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It’s not a good sign when the closest pediatric ICU bed a doctor in Boston can find is in Washington, D.C.
Since late summer, kids’ intensive care units across the country have been operating at or near capacity, scrambling to keep up with a surge of respiratory viruses that have hit earlier and harder than recent memory. With flu and covid surges looming, children’s hospitals already strained by the pandemic are bracing for what could be a long and taxing winter.
Most years, the seasonal respiratory virus season starts around now, with rhinoviruses, enteroviruses and respiratory syncytial virus (RSV) causing serious illness in a small subset of children, especially infants. Those viruses largely disappeared the first year of the pandemic because of widespread social distancing. They started re-emerging last year, and this year, viruses arrived several months early. Some doctors say they’re noticing more severe cases, too.
The pattern change is a rebound of sorts from the pandemic. Masking and other protective measures have been abandoned by many, giving these viruses ample opportunity to spread through daycares and schools. And many kids who were spared exposure to these viruses during the pandemic have become extra susceptible. The result is a flood of cases that hasn’t abated since it started and might extend for many months if flu comes roaring back, as expected, and covid cases increase this winter.
That’s a problem for health systems grappling with burnout and workforce departures, especially in nurses. Children’s hospitals have less wiggle room than adult hospitals since there are fewer of them, and many adult hospitals don’t always have the tools or expertise to treat sick kids. As one doctor put it to me, “My peers at other institutions and I are trying to figure out the best way to stretch and stretch, but we’re afraid we’re reaching a breaking point where something’s gotta give.”
We can all help “flatten the curve” of pediatric hospitalizations by practicing the basic public health measures that have become so familiar the past few years, like masking in crowded indoor spaces and staying home when sick. And while there’s no vaccine for rhinoviruses or RSV yet, there are for flu and covid for kids older than 6 months. Such measures represent our best bet in keeping children’s hospitals able to provide care for all kids this winter.
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