Bay Area Children's Hospitals Strained as RSV Surge Arrives

Patients are flooding Bay Area hospitals as a common respiratory virus sweeps across the region, mirroring a similar surge that has ravaged the East Coast this month.

“Last night I admitted a 3-year-old child from the emergency department who spent nine hours in the emergency room waiting for a bed in the hospital,” said Dr. David Cornfield, pediatric pulmonologist at Stanford University. “And that’s not terrifically unusual [right now].”

The main culprit is respiratory syncytial virus, or RSV, which feels like a bad cold. Symptoms can include a runny nose, a barking cough, wheezing or rapid breathing. Nearly every child on the planet has had RSV by the time they are 3 years old, and many catch it before they are 1 year old. However, the pandemic broke this pattern because older kids may have escaped it as an infant. Now they are catching RSV for the first time.

“It’s almost as if we’re seeing a stacking up of the infectious risk that was deferred in recent years when viruses weren’t exchanged as readily because people were in isolation, wearing masks and not going to school,” said Cornfield.

He says the emergency department at Stanford’s Lucile Packard Children’s Hospital is full. Doctors at UCSF Benioff Children’s Hospitals and Kaiser Permanente also say patient volume is unusually high, although they still have capacity.

Wastewater data from San Francisco, Santa Clara and Sacramento and other Northern California communities show RSV levels are sky-high, similar to last winter’s peak in January. Scientists sampling sewage can measure the genomic material of viruses circulating in mucus, feces and urine to determine how much a bug is spreading within a community.

“There’s a really large increasing trend across all of our wastewater treatment plants that we are monitoring in the Bay Area as well as in Sacramento,” said Alexandria Boehm, who monitors the data and is a Stanford University environmental engineering professor.

The good news is most people recover from RSV in a week or two. Doctors recommend drinking lots of fluids, resting and taking medications like ibuprofen or acetaminophen to reduce fever. You can clear mucus from an infant’s nasal passage with a bulb syringe.

“If they breathe and you see the skin around their bones kind of sink in and it looks like they’re really sucking, that should certainly be a red flag to take your kid to the clinic or to the hospital,” said Dr. Ted Ruel, chief of pediatric infectious disease at UCSF.

He recommends people wash their hands frequently and stay home if they are sick. He’s also warning a nasty “tripledemic” could hit this year with flu, RSV and COVID-19 surging all at once. Ruel urges people to get a flu shot and stay current on coronavirus vaccines.

Current COVID-19 rates have been decreasing and flattened in the Bay Area, but experts say a winter wave is likely. New omicron variants are circulating in Germany and France, and European surges have been harbingers of what’s to come in California.

“We are absolutely worried about overlaps of all three viruses colliding at the same time,” said Ruel. “I think we’re still in the watch-and-see phase.”