A tripledemic in California? 3 viruses have experts worrying about hospital beds
A lot of toddlers and preschoolers in the Sacramento region are coming down with a virus that many parents of very young children have never seen before.
The number of cases are climbing sharply even as two other viruses — the flu and COVID-19 — are widely expected to surge over the fall and winter.
Could there be a tripledemic?
“The concern that everyone’s worried about right now is that it’s also looking like it’s going to be a bad season for the flu,” said Dr. Malaika Stoll, a senior medical director at Blue Shield of California., “and then COVID continues to be unknown in terms of what that’s going to bring to us. There’s just a lot of worry about these three viruses and what that will look like as we get into winter, (given) of course, what we’ve been through with hospital beds and health care shortages.”
Amid the COVID-19 pandemic, some hospitals around California and the nation got so many critically ill patients that they had to divert patients needing treatment in an intensive care unit to hospitals outside their regions. Then last year, as stay home orders lifted, the number of flu cases rose and added to the demand on hospital systems.
This year, mask mandates and limits on indoor crowds are gone, and another virus has come back with a vengeance: respiratory syncytial virus, or RSV.
While pediatricians are quite familiar with it, many parents may not have had to treat a case of it in their children over the last few years because precautions taken during the COVID-19 pandemic dramatically curtailed its spread.
Now, the microbe has come back earlier than usual here in California and around the nation — and it has packed a powerful punch that has landed scores of kids and adults in hospitals, physicians said.
“Kids who have been otherwise protected because of the social distancing, the masking, ... are now getting it for the first time and they’re getting it pretty bad,“ said Dr. Matt Donnelly, the medical director for the emergency department at Sacramento’s Methodist Hospital.
Stoll noted: “We’re also seeing it just in the general population because, again, you can get it more than once. If you or I had it, we’d probably just think we had a cold. We wouldn’t be able to tell the difference between that and the rhinovirus, which is what causes a lot of the common cold.”
The California Department of Public Health noted in its latest report on respiratory illnesses that RSV activity was higher than usual for this time of year. The agency reported that 15.3% of specimens tested for RSV in the week ending Oct. 22 were positive. That’s up from 9.8% In the comparable week last year.
At Methodist, which Donnelly said treats the highest percentage of pediatric patients under age 18, the medical team has had to treat some RSV patients in the ER until they could be transferred to another hospital. They didn’t have enough pediatric beds to admit them, he said.
“It’s been a very unusual fall in the sense that we have this large surge in a number of respiratory illnesses,” said Dr. Kenneth Hempstead, a Roseville-based pediatrician with Kaiser Permanente, ”and RSV is certainly one of the ones that becomes the most severe in kids. And ... then we’re starting to have flu trickle in as well.”
Parents on alert after COVID
Just as with the flu and COVID, most cases of RSV can be treated at home, Hempstead said.
“Just because someone has RSV doesn’t mean that they are doomed and are going to have a severe outcome,” he said. “We’ve had so much less parental experience with their younger children having had colds. I think that to some degree that leads to greater concern when their kids do have colds, that they haven’t kind of been through that as many times and it’s not quite as normal as for them.”
In such instances, Hempstead said, parents will request an antibiotic or antiviral for their children, thinking that one of the drugs will act as a remedy or stave off severe infection. Unfortunately, he said, there’s no such treatment for RSV.
RSV can cause a runny nose, decreased appetite, coughing, sneezing, wheezing and fever. The illness can lead to pneumonia and to inflammation in the small airways of the lung, a condition known as bronchiolitis.
How to care for a child with RSV
While a few drugmakers are pursuing vaccines against RSV, the virus has so far proven too complex to combat.
Hempstead recommended:
▪ Using a humidifier, steamy shower or saline drops to keep nasal passages moist.
▪ Suctioning the noses of infants who may be having a difficult time clearing mucus. and who may not yet have the reflex that spurs them to breathe through their mouths.
▪ If your children’s symptoms are mild, Hempstead said, don’t worry about getting them tested to determine whether they have RSV or flu or COVID.
“We’ve been getting requests from daycares this week, instructing parents to ask their pediatricians for an RSV test, which really is not our recommendation, because again, it does not change our treatment of that patient,” Hempstead said.
If symptoms are severe and a child or adult is clearly struggling to get enough oxygen, Hempstead said, go to a hospital. In infants and very young children, he said, parents may see the ribs showing as they try to draw in enough air, and that’s an indication that medical care is necessary.
This story was originally published November 1, 2022 at 7:50 AM with the headline "A tripledemic in California? 3 viruses have experts worrying about hospital beds."
