Seasonal Surge in Respiratory Illnesses Hits Mostly Children

by Sally James

Local health officials are concerned about a surge in respiratory illnesses, including flu and Respiratory Syncytial Virus (RSV), which can be severe in young children.

In two interviews this week, physicians Shaquita Bell of Odessa Brown Children's Clinic and Eric Chow of Public Health — Seattle & King County called the situation "urgent." The rate of hospitalizations from the flu is higher nationwide than at any time in the past decade for this time of year. An article in The Atlantic about the national scene called this "the worst pediatric health care crisis in decades."

From their home in Columbia Cty, one family knows the stress of taking their 7-year-old daughter to an emergency room on Thanksgiving Day. She had a fever of 103 and was vomiting. In a phone interview with the Emerald, the couple, who did not wish to be identified, told of trying and failing to find an open urgent care clinic. They drove to Seattle Children's Hospital in North Seattle, where they waited more than three hours to see a physician and were at the hospital a total of six hours before they could return home. Lab tests showed their daughter had influenza A, one of the strains of flu virus that go around this time of year. Dr. Bell said Odessa Brown Children's Clinic is getting 100 calls a day now where they might normally get 30. Over the phone, a specialist can help parents make a decision about their child's symptoms. "We are encouraging people to come here" rather than an emergency room in many cases, Bell said. Children 2 months old or younger may need more urgent visits. Bell is the senior medical director of the clinic, which serves about 150 patients per day, but has seen closer to 200 on some recent days.

The surge in flu and RSV cases is unusual for this time of year, according to Dr. Chow, who is chief of communicable disease epidemiology and immunizations for Public Health — Seattle & King County. What both doctors fear is that if COVID-19 cases increase over the winter, or the flu/RSV surge gets any worse, it will force the pediatric health system into longer wait times and keep families from rapid care. Some have labeled this a "tridemic" or "triple-demic" because of the three respiratory illnesses posing a danger at the same time.

In a typical year, RSV cases peak in January. RSV may cause only a mild cold in adults but can be severe in children under six months of age, immunocompromised children, and those with certain underlying conditions. What we call the flu is really a variety of different viruses that also typically peak in January in our area. But nationwide, the flu has hit the United States earlier than usual this year and led to more hospital stays. A CDC map shows Washington State flu at "very high" levels. Drs. Chow and Bell recommended that people get immunized against flu and get boosters against COVID-19 as soon as possible. Both shots are safe to get at the same visit. The CDC recommends anyone with symptoms of respiratory illness to avoid contact with others and take other precautions to avoid spreading, such as masking in public places, covering coughs and sneezes, frequent washing of hands, and avoiding those who are ill.

At Odessa Brown, families do not need to worry about lacking health insurance. The clinic will not send a bill to them, but will bill their insurance if they have it and can sometimes arrange for transportation if a family does not have a way to come in. "We don't turn anyone away, " Bell said. She recommended families without a primary health provider to call up and ask for one now so they are ready for any winter infections.

The rate of COVID-19 infections in Washington State is not climbing dramatically, but both doctors warned that people should remain vigilant about vaccines and boosters. It is possible for a patient to have more than one virus at the same time, so doctors want people to test and stay away from others if they have symptoms.

From his perspective, Chow wishes we could turn one of the pandemic rallying cries on its head. For months, people thanked frontline workers in health care for bravely facing infection and long hours to protect patients.

"That narrative really should change," he said. Those hospitals and that system should be the last line of defense that is always available. But the "front line" is really all of us, and our community behavior that can soften and ease the surge in respiratory infections.

"We all have a responsibility to protect ourselves, our loved ones, but also our health care system," Chow said. "That's why a lot of us support masking. And we are seeing that with the pediatric health system. And it is our role to play to take steps to protect ourselves."

The Washington State Health Department announced Monday, Nov. 28, that it was closing down a special COVID-19 website because according to a Washington Department of Health press release, "although the COVID-19 pandemic remains … it's no longer an emergency thanks to vaccinations [and] medical treatments." The figures about outbreaks and other data once housed on the special site will still be visible on the department's main site.

The Washington DOH has free at-home tests to give away, but they have run out temporarily. A spokesman said they hope to get a new supply of tests by next week.

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