The Sacramento region is seeing a rise in respiratory viruses affecting children. That, paired with an early influenza season has local hospital systems taking action to expand care capacity, including adding staff.
The county’s public health department, in a press briefing on Wednesday with area hospital physicians, reported it is also working to get the word out to parents about how to prevent infection and what to do if they believe their child is very sick.
One main driver of hospitalizations is Respiratory Syncytial Virus, or RSV, which is a common infection among children.
“Virtually every child gets RSV between zero and three years of age,” said Dr. Dean Blumberg, Chief of Pediatric Infectious Diseases at UC Davis Children’s Hospital. However, Blumberg and other pediatricians agreed that COVID-mitigation efforts, like masking and social distancing, resulted in children being less exposed to the virus than in years past, leading to increased susceptibility this year.
“At UC Davis, we didn't see any hospital admissions for influenza in the 2020-2021 flu season, which is highly, highly unusual,” Blumberg said. “But that means that all those children; they missed out on getting RSV for the first time.”
Children can become extremely sick with RSV, as it can lead to bronchiolitis or pneumonia or exacerbate symptoms of asthma.
Dr. Zoey Goore, a pediatric hospitalist at Kaiser Permanente and the assistant physician and chief for Kaiser’s Women's and Children's Hospital said in addition to higher rates of RSV, the hospital is seeing significant flu complications in children.
“All of the children that have been hospitalized with complications of the flu did not have their vaccine yet this year,” she said, urging the importance of getting vaccinated for both the flu and COVID-19.
Consensus among the pediatricians at the briefing was that the best protection against both RSV and the flu is for everyone in the family, older than six months, to get the flu vaccine. They also recommended proper hygiene and masking for families at higher risk.
“Going into the holidays with a lot of people gathering and a lot of travel, that might also accelerate the increase that we're seeing,” said Sacramento County Public Health Officer Dr. Olivia Kasirye. “And that's why it's been really important for us to get the message out.”
What to do if your child is sick
Pediatricians agree that most children who get RSV will recover without experiencing complications, although some may get sick enough to need medical attention.
“It's important for parents to know the signs of moderate or severe illness,” said Blumberg. “And these can include fast breathing; blue tinged skin, which is especially noticeable around the lips; any severe coughing episodes or severe sucking in at the base of the throat or seeing the outlines of the ribs while breathing.” He added these are signs the child may need help breathing, and may require in-person care.
Goore said parents of young children can help with breathing difficulties by relieving congestion. This is especially important because children struggling with breathing may not be able to drink and could become dehydrated.
“RSV, as I'm sure my colleagues would agree, is sort of more snot than we know what to do with or than you think is humanly possible,” she said. “That is the problem with RSV. It's just the tremendous amount of congestion.”
She says parents can use tools like bulb suction to clear breathing passages.
How hospitals are preparing
Earlier this year, RSV made headlines as it closed ICUs on the East Coast. Is Sacramento seeing the same?
“It's not as bad as the East Coast where we saw reports of children's hospitals being overwhelmed with admissions and sometimes closing their doors,” Blumberg said. “But things can change quickly.”
Kasirye pointed out that children’s ICUs have much less capacity than those that treat adults. Therefore, she said, the county’s priority is to be sure that any further increase in illness case rates can be managed.
“It's very important for us to have systems in place to be able to make those assessments, to decide if a child can be seen by telehealth, and to point out to the parents what the danger signs are,” she said.
Dr. Craig Swanson, head of Children's Services at Sutter Medical Center, says he’s been watching the progression come from the East Coast, and has prepared for the surge.
“Typically, this time of year is the beginning of a very busy season that lasts through March or so,” he said. “This is probably the busiest moment I've ever been a part of. We're full — mostly full — and putting patients in as they leave.”
Swanson said his team has tried to beef up its capacity, accessibility and physician staffing, while training virtual care centers to help manage a potential surge. He added that the pediatric care community activated an Incident Command Center on Tuesday, like one that was activated for COVID, but smaller in size, that will allow various pediatric care centers to assess resources and manage the situation.
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