Children’s health officials call for emergency response as respiratory viruses continue to spread in US



CNN

Seasonal influenza activity is “high nationwide,” with “high” or “very high” respiratory virus activity in more than half of U.S. states, according to an update released Friday by the Centers for Disease Control and Prevention of the United States.

And health systems nationwide continue to feel the strain of a respiratory virus season that has hit earlier and harder than usual.

There have been about 8 flu hospitalizations per 100,000 people this season – rates typically seen in December or January. The cumulative hospitalization rate has not been this high at this point in the season in more than a decade, according to the CDC.

The hospitalization rate for RSV is also 10 times higher than usual at this stage of the season. Children are especially at risk: Nearly 6 in 1,000 infants under 6 months old and 3 in 1,000 infants 6 months to 1 year old have been hospitalized with RSV this season, CDC data shows..

This week, the American Academy of Pediatrics and the Children’s Hospital Association requested a formal declaration of emergency from the federal government to support hospitals and communities amid an “alarming increase in pediatric respiratory illnesses, including respiratory syncytial virus (RSV) and influenza, as well as the ongoing children’s mental health emergency.

“These unprecedented levels of RSV are occurring with rising rates of influenza, high numbers of children in mental health crisis and severe workforce shortages combine to expand pediatric care capacity at the hospital level and community to the breaking point. Because of these challenges, pediatric hospitals and pediatricians are urged to support more care and higher levels of care than ever before,” the organizations leaders wrote in a letter to President Joe Biden and the U.S. Secretary of the Department of Health. Health and Social Services Xavier Becerra. “We need emergency financial support and flexibilities along the same lines as what has been provided to respond to COVID surges.”

Children’s hospitals have been fuller than usual in recent months, according to HHS data. More than three-quarters of children’s hospital beds are in use nationwide, up from an average of about two-thirds over the past two years.

“Hospital systems, medical care facilities, STAT clinics, pediatricians’ offices, adult physicians’ offices are all feeling the stress of these respiratory viruses right now,” said Dr. William Schaffner, medical director of the National Infectious Diseases Foundation and a professor at Vanderbilt University Medical Center, said during a briefing hosted Friday by the Infectious Diseases Society of America.

ERs in Washington state are in “crisis mode” and are “borderline, if not already in disaster mode,” Dr. Tony Woodward, medical director of emergency medicine at Seattle Children’s Hospital, said this week. .

“Our emergency room is at 100% capacity almost 24 hours a day and in the evenings up to 300% capacity, and that means that for patients who come in urgently, [they] are not dealt with immediately,” Woodward said.

Dr. Rustin Morse, chief medical officer at Nationwide Children’s Hospital in Ohio, said Tuesday that you have to be “judicious” about which patients to accept as transfers.

“We all see and are asked to accept remote patients, and we’ve had requests as far away as Virginia and Missouri,” Morse said. “And we had to say no to these other hospitals in far states so that we could maximize our ability to care for patients in the state of Ohio.”

While RSV activity shows signs of slowing down in the South, it continues to spread nationwide, with nearly one in five PCR tests coming back positive. And influenza activity continues to be highest in the South. Data from Walgreens tracking prescriptions for antivirals such as Tamiflu suggests hotspots centered in Mississippi, Texas and Alabama, stretching from Houston and the Gulf Coast region to Knoxville.

“It’s one after another,” said Dr. Tina Tan, professor of pediatrics at Northwestern University’s Feinberg School of Medicine and vice president of the Infectious Diseases Society of America. , during Friday’s briefing. “RSV has already strained hospital systems at full or overcapacity. Now you have the flu starting to surge in other areas where they’re trying to deal with the RSV surge, and you also have the Covid starting to surge. So this is really straining hospital systems all over the United States. »

The United States is in a different place this holiday season than in previous pandemic years, White House Covid-19 response coordinator Dr. Ashish Jha told CNN on Thursday.

“Hopefully we won’t see anything like the spike we saw in January, but we could very well still see a lot more infections in the weeks and months to come,” Jha said. “The good news, though, is that we can come together safely, we can do all of these things, if people go ahead and get this updated bivalent vaccine that’s available, get treatment if you have an infection. We’re just in a very different place.

CDC data shows that less than 5% of the US population lives in a county considered to have a “high” community level of Covid-19, a measure that captures community transmission and hospital capacity. But for the first time in weeks, CDC forecasts suggest that trends in new Covid-19 hospitalizations will increase in the coming weeks.

Although the Covid-19 emergency declaration remains in place, the federal government has not issued a formal emergency declaration regarding health care for children. HHS and the CDC are in regular contact with officials and health care providers, actively monitoring the needs of the situation and ready to provide assistance on a case-by-case basis, an HHS spokesperson told CNN.

Experts urge taking preventative measures to stay healthy during this unusual respiratory virus season.

“We learned some things from Covid. Masks work. Dust them off, bring them back,” Schaffner said.

They are also urging all eligible people to get their flu and Covid-19 shots, as well as other routine vaccinations.

Routine vaccination rates plummeted during the Covid-19 pandemic and haven’t improved much. The situation is “pretty bad in the pediatric population, as vaccination rates in some age groups are still 50% lower than they were before the pandemic,” Tan said. There are therefore many unprotected children who are at risk of contracting vaccine-preventable diseases.

Children are also lagging behind in Covid-19 vaccination rates. Less than 5% of children under age 5 have completed their initial round, as well as less than a third of children ages 5 to 11, according to CDC data.

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