Across The Country, RSV Is Overwhelming Medical Systems

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IRA FLATOW: Local science stories of national significance. If you have a child or someone close to you has a child, odds are you’ve heard about a very contagious virus, RSV, Respiratory Syncytial Virus. This is not a new virus, but it has been surging across the country, leaving parents and caretakers stressed about how to keep their kids safe. And hospitals around the nation are having trouble coping with this new surge, as they were with the original outbreak of COVID.

Joining me are two reporters who are watching and reporting, Jenny Peek, news editor for Wisconsin Public Radio, based in Madison; Aja Drain, reporter at WAMU Public Radio, in Washington, DC. Welcome, both of you, to Science Friday.

JENNY PEEK: Thanks so much. Thanks for having me.

AJA DRAIN: Hi, Ira. Thanks for having me, too.

IRA FLATOW: You’re all welcome. All right, Jenny. Let’s begin with you. What’s the surge been like in Wisconsin?

JENNY PEEK: It’s been significant. Just last week, the Wisconsin Department of Health Services counted more than 2,000 cases of the virus, up from about an average of 800 just a few weeks ago. From what I’ve heard, RSV is the predominant virus affecting the state right now. And as usual, it’s hitting the youngest residents particularly hard.

IRA FLATOW: And Aja, what about DC, same story?

AJA DRAIN: Yeah, pretty similar. So DC is kind of unique because we have DC, parts of Maryland, and parts of Virginia when we’re thinking about health issues. And so, in DC specifically, Children’s National Hospital has reported more than 1,000 RSV cases as far as hospitalizations go, and capacity is changing hour to hour. But they’re fluctuating between being at or near capacity pretty consistently.

IRA FLATOW: I remember during COVID we talked about the reporting of cases, right, and it was hard to get accurate numbers. Is that the same thing in this case, Aja?

AJA DRAIN: It’s pretty accurate, too, here. So experts were telling me that when it comes to RSV or with most respiratory viruses, since those symptoms are really similar, the focus is on treatment first. So you have a patient coming in, they’re trying to treat them as quickly as possible, and testing isn’t as much of a priority. So those numbers come with a caveat, but there’s still enough to indicate that there is a surge happening.

IRA FLATOW: And Jenny, what have you been hearing from the experts in Wisconsin?

JENNY PEEK: Yeah, something really similar. I would also just say that one thing that’s setting this respiratory season apart from others is how early it’s arrived. It began in October, when it usually starts in the middle of December, and peaks toward the end of January. One thing health experts aren’t sure of is how long the RSV season is going to last. But having it start this early is definitely unusual.

IRA FLATOW: Well, I know that DC is a huge metropolitan area. It has some massive hospitals. Aja, why is it still having such a hard time dealing with this RSV surge?

AJA DRAIN: Yeah. So similar to what Jenny was saying, we have the same issue. We’re not expecting a surge of this size this early. We were having cases as early as this summer. But one of the biggest reasons that, even in a big metropolitan area this is a problem, the virus itself isn’t actually the issue. Doctors know what to do. They’re prepared. They’ve seen it before. But the biggest problem, at least in our region and somewhat nationally too, is there’s been a decrease in the amount of pediatric inpatient units there are.

And so what that means is, when you typically go to a hospital to bring your kid to the doctor, you don’t go straight to a children’s hospital. You have adult hospitals with pediatric inpatient units that you go to first, and that helps with the distribution. But now, because of a bunch of closures in the region, all of that is causing a bottleneck, which an expert, Dr. Eric Biondi, who’s the division director of Johns Hopkins Children’s Center, explained to me.

ERIC BIONDI: It surprises most people to learn that most pediatric care in the country is not done at large children’s hospitals. It’s done at small community sites, which are often pediatric units within larger adult hospitals. And so those small units, over the last couple of years, we’ve seen a lot of them close down as they’ve needed more adult beds.

IRA FLATOW: Yeah, that’s interesting. And Jenny, Wisconsin has some large rural areas. Is there concern that some kids may be too far from hospitals?

JENNY PEEK: Yeah. And this is a concern that isn’t specific to RSV, but there are only a handful of children’s hospitals with ICUs in the state. And as for clinics, there are a lot of rural communities in Wisconsin that are at least 30 minutes or more away from the nearest health care facility. Rural hospitals struggled with capacity during the peak of COVID, and sometimes sending patients up to several hours away to receive care. And so that’s absolutely a concern with RSV in the state right now as clinics and hospitals are reaching capacity or are at capacity already.

IRA FLATOW: Yeah. We’ve been talking about kids so far, but RSV can be dangerous in older people, too, right? How big of a concern is this in Wisconsin, Jenny?

JENNY PEEK: So the focus tends to be on children, like you said. But with RSV, COVID-19, influenza, older people are at a significant risk, too. It can turn into bronchiolitis, making it harder to breathe, requiring hospitalization. In general, Wisconsin’s population skews slightly older than the national average, with about 18% of the state’s population 65 years and up. And so health officials in Wisconsin are warning families to be careful in terms of spreading RSV to grandparents or other older people in congregate health care settings and nursing homes.

IRA FLATOW: With all these hospitals overloaded– I sort of referred to it before– it feels like virus deja vu all over again. I mean, we just dealt with this with COVID. And this winter is expected to be bad for the flu and COVID as well. Any idea how this might go in Wisconsin, Jenny?

JENNY PEEK: Yeah. So like I said, there’s already quite a bit of concern about hospital capacity. And just today, on Tuesday, Children’s Hospital of Wisconsin, in Milwaukee, announced it was going to be rescheduling all of its wellness visits and minor surgeries just to handle the surge of RSV cases because they’re so full.

Tom Haupt is the respiratory disease epidemiologist for the Wisconsin Department of Health Services, and he says it’s something they’re keeping a really close eye on.

TOM HAUPT: This could be a potentially very serious respiratory season, especially for the children in Wisconsin. We are not aware of any deaths from RSV yet. We’re hoping that we don’t get any. But as I said, the hospitals are becoming more and more crowded as we speak. Some of them are very near capacity.

IRA FLATOW: Aja, same question for you, in DC. What are you hearing about how this trifecta of viruses may play out?

AJA DRAIN: Well, Children’s National was telling me they haven’t seen an increase in COVID hospitalizations so far. Which is kind of nice to hear. But the flu seems like the next challenger approaching, if you will. And there are big concerns about that. By mid-October of this year, Children’s was telling me that they’ve already seen 10 times the amount of cases that they saw a year ago.

IRA FLATOW: Wow.

JENNY PEEK: And we just did some reporting already, anticipating an influenza surge upcoming. So not great.

IRA FLATOW: Not great. Aja, what will you be keeping an eye out, then, for as you keep reporting on this?

AJA DRAIN: Yeah. I think the one thing I’m really fascinated about, and from the doctors I talked to, there’s a little bit of mixed opinions about whether or not patients are sicker this year from RSV specifically. And so I’m really curious if kids are actually getting sicker and what role changed immunity has for at-risk populations for RSV and other respiratory viruses, especially since COVID has happened. So I’m keeping an eye on that.

IRA FLATOW: And Jenny, you?

JENNY PEEK: Yeah, I think just really tracking the intersection of RSV, influenza, and COVID-19, and how they’re going to be interacting. As it gets colder in Wisconsin and more and more things move inside, we often have an increase in illnesses because those viruses are spreading just that much easier. So looking at that and keeping track of how vaccines are going in terms of both influenza and COVID-19 for the younger kids.

IRA FLATOW: Yeah. It seems like we’re in for an interesting winter. I want to thank both of you for taking time to be with us today.

JENNY PEEK: Thank you so much, Ira.

AJA DRAIN: Thank you so much.

IRA FLATOW: You’re welcome. Jenny Peek, news editor at Wisconsin Public Radio, in Madison, and Aja Drain, a reporter at WAMU Public Radio, in Washington, DC.

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