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Back 'with a vengeance,' respiratory viruses filling up emergency rooms

Part of a flyer produced by the Centers for Disease Control and Prevention about how to prevent the spread of the respiratory syncytial virus.
Part of a flyer produced by the Centers for Disease Control and Prevention about how to prevent the spread of the respiratory syncytial virus.

Pediatric emergency rooms across New England are reporting an unprecedented spike in respiratory illnesses. This is filling some hospital and emergency beds to capacity.

Dr. Charlotte Boney, pediatrician-in-chief at Baystate Children's Hospital in Springfield, Massachusetts, says the surge is occurring in two viruses: respiratory syncytial virus, also known as RSV, and rhinovirus, which typically causes the common cold.

Charlotte Boney, Baystate Health: Before the pandemic, RSV would sort of show up in the late fall. It would peak in the winter and would be gone by spring. And it caused significant respiratory illness in young babies, particularly infants and young children, because it basically clogs up your little bronchioles. So if those tiny little tubes are all clogged up, you can't breathe. In older kids and adults, it just gives us a really bad cold. So typically we see this seasonal variation of RSV peaking in the winter.

However, the first full winter of the pandemic — so that's '20 into '21, we didn't have one case of RSV in our hospital — unheard of. And then RSV started coming back in the spring of 21. It sort of hung around in the summer and we had this little bit of a peak last year and then it sort of went away. And then Omicron, the variant of COVID 19, surged like crazy in children last winter. Right? Omicron caused more COVID 19 and kids than we'd seen in the previous two years. So that goes away. And sure enough, RSV starts to rise again in the summer instead of late fall. And now it's peaking. It's at a higher prevalence than we've ever seen during any winter season that I've been here. And this is true all over New England.

And rhinovirus typically causes a little cold, doesn't really have that much of a seasonal variation. But now it's back and it's making young kids really sick. That's really new.

Kari Njiiri, NEPM: So these are not COVID-related?

No. So what we think — and when I say we, I mean infectious disease epidemiologists and experts — that with COVID-19, with all the mitigation strategies to reduce infection — kids stayed home, they stayed home from day care, they didn't do sports, all the isolation, all the mask-wearing — nobody got anything. You didn't get COVID. You also didn't get these other respiratory viruses. And now that all those infection control measures have relaxed, these viruses are back, it almost seems like, with a vengeance.

So what alternatives are there for those seeking care, with emergency departments near or at capacity?

So the first thing that parents could do is really call their pediatrician or their primary care provider to talk about those symptoms of fever, runny nose, cough, congestion. There are some symptom relief medications that you can take to make your child feel better.

All those infection control strategies that work with COVID [also] work now. Right? So I've had the experience myself of people saying, "Well, I'm going to work even though I have this bad cold. It's not COVID, so I'm going to go to work." Well, now you go to work and you spread that virus to everyone, they take it home to their kids and now their kids are really sick.

And the second thing is to really call your primary care provider to give you some advice about how to help the symptoms now and how to gauge when your child is sick enough to come to the emergency room. Because right now, our emergency room is really full of people seeking care, but their child is not seriously ill. So it's a long wait time. And we, of course, want to get to the kids that are seriously ill fast.

Full disclosure: Baystate Health is a sponsor of New England Public Media, although funding relationships do not influence our news coverage.

Kari Njiiri is a senior reporter and longtime host and producer of "Jazz Safari," a musical journey through the jazz world and beyond, broadcast Saturday nights on NEPM Radio. He's also the local host of NPR’s "All Things Considered."
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