Health

RSV is pushing Boston’s pediatric units to the brink. Here’s what hospitals are doing about it.

"All of us are full every single day."

Dr. Brian Cummings, the medical director for pediatrics at Massachusetts General Hospital (MGH), at Thursday's news conference. Erin Clark / The Boston Globe

If you’re a parent, you’ve probably already heard about respiratory syncytial virus, or RSV, and the surge of pediatric cases seen both in Massachusetts and around the country — but it’s getting worse.

As cases of the usually mild, cold-like virus ticked up toward the end of the summer and into fall, Boston hospitals started filling up with children that developed more serious infections.

Now, the hospitals say, they are at a breaking point.

How did we get here?

Dr. Brian Cummings, the medical director for pediatrics at Massachusetts General Hospital (MGH), said Thursday during a news conference that they are taking in so many patients with RSV that they are exceeding both their physical and staffing capacities.

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Cummings said the problem began in the late summer and continued into the fall. At the time, doctors were primarily seeing children come down with different viruses, but they were still causing many children to have trouble breathing, leading to a high number of hospitalizations.

Beginning in October, Cummings said, cases of RSV grew exponentially, causing even more hospitalizations.

Normally, he said, RSV circulates every winter, and most children encounter it by age 5. But during the past two winters, social distancing, masks, and other measures taken to stop the spread of COVID-19 stopped RSV from spreading naturally too, keeping children from developing immunities as they usually would.

“There has been a lack of population immunity with RSV. Many of our younger children have never seen the infection,” Cummings said. “Now that it is circulating a little bit more typically, there are many more people susceptible to infection.”

With so many children getting the virus for the first time all at once, Cummings said, hospitals are seeing far more children needing hospitalization and beds in the pediatric ICU (PICU) than is normal.

How bad is the problem?

Cummings said that within the Mass General Brigham health care system, doctors treated 2,000 children for serious RSV infections during the month of October. Then, in just the first week of November, they treated 1,000 children.

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“Thankfully, most of those infections are being treated in urgent care facilities or emergency departments, and most people are discharged home,” he said. “But even if just 10% of those need hospitalization, they place a lot of stress on health care facilities.”

Cummings said the Mass General Brigham health care system has had 250 hospitalizations for RSV so far, on top of hospitalizations caused by other viruses, so they’re struggling to find beds for all these children.

Last week, the situation got so bad that they had to transfer children to hospitals out of state, he said.

“All of us are full every single day,” he said. “At any given point when you look, there are no available pediatric ICU beds, there are no available pediatric general care beds. And almost all of us are operating over capacity.”

What are hospitals doing about it?

Since then, the Massachusetts Department of Public Health has been convening a weekly call with the five Boston hospitals that have pediatric units to help coordinate their response, Cummings said.

The hospitals are working on maximizing pediatric bed spaces across the state and beefing up staffing, he said. They’re also sending older pediatric patients to adult ICUs and younger pediatric patients to newborn ICUs, but those units are now also full every day.

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To keep patients out of the hospital, Cummings said, their community health centers are increasing telemedicine and oxygen access so that patients who can stay at home can receive treatment there.

Unfortunately, he said, doctors have had to cancel pediatric surgeries to leave bed space for severely ill patients.

Boston Children’s Hospital told Boston.com it is also reducing its elective procedures schedule.

“Currently, we are not transferring patients to other hospitals, and in non-emergent cases, we encourage families to contact their primary care providers to determine the best treatment option,” Boston Children’s said in a statement. “We continue to monitor the situation and adjust our process as needed.”

Similarly, Boston Medical Center said an increase in pediatric cases has caused bed capacity challenges across the system.

“In several instances, we safely postponed pediatric elective surgeries for capacity reasons,” the hospital said in a statement. “BMC is working daily with other hospitals in the area to manage inpatient bed capacity across the region and ensure our patients receive the care they need.”

Cummings assured parents that the vast majority of children with RSV will get better, even if they have a severe illness.

“99.9% of patients with RSV are going to get better, but sometimes they do need transient support and sometimes they need ICUs,” he said.

What should parents do?

Dr. Alexy Arauz Boudreau, the associate chief of pediatrics at Mass General Brigham, said that the most important thing parents can do right now is monitor their children for symptoms. She said parents should keep track of things such as how their child is breathing and playing.

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“If you start to get concerned that they’re tired at rest, working harder to breathe, or not drinking fluids, that’s when you call your pediatric office,” she said. “And for the most part, we can manage it staying at home, resting, and drinking fluids.”

Arauz Boudreau said that good hand washing, cleaning surfaces frequently, and staying away from people who are sick will help prevent the spread of RSV. She also reminded parents that there are vaccines available to prevent many different viruses that are contributing to the current caseload.

“This is the best time to take advantage of that and vaccinate your children and yourself against any virus for which you are eligible,” she said.

Staff writer Abby Patkin contributed to this report.

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