Staffs at U.S. hospitals — especially in pediatric wings — have seen a sharp rise in the number of patients suffering from respiratory syncytial virus, or RSV, this fall.
The virus has come earlier and hit harder than in most years, according to experts. Infectious-disease specialists worry about what will happen to the health-care system if RSV, influenza and covid-19 peak at the same time — a “tridemic,” as one expert called it.
RSV primarily affects children, but a spike would tax all parts of the medical system. As in the coronavirus pandemic’s worst days, elective surgeries could be paused again, doctors’ offices could be flooded with calls, people could fill emergency rooms.
Here’s what RSV is and why it has become such a problem on such a large scale:
What is RSV?
RSV is a common respiratory virus that causes cold-like symptoms in most people. Adults can usually brush off RSV in a week or two. But it’s a different story for children under age 1.
The virus is usually behind bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) for children who haven’t reached their first year, according to the Centers for Disease Control and Prevention. An estimated 58,000 children under 5 are hospitalized every year in the United States because of RSV infection, according to the CDC. Between 100 and 500 children under 5 die of RSV every year.
RSV, other viruses making it hard to find a bed in children’s hospitals
The virus can give children a fever, a runny nose and a cough and cause difficulty breathing. So how do you tell the difference between RSV and the flu or covid-19?
“It’s almost impossible,” said Thomas Murray, an associate professor at the Yale University School of Medicine who specializes in pediatric infectious disease.
There is a rapid antigen test, but it can’t be administered at home like coronavirus tests.
Murray said RSV, unlike the coronavirus, spreads more via surfaces than droplets. He suggests sanitizing high-touch areas such as toys, doorknobs, kitchen counters and bathroom sinks, along with washing your hands.
“Where these infections might have been spread out over time, they’re happening all at once now,” said Céline Gounder, a clinical assistant professor of medicine at the New York University Grossman School of Medicine.
Simple physics is another reason children under age 1 struggle with RSV: They have smaller airways, so they are more likely to need oxygen or treatment, because inflammation affects them more severely.
Why is RSV so bad this year?
Experts agree that people did the right thing by wearing masks and socially distancing because of the coronavirus, but the lack of interaction with germs also made our bodies far less resilient to disease.
Mack said RSV is the most common reason infants are hospitalized. The season for RSV usually starts in October, she said. This year, the wave began in September or even August.
“It seems to be back early,” she said.
For decades, fear and failure in the hunt for an RSV vaccine. Now, success.
There’s no research to show that RSV has changed. Instead, we have.
Cases beginning a month or so earlier may not sound like a lot, Mack said, but there are other disruptive forces beyond anyone’s control: She is expecting a worse flu season in South Carolina because Hurricane Ian delayed delivery of flu vaccines.
The pandemic has made RSV and the flu present in new ways and at odd times of the year, said William Schaffner, medical director for the nonprofit National Foundation for Infectious Diseases and a professor of infectious diseases at that Vanderbilt University School of Medicine.