RSV still straining children's hospitals, but may be on the decline
The sheer number of kids being hospitalized with RSV continues to strain Michigan’s health systems, but some hospitals say this year’s unusual surge may be starting to wane.
“We probably have peaked, based on the past week’s numbers,” said Dr. Whitney Minnock, pediatric chief of Emergency, Corewell Health William Beaumont University Hospital (formerly Beaumont Hospital, Royal Oak.) “But we are still very busy…I think it’s a little bit too early to predict, and we'll really be able to kind of have an idea of where things are going after the holidays.”
The Corewell Health East (formerly Beaumont) system’s eight hospitals saw 302 pediatric patients with RSV last week, down from a high of 520 the week prior and 577 two weeks ago.
Emergency departments are seeing “quite a bit less volume of pediatric patients coming in with RSV,” Minnock says. “Though we still are seeing many sick patients and caring for them, we're still busy. [But] we are nothing like we were two weeks ago. That was a really tough time, I think, for all of us in the pediatric community.”
Melissa Parker, a pediatric nurse and the mom of three children, had to rush her baby, Owen, to the ER in October. At just three weeks old, Owen woke up with a stuffy nose and congestion that got worse throughout the day, Parker said.
“And then by the evening, he was very congested and he wasn't able to breathe through his nose at all. So when he was eating, he wasn't able to breathe. His lips would turn blue. So that happened a couple of times. And I knew that at that point we needed to take him to the emergency room, just get him checked out.”
Owen was admitted to the hospital, and was put on a high-flow nasal canula and a nasal-prong ventilator to help him breath, as well as a feeding tube. He was able to leave the hospital on October 31, and has been recovering well, Parker said.
But the experience has made her want to help other parents keep their kids healthy: stay home if you’re sick, get your kids vaccinated, and be extra cautious around those who are at highest risk for getting seriously ill - namely, those under the age of one. If your kid does get sick, parents need to know what to watch for in their own children.
“You need to be very diligent about monitoring symptoms at home,” Parker said. “With babies, they tend to have no respiratory reserve. So once they start to decline and need help with their breathing, it tends to go relatively quickly.”
Some hospitals requesting emergency beds
The recent wave of kids becoming seriously ill with respiratory viruses threatened to overwhelm the state’s health system. Pediatric ICU bed occupancy was at a one-year high, according to the state health department, and some hospitals reported being maxed out completely,
So far, two hospitals have made emergency requests to the state for extra beds, according to the Michigan Department of Health and Human Services: St. Francis Hospital in Escanaba for 24 beds, and Helen DeVos Children’s Hospital in Grand Rapids for 48 beds. Both requests were approved.
“Combined with cold and flu season and COVID-19, we expect the current RSV surge could last for many weeks,” a Helen DeVos Children’s Hospital spokesperson said Tuesday via email. “To meet the demands of children who are sick now and could become ill in the coming weeks, we are seeking emergency Certificate of Need approval from the State of Michigan to add 48 beds to the children’s hospital and to designate 117 beds as intensive care beds. While we hope we will not need all these beds, we want to be prepared to care for children who are ill.”
As of Tuesday, some 51 children were admitted to Helen DeVos Children’s with RSV, said hospital president Dr. Hossain Marandi. Twenty of those were in the ICU, out of 54 total available ICU beds. To handle the current surge, the hospital has transferred staff from other parts of the health system to the pediatric floor, and is doubling up on beds.
"We are looking at the… possibility of having almost every one of our beds become a cohort,” Marandi said. “Because again, physically, while we might not be able to add additional beds to a building that's already built, from an operational standpoint, we can start to continue to serve more patients by taking a room and calling patients that are appropriate to be in a room together.”
There have also been multiple instances of siblings being hospitalized simultaneously, he said. “We are seeing multiple siblings that are being admitted, especially [those who are] younger, under one year of age, where we have seen some of those patients needing that.”
More beds are also being added at the University of Michigan Health C.S. Mott Children’s Hospital. "This additional capacity, which will be determined by additional staffing availability, would allow us to move some single rooms into double occupancy," said COO Luanne Thomas Ewald in an emailed statement Tuesday. "We are still full in the children’s hospital and expect to see even more patients after Thanksgiving holiday gatherings.”
An uncertain winter ahead, as influenza expected to rise
Hospitals overall are still “reporting large surges in young patients visiting emergency departments,” an MDHHS spokesperson said Tuesday. And RSV is a tough pathogen to track, because it’s not a “reportable condition” that’s monitored by the state health department (unlike, say, COVID.)
But there are some indicators that things may be improving: a handful of Michigan hospitals that report RSV cases to the CDC are experiencing a sharp decline in RSV pediatric hospitalizations, according to the most recent data.
“As far as what Thanksgiving and these holidays will bring, it is very difficult to tell,” Minnock said. “In addition to RSV, I think that there are other viruses, particularly influenza, that we're going to have to stand guard and… keep our precautions in place.
“...I think we’re going to start to see influenza numbers rise. I think we already are seeing it: I worked over the weekend, [and] I saw more patients than I have been with influenza. As far as COVID, I still am seeing kiddos with that. I think that if RSV continues to decline, hopefully we won't be faced with the ‘tridemic.’”
Increasing flu shots for kids will be critical, Marandi said, in determining whether Michiigan sees additional surges.
“We have seen multiple admissions over the last week with patients with influenza,” he said. “As we look across the nation, we are seeing an increased number of admissions to children's hospitals in the southern part of the United States, and that historically moves up into the Midwest by about this time…
“So we're asking parents to, again, be very engaged in the care of your child…and making sure that not only are the children receiving their required vaccinations, but specifically thinking about influenza vaccines.”