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As the COVID-19 delta variant sweeps through much of the nation, children’s hospitals are struggling to deal with a flood of young patients — and not just ones stricken with the coronavirus.
Pediatric hospitals say an influx of young patients with respiratory syncytial virus is combining with the surge of COVID-19 to push them to capacity. But in an ironic twist, some experts say the RSV surge may be partly driven by mitigation efforts to curb the spread of COVID-19.
“We’ve seen a slight increase in COVID cases, but this is in the background of seeing many more cases of respiratory complaints in children due to viruses other than COVID, such as RSV, rhinovirus, and enterovirus,” said Dr. Sarah Combs, an emergency medicine physician and the emergency department director of outreach at Children’s National Hospital in Washington, D.C.
RSV is usually prevalent in the fall and winter. Experts believe the unusually high number of RSV cases this summer may be the result of children being largely quarantined last fall and winter, hindering them from building up an immunity. When coronavirus restrictions were relaxed in the spring and summer, children resumed playing with each other and RSV broke out.
Children’s hospitals may also be seeing more RSV cases because parents are worried the symptoms of RSV are actually COVID-19, so they are more likely to bring their children to the doctor.
“Many of the RSV patients that would have been seen in a pediatrician’s office or maybe a school nurse’s office, but because parents are concerned about COVID, they are going to a system where testing is available, or there are additional resources, and that is putting a strain across the pediatric health system nationally,” said Dr. Chad Perlyn, president of pediatric specialists at Nicklaus Children’s Hospital.
The viral one-two punch, plus the normal patient load, has Nicklaus nearly full, according to Perlyn. The facility currently has 27 pediatric patients with COVID-19, with seven in the ICU and two on ventilators.
While Texas Children’s Hospital is not yet at capacity, it is being pushed to the limit, according to Dr. James Versalovic, chief pathologist at the Houston facility.
“The numbers have passed the previous peak we saw in January,” Versalovic said. “In January, our peak was just over 40 pediatric patients with COVID per day. Earlier this week, we surpassed 45. We’ve fully activated our surge plans, which means we are adding units and redeploying staff.”
Texas Children’s Hospital is also inundated with RSV patients, including some patients who contracted both RSV and the coronavirus, Versalovic said.
Nationwide, the number of patients under the age of 18 with COVID-19 in the United States has increased more than three-fold since the beginning of July, rising from 99 cases per 100,000 population to 361, according to the Centers for Disease Control and Prevention.
The number of new hospital admissions among that age group has risen from .08 per 100,000 people in July to .34 at present. That is the highest it has been for that age group during the pandemic.
Much of the overall increase in hospitalized children has come in Southern states, where the delta variant has surged.
“Where we have rural and urban areas with low vaccination rates, we have completely busy hospitals. And that would be in the states you can imagine — Arkansas, Louisiana, Georgia, Florida, Texas,” said Mark Wietecha, CEO of the Children’s Hospital Association that represents over 200 pediatric hospitals in the U.S. “In a typical month, across all children’s hospitals, we are at 85% capacity. But in those hot spots right now, there are hospitals at 110%.”
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Original Author: David Hogberg