Addressing Rising RSV Cases in CT Hospitals

You may have seen recent news stories reporting a surge in respiratory infections called RSV (respiratory syncytial virus) in children, which is a common respiratory virus that produces cold-like symptoms. If the news is worrying you, it doesn’t have to. RSV has been around forever and in most cases, it is no more serious than a common cold. Our world has just changed in terms of exposure and how we react to it. 

First, we are paying back an immunity debt accrued by years of non-social behavior due to COVID. Kids’ immune systems have had no exposure for a very long time, or ever for very young children. Humans are now back to normal again in terms of socialization, work, and school, and the viruses we usually get are too. It’s just that kids have never seen them before. As bad as that seems in the long run, it was inevitable and it’s actually necessary.

Second, fear of any disease has peaked post-COVID. What was once accepted as the normal cold and flu season is no longer. This drives a lot of what healthcare providers call the “worried well”, to seek care for things that they used to just stay home for. A cough is not commonly a reason to seek care but we are now seeing calls from parents who think it’s pneumonia and will become life-threatening. More than two years of COVID fear will illicit such a reaction.

Third, more illnesses are present simultaneously than normal. We still have some COVID happening but because it’s acting more like an endemic pathogen (around every year like all the others) it has been added to the usual panel of viruses. There are also RSV, some flu, some parainfluenza, adenovirus, viruses that cause croup, rhinovirus, and others.

Lastly, the capacity to see sick patients has diminished in primary care. That burden is being shifted to hospitals which themselves may have decreased capacity due to staff shortages. This is why hospitals are having some of the issues that are being reported in the news.

We have seen this before. Last winter when Omicron came and certainly in 2009 when H1N1 hit in October, it was exactly the same.

So what can you do? 

Nasal congestion and cough are very common symptoms. Expect to see that in your children from time to time. They will usually self-resolve but this takes five to seven days. Illness will progress so some worsening before improving is normal. Expect peaking, usually around day three or four. A mild cough can linger for up to two weeks as children improve.

If your child is not having trouble breathing, acting fairly normal, or just a bit off, they do not always need to be seen. They can recover well at home with time and your TLC. Try to keep them home until symptoms are improving and they’ve been fever free for 24 hours (without help from Motrin or Tylenol). Even with a fever, your child most likely has a virus and despite the fact that RSV and COVID have been made out to very be dangerous, most often they pose very little risk.

Always watch for trouble breathing in any child. This would include using extra muscles to gain air, rapid respiratory rate, or unusual sounds emanating during breathing. If your child becomes more irritable or voices specific complaints like ear pain or bad sore throat, evaluation is warranted for possible treatment. Also, any child under two months old with a fever always deserves at least a call to your primary care provider. 

I believe this will just be one of those years, similar to 2009. In that year, after October, things settled down fast. The following 2010 cold and flu season was one of the quietest seasons we have ever had.

-Dr. Peter Jannuzzi