Children's hospitals in Austin, across Texas battling surge in respiratory viruses
Flu has hit Central Texas but so have a number of other respiratory viruses, medical experts say. Pediatric hospitals are full of cases throughout Central Texas and the state.
Austin Public Health last week sent an email warning about capacity at pediatric emergency rooms at Dell Children's Medical Center and St. David's Children's Hospital.
"We are just full of kids with respiratory illnesses," said Dr. Renee Higgerson, medical director of inpatient pediatrics and pediatric critical care at St. David's Children's Hospital and the Pediatrix group medical director.
She is seeing kids hospitalized because of viruses who are as young as days old on up to school-age kids. They have respiratory syncytial virus (commonly known as RSV) or rhinovirus or adenoviruses, sometimes even the flu. These viruses all have similar symptoms with coughing, congestion, runny nose and fever.
While many of these illnesses are just felt as a cold in older children and adults, the illnesses can become critical in the very youngest children, especially kids that were born prematurely or kids with heart conditions or asthma. Those kids are coming to the emergency room with difficulty breathing and needing to get support, sometimes in the intensive care unit.
Staff members are sometimes struggling to find enough beds for the children who need to be admitted, Higgerson said.
"When we're looking for ICU beds, we're calling all the hospitals in the region," she said. "They're all full."
Last week, she said, her team called 12 different hospitals from Dallas to Houston to San Antonio looking for ICU beds. Two patients had to stay in the emergency room for 18 hours until they found a bed within the St. David's Children's Hospital. The ICU doctors and nurses came down to the emergency room to treat the patients until they could be moved to an ICU bed.
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At Dell Children's Medical Center, chief medical officer Dr. Meena Iyer said there are plans in place to create beds for kids who come up through the emergency room. They can be placed in areas of the hospital that are typically not used for those kinds of cases.
The waiting time in the emergency rooms at both Dell Children's and St. David's Children's is much longer than normal. Iyer clocked it at five or six hours or more. Higgerson said up to 12 hours. "It's longer than we want it to be," Iyer said.
The longer wait times because of the number of children with respiratory illnesses affects other kids needing care, Higgerson said. They might have to wait longer based on triage protocols and sometimes they give up waiting, when they really need to be seen, potentially making their conditions worsen.
Higgerson said at her hospital some planned surgeries have been put off because of the current number of children already in the hospital. Kids waiting for procedures such as seizure monitoring or changing out a battery on a medical device are having their cases delayed.
"We're doing it on a case-by-case basis," Higgerson said. "We know how hard this is on families, even for an elective admission."
Both Iyer and Higgerson said all kids will be seen, but the time it might take requires patience.
St. David's has staffed up on physicians, but, Higgerson said, the shortage is in the nursing staff. "There is no ability to staff up. Our nurses are working overtime shifts. Our nurses are exhausted. There are no nurses out there applying for jobs. We have so many openings. We're doing everything we can," she said.
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When to go to the emergency room
Most of these viruses can be treated at home. Doctors recommend Tylenol or Motrin to control fever and pain, and they say to encourage kids to keep eating and drinking to stay hydrated and energetic.
Dr. Mitchell Walton, a pediatrician at Austin Regional Clinic's Wilson Parke location, recommends against multisymptom cold and flu medications because often they have medication in them that you don't need or doesn't work well or are already taking with Tylenol or Motrin, which puts you at risk for an overdose.
Hot baths or running the shower to create steam and sitting in the bathroom can also help with a cough.
For kids who have asthma, Walton will often recommend they start using their rescue inhaler as well as their regular medication.
Premature babies and babies with heart conditions often will be given a monthly injection to help them fight RSV. It doesn't prevent them from getting it, but it can help them avoid the dangerous side effects.
You should only head to the emergency room if children are having trouble breathing. That can be seen by the nostrils flaring out, the muscles around the ribs and sternum sucking in, a faster pace of breathing, wheezing or lips turning blue.
The emergency room is also the place to go if children are very lethargic or can't seem to stay awake, or if you notice that they are not eating or drinking, can't stop vomiting to get fluids in or have stopped urinating.
For anything else, treat at home unless they worsen. Then you can call your primary care doctor and set up an appointment or talk to a triage nurse, or go to an urgent care setting if you can't get in to see your doctor.
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Winter is coming
While these are not new viruses, "the number of patients coming in with these symptoms is much more than in recent years," Iyer said.
It's unusual for October, she said: "It's a little worrisome that we've got all these viruses. What's coming in December?"
December, January and February are typically cold and flu season in Austin. The 2021-22 cold and flu season was unusual because most people were wearing masks earlier in the year and the years before, which put off cold and flu season, health care experts say.
Then last spring, flu season arrived months late once people began taking off masks. Austin even had a summer season of RSV, which is usually confined to fall and winter.
This fall, in addition to respiratory viruses being seen earlier and in high numbers, Texas' flu numbers have been high, compared with most other states. In Travis County, two schools have reported flu outbreaks to Austin Public Health.
While emergency rooms test for which respiratory virus someone has, including for RSV, COVID-19 and flu, often primary care doctors will only test for COVID-19 and flu. With flu, Tamiflu can be given to anyone 6 months or older to shorten the symptoms if it's within a 48-hour time period of symptoms starting.
Walton has seen a lot of influenza A come through his doors already this fall. He still sees some COVID-19, but not as much as before. Influenza B has not been detected yet.
That's also what Austin Public Health is reporting: dropping COVID-19 numbers, but rising influenza A numbers.
COVID-19 isn't over yet. Austin Public Health notes that the World Health Organization is tracking 300 omicron variant strains of COVID-19, including what's spreading again in Europe and beginning to hit the United States. This summer we had mainly BA.4 and BA.5. Now it's mainly BA.5, with some of its closely related cousins BQ.1 and BQ.1.1.
What you can do to prevent illness this winter
Everybody six months and older should get a flu shot. Kids 8 and younger need two doses the first time they get a flu shot.
Get a COVID-19 vaccine starting at age 6 months, and get an omicron-specific booster, which is available now for ages 5 and older.
Wash everyone's hands often, before eating, after using the bathroom and after coming home from work or school.
Consider putting a mask back on during cold and flu season.
Day care facilities and schools should be vigilant about cleaning shared surfaces and toys.
Limit visiting and socializing with large groups of people.
Stay home if you are sick or if someone in your house is sick. You should be fever free for at least 24 hours without any medication before returning to work or school.
Don't go to the emergency room unless it is an emergency. Instead use your primary care doctor or an urgent care office.
This article originally appeared on Austin American-Statesman: Children's hospitals in Austin grapple with surge in respiratory viruses
