CHEO warns of surge in patients amid RSV, COVID-19, flu cases

A warning from the city’s children’s hospital about unprecedented pressures on a system that is seeing record high volumes month after month.

CHEO president Alex Munter says inpatient medicine occupancy was at 134 per cent of occupancy rate, and the pediatric intensive care unit was at 125 per cent occupancy rate. There were 254 visits to the emergency department.

Munter says, “To put that into context, the emergency department is built for 150 visits, so 100 more than space was designed for. We are averaging 229 visitors a day.”

The hospital says the reasons for the recent surge right now include an increase in RSV (respiratory syncytial virus), a rise in COVID-19 cases, and an upcoming flu season.

RSV infects lungs and breathing passages. Symptoms include coughing, sneezing, wheezing, and congestion. It can lead to more serious illnesses like pneumonia or bronchitis.

CHEO also says RSV admission numbers so far this month are 10 times the pre-pandemic historical average of three for the month.

“What we are seeing right now in terms of RSV at CHEO reflects what we are seeing across Ontario and south of the border … a significant increase number of RSV numbers and significant increase in RSV hospitalizations and this is an early surge,” says Dr. Chuck Hui, chief of infectious disease, immunology and allergy.

“But like with all respiratory illnesses, they disproportionally affect children, especially children less than two years of age. So, what happens with RSV, you can get a fever, a cough, runny nose, most of the time people do fairly well.

“Some people might require hospitalization to support them, either because they are breathing quickly, and they are exhausted in terms of their breathing or oxygen levels have decreased,” says Hui.

There is no vaccine for RSV, but Hui says there is hope one might be developed in near future.

Munter says, “The simple fact is we have a surge in demand, an increase in demand, for a variety of reasons and, at the same time, families have fewer care options, and so CHEO nor any of our organizations are built for this kind of demand. Our clinicians, our staff are working as hard as they can. We are innovating, we are changing processes, we are recruiting staff, but we know that waits are longer than you would like—they are longer than we would like and we are working to rectify that.”

The hospital has redeployed staff from other areas to help with the demand.

On Tuesday, CHEO was caring for five children and youth as inpatients – four admitted for COVID-19, and one with COVID-19m but admitted for another reason. On Monday, it was caring for eight children and youth as inpatients, seven for COVID.

CHEO says it is rare to have flu admissions in October, but so far this month there have been two.

 

Dr. Melissa Langevin, associate medical director of emergency medicine at CHEO, says there are something parents can do at home while monitoring symptoms.

Langevin says parents need to try to clear children’s noses as much as possible, and keep them hydrated with lots of fluids.

“Keeping children upright often with the secretions, gravity helps, and especially with young children who don’t have the ability to cough,” Langevin says.

An emergency visit may be required.

“You want to be watching for difficulty breathing at the ribs and the neck, poor feeding, sleepiness if they don’t have a fever or, in young babies, if you have a fever or breathing pauses, you should come to emergency.”

The hospital says the demand is not expected to decrease in the next few months.