The head of emergency medicine for the Calgary zone says emergency rooms will likely become busier this winter in part because of rising respiratory syncytial virus (RSV) rates.
According to federal data, RSV cases have doubled in Canada over the past two weeks.
For the week ending Oct. 29, data shows RSV activity is increasing and is above expected levels for this time of year with 1,045 detections.
Symptoms of RSV resemble those of a cold or flu, such as coughing, runny nose, fever and loss of appetite.
“I have never seen this much RSV affecting so many young children with such high oxygen requirements in so many of them,” said Dr. Eddy Lang, the head of emergency medicine for the Calgary zone.
He said the RSV season has started earlier than usual and is causing more severe infections than in previous years.
“We are seeing a number of young children below the age of five who are so severely affected that they need to come in the hospital and get oxygen, and even some of them have oxygen levels that are so low that they need to be intubated,” Dr. Lang said.
Lang added normally pediatric emergency departments don’t have many patients stay in the ER because there are no beds upstairs, but this year is different.
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“Now there are patients with respiratory problems, namely RSV, who also don’t have beds upstairs at the children’s hospital,” he said. “And that again is contributing to the prolonged wait times that we are hearing about.”
“We are already pretty full in our emergency and inpatient wards,” said Dr. Sam Wong, the president of the pediatrics section of the Alberta Medical Association.
Wong said getting kids vaccinated for the flu and COVID is important in helping ease the strain on the healthcare system.
“If they have had COVID, this would be a booster to that and it would protect them for the winter time which is the highest risk,” Dr. Wong said. “I think just because you’ve had it once and it was mild, doesn’t mean that with the second time it will be mild as well, and the risk of long COVID increases with repeated infections.
“One of the things I would say to parents is that the risk is not totally gone.”
There is no vaccine for RSV. The virus is common, very contagious and infects the respiratory tract of most kids below two years of age. For most children, the infection doesn’t manifest beyond a cold, but for a small group, RSV can lead to bronchiolitis — which is an inflammation of the lungs — or pneumonia, according to the U.S. Centers for Disease Control and Prevention (CDC).
Lang said to have an effect on emergency departments in terms of crowding, 80 to 90 per cent of the population needs to be vaccinated against influenza — which he doubts will happen.
“As long as our most vulnerable get the flu shot, the frail elderly, those with lung disease, very small children — it could make a bit of a dent in the number of patients coming to emergency for respiratory illnesses,” Dr. Lang said.
He added that judging by Australia’s experience with a difficult flu season, along with wastewater data in Alberta, it looks like ER departments are going to become even busier.
“If things are bad now, we are really worried about December and January,” he said.
“RSV concentrations in the wastewater suggest that we are on a sharp uprise… which does not bode well for what we can expect in the emergency department, especially on the pediatric side for the next several weeks,” Dr. Lang said.
Dr. Wong said there are several hypotheses behind the increase in RSV.
He said it’s hard to be certain because there are so many different factors in RSV and the viral infections we are seeing this year.
“Is it because we haven’t had RSV and influenza for a couple of years so there’s a cohort of kids for a couple of years who have not really been exposed to any viruses and thus are more susceptible? Has COVID changed things and made us more susceptible to viruses or made the viruses more potent?” Dr. Wong said.
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