Influx of RSV infections have children's hospitals running short on space

Media reports are accumulating of children’s hospitals overflowing with respiratory syncytial virus (RSV) patients, particularly in the northeastern U.S.

Lab-reported cases of the disease have spiked over the last several weeks, increasing from the low 1,000s in August and September to more than 5,000 PCR-confirmed five-week average cases across the country, according to Centers for Disease Control and Prevention (CDC) surveillance data.

That volume of confirmed cases is pushing past the height of what the agency sees during a normal year, per the data. Hospitals also told reporters that the current wave of patients is hitting earlier than in years past.

“What has changed now, is from those seasonal normal patterns of distribution, it's all shifted into late summer, early fall in a way that I've never seen before,” Juan Salazar, M.D., physician-in-chief at Connecticut Children’s, told Connecticut Public Radio.

The 187-bed hospital told the outlet its emergency room had 17 RSV patients waiting for an inpatient bed on Wednesday and that it was seeing roughly 30 such patients daily. Nearby Yale New Haven Children’s Hospital said it was admitting about 30 children a day and that RSV cases in its emergency department had nearly doubled within the past week, per the report.

Salazar and another Connecticut Children’s official told CNN that the wave of RSV cases is unlike anything they had seen before and that their hospital had met with the Connecticut Department of Public Health and the National Guard to consider whether to erect a mobile field hospital to expand capacity.

Similar scenarios are reportedly playing out across children’s hospitals at Maryland’s Johns Hopkins, Virginia’s Inova Fairfax and Washington, D.C.’s Children’s National Hospital.

The latter told the Washington Post earlier this week that it had 18 children waiting for one of the 323-bed facility’s pediatric intensive care units. All three hospitals said they were working to expand capacity but were concerned about the coming weeks.

NBC News reported earlier this month that doctors in California, Massachusetts, Illinois, Rhode Island and North Carolina were seeing pediatric bed capacity shrinking at their hospitals due to RSV. More recent reports add Colorado, Ohio, Michigan and Texas to that list.

Roughly 58,000 children five years of age or younger are hospitalized in the U.S. due to RSV, according to the CDC, and “virtually all children get an RSV infection by the time they are two years old.”

Clinicians and other hospital leaders at overwhelmed hospitals told reporters they believe an early, severe wave of infections could be the result of limited exposure during pandemic lockdowns.

“Virtually every child by the age of two would have had RSV,” Thomas Murray, M.D., associate medical director for infection prevention, told Connecticut Public Radio. “And now we have children who are probably close to 3 years old who may never have had RSV. So the total number of kids that are getting RSV for the first time is likely to be much higher.”

Experts have already warned that a winter “twindemic” of COVID-19 and influenza could be on the horizon. With RSV coming early this year, clinicians at the affected hospitals said they are concerned that the seasonal influx of respiratory disease patients could drag their facilities underwater.

“In order to give both a sprout of hope and also some micro sense of control of, ‘Well, what can I do other than panic?’ Sarah Combs, M.D., emergency medicine physician at Children’s National, advised parents via the Washington Post. “Go back to basics, do what you’ve been doing over the past couple of years of the pandemic: Get your immunizations … and just do your best.”