The rate of increase in RSV hospitalizations among children has begun to ease in Maine as cases have flattened in the rest of the country.
But flu hospitalizations are starting to increase, adding to the strain on Maine hospitals from a trio of diseases – respiratory syncytial virus, or RSV, seasonal influenza and COVID-19.
“We are in for a very busy winter,” said Dr. Mary Ottolini, chair of pediatrics at Barbara Bush Children’s Hospital in Portland.
Health officials in Maine say they are hopeful that RSV cases will subside in the coming weeks as peak winter flu season arrives.
“We’ve seen RSV peak and maybe turn down,” Dr. Ashish Jha, the White House’s coronavirus response director, told ABC News early this week.
Unlike other infectious diseases, there is no robust system in place to track RSV cases, in large part because there’s no vaccine or effective treatment available. Health officials interpret the general trends based on hospitalizations and anecdotal reports from pediatric primary care practices.
RSV is a common virus that typically circulates each winter, but this year began to surge in the fall, the first autumn without the widespread COVID-19 restrictions, such as masking, that clamped down on COVID and other viral illnesses the past couple of years.
In older children and adults, RSV infections cause mild symptoms similar to the common cold – runny nose, cough and congestion. But in very young children, babies and toddlers, RSV can cause severe breathing problems and lead to pneumonia.
Ottolini said RSV cases are still climbing in Maine, but the rate of increase has slowed. RSV surged in other parts of the country, including Massachusetts and New York, at least a few weeks before it became widespread in Maine, Ottolini said, which likely means it will plateau and then decline in Maine later than it did in other states.
“Eventually, RSV will plateau (in Maine) in another few weeks,” Ottolini said, but influenza and other respiratory viruses could increase.
Influenza infections have been increasing recently in Maine – more than half of Maine’s 1,652 reported influenza cases were recorded in the past week. Seventeen people have been hospitalized with the flu during the past week, according to the Maine Center for Disease Control and Prevention, accounting for nearly half the 39 flu hospitalizations the state has seen so far this season.
In other parts of the nation, including much of the East Coast, flu cases are soaring. The U.S. CDC lists Maine as having high flu activity last week – the most recent for which data was available – but the Maine CDC reported low levels during the same period. The Maine CDC was not able to explain the discrepancy Friday afternoon.
Meanwhile, fueled by RSV cases, the 87 pediatric beds at Barbara Bush are full, hospital officials said, and have been for more than a month. Ottolini said about 10 non-emergency surgeries had to be delayed in the past month – mostly ear, nose and throat procedures – because of the crush of RSV patients.
But Ottolini said the hospital system, because of its experience with COVID-19, has learned how to flex resources to best take care of patients. Older pediatric patients – teenagers – can be cared for in adult wings when necessary, for example.
“We’ve done everything we can to adjust our practices so we can roll with it and take care of more patients,” Ottolini said.
At Eastern Maine Medical Center in Bangor, the other hospital in Maine that takes in large numbers of pediatric patients, 29 of 52 pediatric beds were full on Friday.
“We continue to see higher than normal admissions of children to both our pediatric floor and our pediatric intensive care unit for RSV infection as well as other respiratory illnesses like influenza and COVID-19,” said Dr. James Jarvis, system incident command for Northern Light Health, the parent organization of EMMC.
Ottolini said that while influenza is a concern, it tends to be less severe in young children compared with older patients, who are more likely to need hospitalization because of the flu.
The flu vaccine provides some hope for a less severe winter. Dr. Dora Anne Mills, chief health improvement officer for MaineHealth, said early indications are that the flu vaccine is a good match for the circulating flu strain, influenza A H3N2.
Everyone age 6 months and older can get a flu shot, and people 5 and older who have not yet received a COVID-19 booster can get one. Many pharmacies and primary care practices will give eligible patients flu and COVID-19 booster shots during the same visit.
Mills said that she hopes RSV cases will decrease, providing some relief to health care systems, even though influenza cases are about to climb.
“A lot of the country right now has very, very high levels of the flu,” Mills said. “It’s coming our way, and we won’t escape that. But the good news is we have the tools we need to take care of ourselves and each other.”
Mills said people should consider masking in crowded, indoor public places, practice good hygiene, stay home when ill and make sure to be up-to-date on influenza and COVID-19 shots.
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