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Pediatric hospitals in Alabama struggle with wave of viral illness: ‘Setting records every day’

An early surge of viral illnesses, mostly flu and respiratory syncytial virus (RSV), has pushed Children’s of Alabama in Birmingham to full capacity and caused long waits for patients in the emergency department.

“We’re seeing families wait 8, 9 or 10 hours,” said Dr. Alicia Webb, a doctor in the emergency department.

The hospital has activated extra staff and transformed other parts in the hospital into treatment areas to handle the influx of patients. Webb said the hospital has had seasonal surges before, but the numbers this fall are unlike anything they’ve seen before.

“We’re seeing an unprecedented number of patients,” Webb said. “We’re setting records every day.”

To reduce stress on the hospital, Webb urged parents to seek care at a primary or urgent care for mild symptoms, such as fever. The emergency department should only be used if a child is struggling to breathe or is difficult to wake.

Flu and RSV are circulating in the community. For most patients, RSV causes mild cold symptoms, but it can be serious for young babies and the elderly.

Webb said the current surge is larger than any the hospital saw during the COVID pandemic. Although COVID is still circulating, it is not as much of a factor in the current surge as the other respiratory viruses. Seasonal viral surges usually peak in January, she said, and doctors are concerned about the number of patients they are already seeing in October.

Flu numbers are up across the state. According to surveillance by the Alabama Department of Public Health, the number of reported flu cases is already as high as last year’s peak and rising. All areas of the state are reporting significant flu activity.

South Alabama is also experiencing a spike in viral illnesses. Deborah Browning, interim administrator at USA Health Children’s and Women’s Hospital in Mobile, said volume is higher than normal.

“We are not experiencing a shortage of beds at this time,” Browning said. “However, we are closely monitoring resources and the spread of illness within the community.”

Over the summer, staff at USA Health Children’s and Women’s Hospital saw large numbers of patients with rhinovirus/enterovirus, said Dr. Benjamin Estrada, professor of pediatrics at the Whiddon College of Medicine at the University of South Alabama. Those cases have declined, but doctors are now treating a sudden surge in flu cases.

“Because of COVID-19 mitigation, many young children have never been exposed to the multiple seasonal respiratory viruses such as RSV and influenza, which implies that they are immunologically naive to these viruses,” Estrada said.

Estrada said he expects the number of children admitted for respiratory illness to continue to rise.

“Typically, these two viruses (Influenza and RSV) do not peak until later during the fall and early winter,” Estrada said. “It is concerning that these numbers are increasing so quickly this early during the season. Regarding COVID-19, we have seen a very significant decrease from 13% two months ago to less than 1% now, but we should not let our guard down, because it is anticipated that we may see another COVID-19 wave in the next two to three months.”

Doctors at both hospitals urged parents to get flu and COVID vaccines for their children and to keep them home from school or daycare if they have symptoms such as fever, cough and runny nose. Experts at the U.S. Centers for Disease Control and Prevention urge people to cover their mouths when they cough or sneeze and to wash hands thoroughly and regularly with soap and water.

Most importantly, Webb urged parent to seek medical treatment at primary or urgent care clinics first to preserve capacity in emergency departments.

“It is imperative that families use the ER only in true emergencies,” she said.

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