Citing a record number of pediatric hospitalizations and emergency room visits, Orange County was under a health emergency declaration Tuesday, with the county health officer pointing to a sharp rise in cases of the respiratory infection RSV, combined with COVID-19 and flu.
Cases of respiratory syncytial virus have been on the rise nationally, exacerbating a health system still coping with the COVID pandemic and an earlier-than-usual onset of flu season.
“While there isn’t a vaccine against RSV, we want OC residents to know there are many ways to protect children and at-risk individuals. Following preventive measures, including remaining up to date with other vaccinations such as flu and COVID-19, can help reduce the severity of disease and can help reduce the burden on hospitals this fall and winter,” Orange County Health Officer Dr. Regina Chinsio-Kwong said in a statement.
“Our best shot at protecting ourselves and our children from respiratory illnesses continues to be the same things we practiced throughout the pandemic including the use of masks when indoors around others and staying home when you are sick.”
In addition to a countywide declaration of a health emergency, a proclamation of local emergency was also issued, allowing the county to access state and federal resources to address the rise in virus infections. The move allows Children’s Hospital of Orange County to use portions of the hospital usually off limits to place beds and paves the way for sending some patients out of the county if necessary.
Orange County Health Care Agency Emergency Medical Services is monitoring regional hospital capacity, and officials said they are working with hospitals experiencing particularly high patient volumes in pediatric units and emergency departments.
CHOC has 65 RSV patients with 11 in intensive care, according to Dr. Jasjit Singh of CHOC. There are 285 patients in CHOC, which is nearly at capacity, officials said.
Dr. Melanie Patterson of CHOC told reporters in a call on Tuesday, “We’re seeing unprecedented volumes” of patients.
“Last year on this date we had 188 patients in our hospital, and today we have 285,” she said. “So that is a gigantic surge for us.”
The children’s hospital in Mission Hospital in Mission Viejo is also nearly at capacity, she said.
The emergency rooms are seeing more than 400 patients daily, Patterson said. Wait times can be up to four to 12 hours, but nurses are monitoring patients in the lobby and are triaging to take in the most seriously ill children, she said.
Chinsio-Kwong and Patterson urged residents to get flu shots and COVID-19 vaccines and boosters to help keep more children out of the hospital.
“The very things we did to protect ourselves from COVID can protect us from getting a lot of RSV and flu cases,” Chinsio-Kwong said. She encouraged wearing a mask indoors and getting up to date on shots. Staying home when ill was also encouraged.
“We must do whatever we can to reduce the strain on the hospital system,” Chinsio-Kwong said. “We are already well above our baseline in influenza activity. This is concerning… Fortunately, our COVID numbers are low, but, unfortunately, we’re dealing with these other respiratory illnesses.”
Singh also urged parents to bring their children to a hospital if they are seriously ill and to not worry about wait times.
“We can definitely do things that make the child feel better” as they wait, Singh said.
Singh also noted that many parents may have fallen behind on getting other shots for children during the coronavirus pandemic, but it’s important to catch up as soon as possible.
“Please make sure your up to date on routine vaccines,” Singh said. “We really don’t need an increase of measles, whooping cough or any of those things.”
RSV is a relatively common respiratory virus. According to the U.S. Centers for Disease Control and Prevention, most patients recover in a week or two, but it can become a serious illness for infants and older adults.
CDC officials have been tracking higher-than-usual infection numbers, reporting that some regions of the country are already nearing “seasonal peak levels” of hospitalizations and ER visits due to RSV.
The Orange County Health Care Agency recommended that parents seek medical attention immediately for children showing warning signs, which may include difficulty breathing, signs of dehydration, persistent or high fever, or looking or acting very sick.
The Health Care Agency also offered a list of preventive actions:
— Do not go to school or work when you are symptomatic.
— Avoid close contact such as kissing, hugging, and sharing cups or eating utensils with people who are sick, and when you are sick.
— Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands. Mask when indoors or large group settings.
— Wash your hands frequently, especially before and after eating and using the bathroom.
— Get flu shots and COVID-19 vaccines to prevent complications from these viral illnesses.
In neighboring Los Angeles County, Public Health Officer Dr. Muntu Davis told the Board of Supervisors Tuesday the county is seeing a higher-than-usual number of RSV cases for this time of year, and health officials are monitoring the situation. He also reported a higher-than-normal percentage of pediatric patients at hospital emergency rooms who are testing positive for flu-like symptoms.
But Davis said hospitals have not seen a major spike in pediatric hospital beds being filled due to RSV cases. However, he said that does not mean hospitals are not experiencing any stress, noting the coupling impacts of flu, COVID and staffing shortages.
Rates of flu infections are also rising earlier than normal in Los Angeles County. Davis said it is too early to tell if the earlier-than-usual onset of flu and RSV cases will lead to dramatic increases in cases throughout the season. But he said the higher numbers do “warrant precautions.”
The Los Angeles County Board of Supervisors unanimously approved a motion by Supervisors Kathryn Barger and Janice Hahn calling on the county to develop a public-outreach campaign to provide parents with information about RSV and preventative measures and encourage childhood vaccinations.
The motion also calls for a more detailed report within 60 days from health officials on RSV case numbers and hospitalizations in the county.
Their motion contends that the positivity rate for RSV has nearly doubled in the past three weeks in the county, “and many hospitals are beginning to report capacity strains.”
More information on RSV and preventive measures is available online at www.cdc.gov/rsv/about/prevention.html.