A surge of respiratory viruses has left hospitals across the U.S. flooded with patients.
An early outbreak of Respiratory Syncytial Virus (RSV), combined with COVID-19 and the flu, is causing what experts call a ‘tripledemic’, causing hospitals to be overwhelmed with patients.
Respiratory Syncytial Virus is a common respiratory virus that typically causes mild, cold-like symptoms, according to the Centers for Disease Control and Prevention (CDC). It can strike people of all ages, but can be most serious for infants and older adults. RSV is the most common cause of bronchiolitis and pneumonia in children under one year old. The CDC estimates RSV leads to more than 58,000 hospitalizations each year in children under the age of five.
The Indiana Hospital Association issued a press release Nov. 7 urging the public to take prevention measures against RSV, such as practicing good hygiene, getting vaccinated for COVID-19 and the flu and wearing a mask.
Pediatric beds across the five largest Indiana children’s hospitals were more than 70% full, the statement said, with some intensive care facilities 90% full. The IHA said in the release that patients should be patient when seeking care at emergency rooms because of increasing wait times and depleting resources.
The onset of RSV season typically occurs in the fall around September, with peak season hitting from December through February. This year, however, cases have surged early. Dr. John Christensen, a pediatric disease specialist at Riley Children’s Hospital in Indianapolis, said he began seeing cases during the summer, with continued activity since.
Cases of RSV, flu and rhinovirus have significantly increased. In November 2022, Riley Children’s reported 317 cases of influenza A, compared to just four in November 2021. There were three cases of influenza B this November, but zero cases were reported in November 2021. And RSV cases jumped from 15 in November 2021 to 54 last month.
The rise in cases is likely due to relaxed COVID-19 precautions, he said. Because of mitigation measures like masks and social distancing, there were few cases of RSV during the height of the pandemic because children were not exposed to RSV. Hospitals are now seeing more RSV cases as children contract the virus following decreased health safety measures.
“We barely had any type of activity because people were being sequestered or kept inside and people were using masks, we basically created a susceptible population there,” Christensen said.
When RSV began peaking about a month and a half ago, Christensen said, the emergency rooms at Riley Children’s were the busiest he’d ever seen them.
“There were people waiting out in chairs and hallways, children waiting in stretchers in the hallways and things like that,” he said.
In some instances when the hospital’s intensive care units got too full, children were being routed to other hospitals in the community due to delays at Riley. At night, some of the observation areas in the post-op and MRI areas are still used for urgent care visits.
Christensen said RSV is now on the downtrend compared to the past couple of months, but providers are now seeing many more cases of the flu. COVID-19 cases are also still a threat, he said, as well as the respiratory rhinovirus.
In non-COVID times, RSV is so prevalent that most children are typically diagnosed with the condition by two years old, Christensen said.
The pharmaceutical company Pfizer is currently developing a vaccine against RSV that can be given to pregnant people in the late second or third trimester. In recent data, the vaccine has been shown to be 81% effective at preventing severe lower-respiratory tract infections in the first 90 days of a baby’s life. It was 70% effective at protecting infants within the first six months of life.
Pfizer is planning to submit an application for the vaccine’s approval by the end of 2022. For now, Christensen said people should practice good hand-washing, get vaccinated for the flu before upcoming holiday gatherings and stay away from young children when sick.
Although RSV is one of the most frequent causes of childhood illness, anyone can contract the virus. Ashley Crites, who is 38 weeks pregnant, was recently diagnosed with RSV. Around 35 weeks, she said, she went to the ER at IU Health Bloomington with wheezing and shortness of breath. She said she was told to use her asthma inhaler and was later prescribed steroids by her family provider.
About a week after her first ER visit, however, Crites’ symptoms had not subsided. She went back to IU Health with severe shortness of breath and was finally diagnosed with RSV. Crites said she spent two nights in the hospital.
“I am finally on the mend, and thankful my baby was safe the entire time,” she said.