How an RSV surge might strain US children's hospitals

This fall will mark the first time vaccines are available to prevent the spread of respiratory syncytial virus. Uptake of those vaccines will be telling of how the virus affects hospital capacity, particularly in children's hospitals.

The vaccines are for the most vulnerable to infection: the elderly, pregnant individuals and infants. Experts, like Mark Wietecha, CEO of the Children's Hospital Association, are hopeful that vaccine uptake, specifically by pregnant individuals and infants will help curb capacity issues that can strain children's hospitals nationwide.

RSV season can cause particular stress for children's hospitals, Mr. Wietecha told Becker's, because these are the facilities best equipped to care for children and babies with the proper sized instruments, dosage information and environments they need, but during a surge it can become a lot to manage. 

"Children's hospitals also have a capacity of people who are trained and are good at dealing with little human beings too — which are not the same as dealing with an adult," Mr. Wietecha said. "They often can't communicate in the same way because they're tiny. Their dosing is different, their equipment is different, and if they get sick, they can often spiral down quickly because they're small, their lung capacity is small, their circulation is small — and they have a high susceptibility to respiratory problems if they get sick … But at the end of the day, the capacity is the capacity. We only have so many beds."

The 2022-2023 RSV season had an average rate of 51 out of every 100,000 people hospitalized, according to CDC data. 

According to Mr. Wietecha, if the U.S. experiences a similar RSV season like in years prior where there is at some point a surge or any sign of COVID-19, and/or flu peaking alongside it and bringing in a lot of pediatric patients, that children's hospitals will be struggling to provide care.

"We may not even need to have a tripledemic to have a lot of congestion in the pediatric system, in terms of flow and bottlenecks," he said. "I think parents should have a plan with the pediatrician or family doctor, and really we all have parents and people who are working with kids who need to step our game up. Wash our hands. If we're sick, we should wear a mask. If our kids are sick, we should not send them to school."

Another issue is a dwindling pipeline of pediatricians and funding. If capacity issues continue, "we're going to be in a backup situation then, and I think we've not had enough investment in the doctor pipeline to support it. We're not training enough pediatricians," Mr. Wietecha said.

Improving data and tools with real-time capabilities and insights into capacity issues may be on the horizon with the rise of advanced technologies like artificial intelligence, he noted, but overall, improving RSV's impact on children's hospitals will take everyone playing a part.

"This is one of those things where we actually have some agency," Mr. Wietecha said. "We don't have it in cancer, we don't have it in an airplane crash, but as far as the spread of respiratory diseases goes, we can play a role. And if we do that, I think we can avoid a lot of heartache and adverse outcomes. So that's something to strive for."

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