Hospital diaries: Doctors reveal how staff are dealing with surge of respiratory infections

(NEW YORK) — Doctors say some hospitals are reaching their breaking points as cases of flu and RSV continue to rise across the United States.

Respiratory viruses have been surging throughout the country, appearing earlier than usual and rapidly increasing every month.

According to data from the Centers for Disease Control and Prevention, more than 11,000 RSV infections were diagnosed in September 2022, rising to 40,000 for October.

Meanwhile, for flu, cases, hospitalizations and deaths have doubled for the second week in a row, CDC data shows.

This has led to some hospitals running out of beds, being forced to treat children in emergency rooms and hallways and seeing patients that are much sicker than usual compared to past years.

“It’s really unbelievable the number of patients that we have seen,” Dr. Juan Salazar, physician in chief and infectious diseases specialist at Connecticut Children’s Hospital in Hartford, told ABC News. “The number of kids that are coming in, children under the age of five that we have seen come to our emergency department has been like nothing I’ve ever seen in my 25 years practicing here at Connecticut Children’s and frankly, over my 30 years of practicing infectious diseases.”

“It’s been unprecedented, the strain on the staff and the parents and the children and the nurses has been really, truly unbelievable,” he said.

Some hospitals are completely full

Salazar said his hospital has fully reached capacity and has been that way for the last five to six weeks. The emergency department also has many more patients than it has beds.

“So, our emergency department has 45 beds at any given time,” he said. “This past three, four weeks we’ve had 110 kids in the emergency department. So, it’s almost three times as many beds as we have capacity for.”

Salazar said he has had to call on specialty providers who do not usually treat emergency department patients to help ER staff.

Connecticut Children’s is not the only hospital experiencing these circumstances. Cook Children’s Medical Center in Fort Worth, Texas, is also seeing more patients than it has capacity for.

“Not only are the viruses hitting earlier in the year, they’re kind of coming back with a vengeance that we haven’t seen, because we’ve been so isolated for the prior two years,” Dr. Maxie Brewer, a hospitalist at Cook Children’s, told ABC News. “And so, the biggest issue we’re kind of running into is running out of hospital beds and long wait times and our ERs and urgent care secondary to the volume of patients that are being affected by these viruses.”

According to Brewer, the ER is seeing about 500 patients a day, which is much higher than normal. This is leading to longer wait times and patients waiting longer to be admitted to the hospital.

Patients sicker than ever

Also different this season is the number of older children who have fallen ill with the virus. Brewer said in past seasons, she usually sees infants under 6 months old with RSV, but she is seeing more toddlers affected and those without a history of pulmonary problems or lung problems.

Brewer remembers one patient, a child around 2 or 3 years old who was born healthy and with no history of asthma or lung disease.

“[The child] started getting ill and did not want to drink as much, parents are noticing a little bit increased work of breathing and came into our ER because of it,” she said.

The child was diagnosed with RSV and needed to be placed on high-flow oxygen, which is different from standard oxygen by providing warmed and humidified gas, which allows oxygen to flow at higher rates.

“I’m not used to seeing kids that are older without a history of asthma and this poor child just working so hard to breathe and needing that extra support having to go the ICU, which is just so different than prior years,” Brewer said. “Normally, I’m able to give them a little bit of oxygen and the older kids are just able to pull through, and this year it’s just been hard because seeing kids like that working so hard to breathe.”

Burned out health care staff

This surge putting strain on hospital systems is also contributing to health care burnout.

Nurses who might normally be taking care of four or five patients at a time are suddenly taking care of several more patients.

“We plan for the normal volumes [of patients], even the high volume, but nothing like this,” Salazar said. “And so that puts a lot of strain on the health care personnel that are already tired coming out of COVID.”

Brewer explained health care workers are trying to balance taking care of sick children, tending to parents frustrated by long wait times and their personal lives.

“We are trying our best to kind of be there for every child that needs us,” she said. “But it has led to a lot of stress amongst physicians and nurses, respiratory therapists and everybody working in the hospitals, because we are seeing so many more than we normally do, are working longer hours, we’re kind of working with more sick kids than we normally see.”

Brewer continued, “This is the most patients I’ve ever seen in my career, which leads to a lot of stress. And you want to be there, you want to help. But you also need to realize you’ve got to take time for yourself.”

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