Respiratory infections other than Covid-19 help fill pediatric wards

It’s the same in Texas.

“This Delta surge has been linked to the re-emergence of other respiratory viruses,” said Dr. Jim Versalovic, acting chief pediatrician at Texas Children’s Hospital in Houston.

And in Ohio.

“We’re definitely seeing more RSVs,” Dr. Joshua Schaffzin, director of infection prevention and control at Cincinnati Children’s Hospital, told CNN.

‘Christmas in July’ – without the joy

“It’s not seasonal. I called it Christmas in July because we usually see it around Christmas,” he added.

“It’s not exactly a gift. We just see it at a time when we usually don’t see it.”

The three hospitals, among others, are also seeing high numbers of other respiratory viruses such as parainfluenza 3, rhinoviruses and enteroviruses that cause foot-and-mouth disease and other ailments.

“The interesting thing about the rhinovirus is that normally it would only cause the common cold,” Combs said.

“It’s normally a very mild virus. It’s the most common cause of the common cold, so it’s unusual for us to see kids getting sicker than we expected. And really what we’re seeing is that kids are getting sicker. just a lot sicker, you know, they might need things like BiPap to breathe. ” Two-stage positive pressure devices are a type of non-invasive ventilator that helps ensure that the lungs continue to fill with oxygenated air.

Everything is new for 2021.

In 2020, Versalovic told CNN, “it was really mostly about Covid.”

Now hospitals are not only seeing more children with Covid-19, and sicker than they were with Covid-19, but they are sicker with viruses that normally don’t land most children. to the hospital.

“We are working with other children’s hospitals and the Centers for Disease Control and Prevention and the Children’s Hospital Association to share data to explore this further,” Versalovic said.

“The cases are there. The cases are increasing. The children are getting sick. And so we have to be prepared to take care of them,” Combs said.

Paediatricians see clear reasons for flare-ups and equally clear ways to prevent them.

Back to school for the kids, and the germs too

“I think it’s clear that over the summer months we had kids playing and playing,” Versalovic said. “A lot of kids now congregate in preschool and obviously primary settings – high schools too. So we also know that they are involved in extracurricular activities, get together socially and play,” he added.

“And we want kids to thrive and be in class in person, but we have to continue to stress the importance of masking. Because masking not only protects against Covid but could prevent these co-infections as well.”

There is another factor. Children have not been exposed to seasonal viruses for over a year.

“I think one thing is we basically sheltered a lot of these kids during Covid,” Combs said.

“So there is a theory that their immune systems did not have the normal level of routine exposure to normal routine viruses like rhinovirus, so they weren’t able to mount those kinds of micro-responses to them. virus and keep it working, ”she added.

“Basically it was like a bubble kid, right? You confined them. You quarantined them… and then all of a sudden we released these kids. They’re often in summer camps and we So all of a sudden these relatively naive immune systems that have sort of rested on their laurels over the past 18 months are being forced to cope with the normal virus load and it’s all the more difficult to fight them. “

On top of that, Schaffzin said, people were fed up with wearing masks, washing their hands, staying away. The heat of the summer prompted many people to come inside.

“We can’t say for sure if unmasking and people wanting to spend time together is causing a larger increase, but we’re certainly seeing a lot more infections and for RSV, not at the typical time of year,” he said.

The benefits of all this masking and social distancing earlier in the pandemic were highlighted by the lack of a flu season in 2020-2021, Schaffzin said.

“On average, 125 children die from the flu in the United States each year, but the range is between 40 and over 200,” he said.

“Last year there was one. And that’s why masking, again, seems to be the answer.”

The CDC only reported one pediatric flu death last season.

“I think that statistic of a single flu death last season in the United States was really striking, and there were a lot, a lot of open and functioning school systems, a lot of open and functioning child care centers,” Schaffzin said.

“And I think it really proves, the real world data shows us, that masking is an inexpensive and effective intervention,” he added.

The masks will not hurt you. Truly

People don’t like masks, but pediatricians have agreed that parents and governors who fuss about mask warrants are misguided.

“I’m not going to lie – you’re outside and there’s 100% humidity, a high heat index, that’s not great,” Combs said.

But it is not dangerous for anyone to wear a mask.

“When people are uncomfortable with the mask it is because they feel overheated and either get a little anxious or the mask is uncomfortable. It is close to their mouth. Sometimes, they’re breathing and they can feel it against their lips and it’s not something they’re used to. And it makes people out of breath, “Schaffzin said.

“It’s a sensation. It’s not an increase in carbon dioxide. It’s nothing internal that is dangerous.”

And kids aren’t afraid of masks unless their parents tell them they should.

“Children tolerate masks very well. Children tolerate masks much more than adults realize,” Schaffzin said.

“Especially if you make it fun, if you make it colorful or something that they like, the kids will not only have no problem, but they will want to wear the masks,” he added.

“If you standardize masking, which is normal in many countries around the world, the controversy disappears.”

The same goes for hand hygiene.

“You know, there are a lot of things that we do for our own health that may not impact the health of others. We brush our teeth. these happen in our daily routine, so it feels weird if we don’t do them, ”Schaffzin said.

“We are more likely to notice that we did not brush our teeth than to remember brushing our teeth on any given day. And what I would like to see is that the methods of preventing Covid are similar to that.”

Pediatricians note that it’s true that masks can interfere with communication, especially in classrooms, where seeing someone’s mouth or expression can be important.

“We need more data in terms of the social effects of masks and we can’t rule that out right away,” Schaffzin said.

There are workarounds. For example, transparent masks, sometimes used in children’s hospitals, can help, he said.

“There’s always a way around that. Humans innovate. That’s what they do,” he added.

“We can control a pandemic”

“We haven’t found a way to prevent all respiratory illnesses, but we have mechanisms, including hand hygiene and including masking and including avoiding sick people, that when we do them together, to reliably, we can actually prevent transmission, ”Schaffzin mentioned. “We can control a pandemic.”

Combs echoed this.

“What we do know, in terms of numbers, is that we were successful when we put all the measures in place,” she said. But people have started to let their guard down.

“There is a lot of fatigue doing the same things over and over again, especially seeing these spikes coming and going and coming and going. But what we do know is when we mask ourselves appropriately, especially if you have a well-fitting mask or even a double mask technique, if everyone in a certain area is wearing that proper mask it will be around 95% effective in preventing transmission or spread, ”she said.

And it will be the same whether the virus kept at bay is either Covid-19, or RSV, or rhinovirus or parainfluenza virus.