Pediatric hospital beds have been filling up across the country during the month of October. In some cases, it’s led to hours-long wait times. That’s been the case at Hasbro Children’s Hospital in Rhode Island. We spoke with Doctor Michael Koster, a pediatric infectious disease specialist to understand what we’re seeing.
Luis Hernandez: How do you describe to people what is an RSV?
Michael Koster: RSV stands for the respiratory syncytial virus for most people is a common cold. For really young infants and for the elderly, it can be a severe lower respiratory tract fissure, what I call a chest cold. And in kids, we have a specific name for that called bronchial itis, which is inflammation of the smaller airways of your lung. And that just makes it really hard for kids to breathe. We do know that kids would prematurity, heart disease, lung disease and chronic illnesses like that are at higher risk, especially under the age of two. But for the most part, kids get exposed to it every year, just like they get exposed to every other virus, influenza para influenza, there’s a whole laundry list of viruses that cause colds and lower respiratory tract infections and kids.
Hernandez: What’s been happening that we’re now seeing stories from around the country and here in Rhode Island where your beds are filled with kids with RSV, what’s been happening?
w: A couple of things. One is there’s what people call the immune gap for kids. So for the last three years, we’ve had both Omicron replacing every other virus, right, we haven’t seen flu, we didn’t see flu in 2020 at all. And then we also didn’t see RSV but saw minor amounts of the other viruses. So So you got three-year-old kids who have never been exposed to something like RSV, they’ve been living in a bubble, right, everybody was masked and living in their house and in, in really shrinking their social circle. Right. So, people were being very careful washing their hands a lot more and using, you know, face coverings and things and so all that led to, you know, less and less exposure to kids. And so now instead of 4 million kids, which is the cohort of kids born every year being exposed to the virus, we had 12 million kids. So it’s a larger number. And these kids didn’t have that buildup of immunity over the last three years. And Luis if you don’t mind entertaining, one additional theory that I have is that pregnant women were not exposed to RSV, or other viruses like influenza and other viruses, respiratory viruses. And so when babies are born, they’re born with their mom’s immune system, the mom actually transmits the immune globulin to the kid through the placenta. And the baby’s born with protection, that wanes over six months to a year. So the kids that we’re seeing that are super sick in the hospital are kids who are under the age of three months. And I think that has a lot to do with the lack of mom’s antibodies. So the kids born without those, and they’re getting really sick. So we’re seeing more kids intubated, we’re seeing higher acuity, which means our ICU is full. And this has happened across the country with RSV because we’ve had just a huge number of kids and they’re more sick.
Hernandez: What is it that parents should know?
Koster: Parents need to watch for signs of severe respiratory distress and that’s where you know they’re working really hard to breathe so you can see their ribs outlining and you can see the notch above their sternum or around their collarbones really sucking in as they’re using extra muscles to breathe. Or something that’s the most severe which is head bobbing and grunting so every time they breathe out there, I mean, that should be a sign for the parents to call rescue
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