Hospitals caring for high numbers of children infected with RSV

With COVID still a concern and the flu season now underway and showing signs it could be severe, there’s a third virus that’s surging and has physicians worried about a potential “tri-demic” this winter. Pediatric hospitals are struggling to deal with cases of respiratory syncytial virus, or RSV. Dr. Juan Salazar of Connecticut Children’s Medical Center joined John Yang to discuss the concerns.

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  • Judy Woodruff:

    COVID is still infecting hundreds of thousands of Americans every week, flu season is under way, and there is a third virus that is surging, causing physicians to worry about a potential tridemic this winter.

    John Yang has the details.

  • John Yang:

    Judy, in an effort to encourage more people to get the updated COVID vaccine, President Biden rolled up his sleeve today to get his jab.

    But pediatric hospitals across the country are struggling to deal with cases of another virus, RSV, or respiratory syncytial virus.

    Dr. Juan Salazar is physician-in-chief at Connecticut Children's Medical Center in Hartford and the head of pediatrics at the University of Connecticut Med School.

    Dr. Salazar, thanks so much for joining us.

    I read where you describe the situation at Connecticut Children's Medical Center as an emergency. What is going on? What's it's like there right now?

  • Dr. Juan Salazar, Connecticut Children’s Medical Center:

    Yes, thanks, John, for having me with you.

    Indeed, we are seeing a tremendous rise in the number of cases of RSV in children. I have been doing this here at Connecticut Children's for years, and I have never seen a surge like the one we're seeing right now.

    I can tell you that, as of this time, we have 18 kids that are in the emergency department that have been receiving care, obviously by us, waiting to come into one of our beds. Our units are full. Our intensive care unit is full. We are creating a new step-down to provide the care for the kids.

    And this is just something that I haven't seen before, started about three weeks ago, and it has persisted. So we are concerned, obviously, providing the care. And I can tell you that this is very similar to what other children's hospitals are seeing throughout the nation.

  • John Yang:

    How much of a strain is this putting on the medical center?

  • Dr. Juan Salazar:

    It is difficult.

    Obviously, we have some health care heroes, our nurses, our respiratory therapists, our pediatric residents, emergency medicine personnel, our doctors. And everyone is working overtime.

    For the first time in my history as the chair of the department and physician in chief, I have had to require people that are in other specialties to be able to provide care in the emergency department to be able to handle the surge.

    This is a difficult situation after 2.5 years of COVID that were complicated for all of us. This has put additional strain on the health care team, on the patients, on the parents. And we're doing our best, of course, but it is very, complicated for all of us.

  • John Yang:

    What does RSV look like?

    How can parents know whether their kids have it? And how is it treated?

  • Dr. Juan Salazar:

    Yes, RSV, for the most part, in the majority of kids, 90 percent of children, will manifest like a common cold, which is what it is. It'll be the runny nose, a little bit of a cough, maybe a low-grade fever for a couple of days, and then they get better.

    But, in some children, especially those that are under the age of 6 months, kids that have other underlying conditions, such as congenital heart disease, cystic fibrosis, lung disease, or extreme prematurity, it can have a really nasty component, which develops into viral pneumonia, classically called bronchiolitis.

    And what that means is that the very small airways that the children have get plugged with mucus as a result of the response to the virus. And in those cases, children can get very sick. They can have difficulty breathing, difficulty feeding very, high fever, respiratory distress.

    When that happens, obviously, a parent should talk to the pediatrician and, if it's in greater distress, they should bring them immediately for care in one of our emergency rooms, so we can actually provide oxygen and supportive care for the kids.

  • John Yang:

    Are you worried about a convergence, COVID, seasonal flu, RSV? Are you worried about this winter?

  • Dr. Juan Salazar:

    I am. I am, of course.

    And, I mean, RSV is going to continue probably in the U.S. for the next two to four weeks. We're not at the peak yet. I think we're probably one or two weeks away from that peak. And, unfortunately, what comes at the tail end of RSV is a beginning or the rise of influenza cases, which is a much more severe disease for children and adults.

    So, I do worry that unless we get vaccinated for influenza, which is something that can be done immediately, you can go to the pediatrician, have any kid over the age of 6 months vaccinated, we will have a convergence of influenza and RSV. And to cap it off, unfortunately, what we predict is that the variants of COVID-19 will come in at the tail end of that.

    Exactly how that will affect the pediatric population is less well-known. But we're in for a few weeks of some difficulties here. So I urge parents that are listening to this that really take this opportunity immediately, right away, to take your 6-month-old and above and get them vaccinated against influenza, get yourself vaccinated. It's a very effective vaccine.

    This year, it matches the virus pretty well. So it's going to be even more effective. So that's my message to all of you. Again, be not afraid, do not panic. Be sensible, be careful. And I think, if you do those things, we will get through this.

  • John Yang:

    And, also, the message to parents, how — with all these bugs flying around, how can a parent know whether it's RSV?

    And I also want to underscore your message, when should a parent take a child to the emergency room?

  • Dr. Juan Salazar:

    So I wouldn't be too concerned that whether they need to know that it's RSV or something else. What's really important is to monitor your child. If your child is having difficulty breathing, grunting, flaring, not eating, not drinking, a high fever, then that's a time that you need to call your pediatrician.

    And if it's more severe, especially if they're immunocompromised or very young, then that's a time that you may need to call 911 and actually head to the emergency department. Most of the time, that will not be needed. So I want to caution that.

    But if you're having difficulty — if your child is not breathing well, that's a time that you need to make a call, and don't wait, because that child probably needs emergency care, needs oxygen, something that we can do in our hospital, and then turn them around hopefully fairly quickly and get them back home.

  • John Yang:

    Dr. Juan Salazar from Connecticut Children's Medical Center and the University of Connecticut Medical School, thank you very much.

  • Dr. Juan Salazar:

    Thank you, John. Pleasure to be with you.

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