More pediatric beds needed
November 29, 20222 — Cold and flu season arrived early this year, with an extra hard-hitting strain of RSV, or respiratory syncytial virus, which can be dangerous for children and elderly people. With dwindling numbers of pediatric beds available nationwide, kids who need to be hospitalized often have to travel out of the county to receive a high level of care. Doctor Casey Johnston, a pediatrician who works in Ukiah and Lakeport, says that on top of covid, this is a particularly bad season for respiratory illnesses.
“There’s several different reasons why it’s a bad year,” she said. “Normally we see surges in influenza and RSV. Every few years there’s a worse year for those conditions. We also have covid now, and actually there are some cases of people getting covid and the flu at the same time. So when your immune system gets hit with one thing, you’re more susceptible to get another virus. And then also a lot of people weren’t getting the normal exposures the last couple of years and building immunity. So we’re seeing a lot of particularly young kids get hit hard with these illnesses, especially flu and RSV.”
The three afflictions present similarly, with cough, congestion, fevers, and body aches. Dr. Johnston recommends lots of rest, and especially hydration. “Because once a kid starts to get dehydrated, they feel worse, and they don’t want to drink, and then it just gets worse and worse. So hydration is key,” she explained.
Babies suffering from RSV often experience a lot of mucus buildup, from the nostrils to the lower airways, which can lead to bronchiolitis, a serious illness. This can be addressed with common over-the-counter bulb suction devices, which can be found at any drugstore and feature easy-to-follow instructions.
“It’s important to know when to get urgent medical care,” Dr. Johnston emphasized. “There’s a lot of things we can try at home, but if your child or baby is breathing really rapidly or using a lot of muscles, for instance you can see their ribs because their chest muscles are working so hard to move their lungs, then that would be a reason to bring your child in immediately to get medical care. Another reason is altered mental status. So they’re excessively fatigued. They’re not wanting to wake up, or if they’re dehydrated, they’re not wanting to drink fluids. They’re not making the normal number of wet diapers if they’re still in diapers. Those are also reasons to get medical intervention. Another thing, too, is if fevers are persisting for more than four days, that might be a sign that there is another infection, such an ear infection or pneumonia. So that would be a reason to get medical care, too.”
The Biden administration has resisted calls to declare an emergency that would make it easier for communities to request state and federal aid, saying assistance would be provided on a case by case basis. Mendocino County has not yet requested state or federal aid, but “Our ER’s right now are packed,” Dr. Johnston said. “There aren’t many hospital beds for kids…the ICU’s in the state are packed as well. It is really difficult to get an ICU bed for kids right now.” She said the pediatric team at U.C. Davis is offering its resources, including consultations, to local practitioners, “So we have state and local resources,” she reflected. But the nationwide shortage of pediatric beds is not helping. “Over the last couple of decades, the number of hospital beds for kids has decreased,” she said. “And the number of hospitals with pediatric wards has decreased….part of that has to do with the effectiveness of vaccines. We’re seeing a lot less meningitis, a lot less pneumonia and serious bacterial infections, thank goodness. So there is probably a little bit less need right now. But when we have these surges of respiratory illness, RSV, and really sick kids, we need those resources still. So it is a tough situation. And we definitely need more pediatric beds.”