Amid RSV surge, children’s hospitals, pediatricians push Biden to declare emergency

With children’s hospitals across the country filled with patients with respiratory illnesses, healthcare organizations are warning that children’s hospitals are approaching “the breaking point.”

The Children's Hospital Association and the American Academy of Pediatrics have issued a joint letter urging President Biden and his administration to declare an emergency to respond to the enormous number of patients with respiratory syncytial virus, known as RSV, and other respiratory illnesses. They also pointed to rising cases of the flu and the rising number of children treated for mental health issues.

With the declaration of a public health emergency, just as with COVID-19, hospitals would gain the flexibility to coordinate and share resources and have access to emergency funding to address growing demands, including labor expenses to deal with the volume of patients.

From coast to coast, hospitals are packed above their usual capacity and struggling mightily to handle the surge of patients with RSV. Physicians are saying they’ve never seen so many RSV cases and wait times in emergency departments are far above normal.

More than three quarters of the nation’s pediatric hospital beds are occupied, and in some states, more than 90% of pediatric beds are filled, the letter notes. Ambulatory pediatric practices are also seeing an overwhelming number of patients.

“Our system is stretched to its limit and without immediate attention the crisis will only worsen,” Mark Wietecha, CEO of the Children’s Hospital Association, said in a statement.

Mark Del Monte, CEO of the American Academy of Pediatrics, said federal action is needed to provide resources to address the crisis, which he said is having a greater impact on “historically under-resourced communities.”

"We are making this urgent request now because the crisis unfolding across the country warrants immediate, comprehensive action from the federal government. We must address longstanding underinvestment in Medicaid and increase payment rates to at least what Medicare and private insurance pay for the same services,” Del Monte said in a statement.

Health officials have been warning of a “triple-demic,” with RSV cases converging with flu cases and a potential uptick in COVID-19 cases.

The letter notes those factors, along with a shortage of clinicians in hospitals to deal with the high number of patients they are receiving.

“These unprecedented levels of RSV happening with growing flu rates, ongoing high numbers of children in mental health crisis and serious workforce shortages are combining to stretch pediatric care capacity at the hospital and community level to the breaking point,” the letter states. “Due to these challenges, pediatric hospitals and pediatricians are being asked to support more care and higher levels of care than ever before.”

Earlier this month, Seattle Children’s said its volume is consistently at 200%, and peaking at 300%. Seattle Children’s said it expects volume to increase in the coming months. James Stein, chief medical officer of Children’s Hospital Los Angeles, said this month that the positivity rate for children tested for RSV was 37%, well above the peak of 24% last winter.

Sage Myers, a pediatric emergency medicine physician at the Children’s Hospital of Philadelphia, told Chief Healthcare Executive earlier this month that the situation in children’s hospitals is comparable to the surge of patients in New York hospitals at the start of the COVID-19 pandemic.

“I’ve been doing this for over 15 years,” Myers said. “I’ve never seen wait times like we’ve seen now.”

In the letter, the Children’s Hospital Association and American Academy of Pediatrics also draw a parallel to the government’s response to the COVID-19 pandemic. “Children and children’s providers require the same capacity support as they strive to keep up with increasing needs of our youngest Americans,” the letter stated.

Oregon Gov. Kate Brown declared an emergency to deal with the RSV surge, allowing hospitals the flexibility to staff beds for children and allow them to draw on a volunteer pool of doctors and nurses, Oregon Public Broadcasting reported.

The Oregon Nurses Association, while supporting the move, said it should have happened sooner.

“Although ONA supports the Governor’s executive order, we are disappointed that state agencies, and the Oregon Health Authority (OHA) specifically, were not more proactive in implementing public health interventions to mitigate this emergency,” the group said in a statement. “The RSV crisis did not happen suddenly. In fact, it has been building over the past weeks and months.”

The Children’s Hospital Association and American Academy of Pediatrics are also calling for the Biden administration to do whatever is possible to alleviate shortages of drugs and other supplies to help care for pediatric patients. They also asked for pediatric providers to get top priority in rental and excess equipment.

Last month, the two groups, along with the American Academy of Child and Adolescent Psychiatry, asked the Biden administration to declare a national emergency to combat the growing mental health crisis in America’s youth. Emergency room visits for suicide attempts among young people have risen sharply during the pandemic.