In recent weeks, the United States has seen an alarming surge in respiratory illness among children — and COVID-19 is not to blame. Common respiratory viruses, particularly RSV (respiratory syncytial virus), are causing an unusually high number of cases and hospitalizations among kids, putting a strain on children's hospitals and even causing some to reach capacity. An estimate 75% of the 40,000 children's hospital beds in the U.S. are currently full.
One hospital, Connecticut Children's, is so flooded with cases of RSV that staff is exploring using temporary units on the hospital lawn to manage patients and discussing plans to use auxiliary resources through the state and National Guard.
"We saw a little bit of (RSV) last year, but this dramatic increase in cases of RSV in September and October is not that something we have seen before historically," Dr. Juan Salazar, executive vice president and physician-in-chief at Connecticut Children’s, told TODAY.
“I’ve been doing this for 25 years at Connecticut Children’s and in practice for over 30 years. … At least in the hospitals that I worked with, I’ve never seen this level of rapid transmission and the need for hospitalization in kids," Salazar said.
He also told NBC Connecticut that “because they’re all coming at such high numbers, it’s creating a challenge for us to be able to have everyone hospitalized who needs to be hospitalized in the way we normally do it."
RSV is a seasonal respiratory virus that usually peaks in the middle of January or in February. “This is coming at the wrong time,” Salazar told TODAY, adding that he has heard that other children's hospitals in the state and Northeast are "equally slammed" with RSV cases.
In coordination with the Connecticut Department of Public Health, the hospital is exploring next steps if RSV numbers continue to increase. "We would need additional capacity within the Children's Hospital to make sure that we continue our full operations ... probably in the form of 10 to 20 (extra) beds," said Salazar.
The National Guard visited the hospital on Thursday morning, Salazar said, and assessed the grounds so that they are ready to add a temporary hospital unit (a medical or field tent) on the hospital lawn for surge capacity if necessary.
Staff at another Connecticut facility, Yale New Haven Children’s Hospital, are also responding to a surge in patients due to RSV. There are more than 100 cases in the emergency department, nearly double from a week ago.
"The majority of the children are coming in pretty sick. They're requiring higher levels of oxygen (than) they normally would," Erica Setzer, Yale New Haven Children's Hospital clinical program director of pediatric critical clinical care services, told NBC News national correspondent Gabe Gutierrez in a segment aired Friday.
Stephanie Fortier, a registered nurse at Yale New Haven Children's Hospital, added: "Just the acuity in how sick the kids are is much higher than it's been ever in the past."
Although anyone can become infected with RSV, it is notorious for causing infections and serious illness in young children, TODAY previously reported. "By the time children are 2 years old, most of them will have been infected with RSV. ... It can cause close to 60,000 hospitalizations every year in children," NBC News Medical contributor Dr. Natalie Azar said on TODAY Thursday.
However, the past few years of the pandemic have reduced kids' exposure to viruses, like RSV, which is likely playing a role in the surge. "A lot of kids just haven’t seen RSV, and then now they’re seeing it for the first time all at once, and it’s leading to a big strain on our hospital resources," said Dr. Scott Roberts, associate infection prevention medical director, told Gutierrez.
What parents should know about RSV
The symptoms of RSV are often indistinguishable from things like colds, the flu and COVID-19. "In the majority of people, it causes a mild cold-like illness ... runny nose, a low grade fever, a cough, sneezing," said Azar, adding that these symptoms usually last about one to two weeks and can peak at day five.
Although COVID-19 can be detected with a home test, testing for RSV or other respiratory viruses needs to be done at a doctor’s office, Azar added.
Most people will recover from RSV on their own, but in certain individuals, the virus can go from the upper respiratory tract into the lungs and cause more severe disease, Azar explained. RSV complications include bronchiolitis (a type of lung infection) or pneumonia, TODAY previously reported.
It's important for parents and caregivers of young children and infants who can't communicate to know the signs of severe disease and when to contact a health care provider, NBC News senior medical correspondent Dr. John Torres said on TODAY Friday. These include:
- Poor feeding. "This doesn't mean refusing food or not liking what you're giving them or the signs they normally give you when they are full and they don't want to eat anymore," Torres explained. "This means basically not paying attention to what you're feeding them. They might eat for a few seconds and then stop eating, and then they stare off. That's the sign for low appetite."
- Irritability, meaning "they're simply not consolable. They continue to cry and cry," Torres said.
- Lethargy, which is "even more concerning" than irritability, Torres said. "They're hard to wake up. They're just laying around. They're staring off. They don't want to pay attention to anything."
- Wheezing. "That wheezing sound that asthmatics make, if you notice your child making that, that's concerning," Torres said. Additionally, if you can see the child's chest caving in, if the ribs become visible when they're breathing, or if you see their nostrils flare out, these are signs they're working extra hard to breathe.
Treatment for RSV typically involves supportive care, such as rehydration or managing the airways.
There is a treatment available for people who are at risk of severe illness, which includes premature infants, children under the age of six months, children with heart or lung problems or weakened immune systems, said Azar. It's a monthly monoclonal antibody injection that can that can help prevent severe disease, Azar added.
Although there is no vaccine yet to protect against RSV, you can protect yourself against respiratory viruses this season by getting your annual flu shot and COVID-19 booster. "That's something that parents can immediately do right now to actually help themselves and help us," said Salazar.
Some experts are concerned that this surge in pediatric respiratory illness could coincide with a severe flu season and a resurgence of COVID-19, TODAY previously reported. "We worry about hospital capacity and of course cases of long Covid, so we’re certainly keeping an eye on that," said Azar.