
Now, with the surge in RSV, it’s struggling to have enough “wiggle room” for severely traumatized patients passing through the emergency room, Sato said. Sick patients used to make up 50 to 60 percent of hospital admissions, but she estimates they make up about 70 percent this year.
Since the pandemic began, low morale, stress and illness have forced thousands of healthcare workers to retire.
“This really steady retirement of nurses from our hospitals has started, but we hear it’s happening everywhere,” Sato said. resignation of [staffing] Scarcity and the biological reasons why RSV is so proliferating are creating this perfect storm. “
COVID-19 Quarantine
Children’s Hospital and the American Academy of Pediatrics have called on President Joe Biden’s administration to declare a state of emergency over RSV. However, the government has not yet done so.
On Sunday, the country’s top infectious disease expert, Dr. Anthony Fauci, told CBS that children’s hospitals in some areas are being overwhelmed.
An expert told Al Jazeera that this fall’s rise in the virus could be linked to a lack of contact among children quarantined during the pandemic.Head of Tufts Medicine’s Children’s Hospital Pre-school children aged 2 to 4 are usually more resilient to RSV than infants, but this year the symptoms have been worse than usual, said Daniel Rauch.
“There is a hypothesis that the children who are currently infected, especially in that preschool age group, are children who were not infected during the pandemic last year and the year before. , and they weren’t sharing those viruses,” Rauch told Al Jazeera.
A decline in pediatric hospital beds over the past two decades has contributed to the current crisis, he said. Hospitals in the United States charge a fee for the care they provide. Generally, hospitals pay more for adults in beds than for children in beds. Supportive care, such as placement on a ventilator and oxygen if respiratory disease is present.
“Hospitals operating on very thin profit margins have to make a decision. Can we take care of our children and lose money for it? Will it make money and support all the other care we do in the hospital? Unfortunately, this is a very simple math for many hospital administrators,” Rauch said.
“We’ve lost this capacity in the last few decades because we’re not paying for pediatric care the way we pay for adult care,” he added. That’s what happens when you don’t take care of your children.”
vaccine development
Finally, experts say another unexpected factor is also contributing to the shortage of beds.
The pandemic has led to increased isolation and stress among children and teens, higher proportions of young people suffering from mental illnesses such as depression and substance use disorders, and ultimately increased risk if these children attempt suicide. may be admitted to the ICU, Rauch said.
“Five years ago, I might have been better able to handle this surge because my bed wasn’t full of children with behavioral problems…there are no psychiatric beds for them. I’m just trapped in,” he said. “So my capacity is actually much less than it seems, because I have children with mental health issues that I can’t send anywhere else. It’s a compounding storm of events that has made access so difficult.”
There is no vaccine against RSV, but US pharmaceutical company Pfizer has announced it will submit a vaccine for approval by the US Food and Drug Administration by the end of the year. The vaccine is given to people who are pregnant, after which the antibodies are passed on to the infant.
Janet Englund, a professor of pediatrics and an infectious disease expert at Seattle Children’s Hospital, told Al Jazeera that her hospital is also contributing to research towards the development of an RSV vaccine. It could be available to at-risk seniors by 2020 or 2024,” she said. , Englund and other experts recommend wearing masks or staying home when sick.
Mr. Sato says he is constantly worried that he will have to deny beds to especially sick children if he takes in too many. She also feels moral pain at having to impose on her staff.
She recommends that people wash their hands, postpone social gatherings if they don’t feel well, and wear masks.
“We’re not asking people to wear masks forever,” Sato said. If they can wear masks this winter, we won’t see burnt out staff leave or see entire systems fall apart.”
