CHEO forced to cancel surgeries to deal with severe virus season

Admissions of children with RSV to CHEO are, on average, ten times higher today than they were before the pandemic

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Record levels of RSV disease along with new cases of COVID-19 and influenza are all driving an unprecedented surge in demand at CHEO which has forced the hospital to cancel some heart, brain and spine surgeries for some children and makes families wait 15 hours or more in its emergency department.

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“CHEO was not built for this demand,” said President and CEO Alex Munter.

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A recent surge in respiratory syncytial virus (RSV), in particular, is pushing the demand for care at CHEO to levels never seen before and hospital officials do not expect the pressure to ease as the cold weather.

RSV is hitting children harder than usual this year across North America, overwhelming some hospitals. The common virus causes respiratory infections in adults and children, but disproportionately affects children, especially those under two years of age, said CHEO’s chief of infectious diseases, immunology and allergies, the Dr. Chuck Hui.

On Wednesday, Munter, along with infectious disease and emergency medicine specialists, held a video media briefing to discuss the situation and advise parents on when to seek medical attention for RSV and other viral infections and when they can deal with them at home. .

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Munter said the hospital was very concerned about the cancellation of some scheduled surgeries and was in talks with the province about additional critical care funding to relieve some of the pressure.

The hospital has also redeployed staff to emergency, intensive care and pediatric medicine. It also employs nurse practitioners — paid for by hospital donors through the CHEO Foundation — to work on pre-triage in the emergency department, a tool that has helped reduce the number of people seeking emergency care.

« Some families are very happy not to stay, after getting this support, » Munter said.

RSV was the leading cause of infant hospitalizations before the pandemic. But now it is infecting children at higher rates, based on hospital admissions and emergency room demand. This is, in part, because it has dropped significantly during the pandemic and more children than usual have not been previously exposed, resulting in more severe cases.

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Admissions of children with RSV to CHEO are, on average, ten times higher now than they were before the pandemic, said CHEO spokesperson Patrick Moore.

« It’s like the perfect storm, the combination of a large cohort of susceptible children in combination with behavioral factors (like going back to school), » said pediatrician and infectious disease specialist Dr Anne Pham Huy.

In addition to RSV, which arrived earlier this year than usual, CHEO is seeing an increase in COVID hospitalizations and has admitted two children with the flu, which is rare in October.

CHEO had the busiest months in its history in May, June, July and September and is seeing 12% more children coming to the emergency room with viral illnesses in October than a year ago. Earlier this fall, he advised families to bring blankets, snacks and toys with them when they come to the ER due to long waits.

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Munter said the pressure on the emergency department is a combination of the multiple severe viruses circulating as well as « fewer care options » for families.

As of Tuesday, the hospital’s pediatric medicine units were 134% busy, the pediatric ICU at 124% and the emergency department, which was built for 150 visits a day, received 254 visits.

“As emergency physicians, we are definitely feeling this wave,” said Dr. Melissa Langevin, medical director of emergency medicine at the hospital.

She advised parents to look after children with RSV and other viruses at home, when they can, by manually clearing mucus from their noses so they can breathe and drink fluids, which are crucial. . Children under two months old who have a fever should be seen by a doctor, in addition to children who have severe breathing difficulties or pauses in breathing in young children. Very young children who drink half of what they normally do should also receive medical attention, she said.

Langevin said RSV usually gets worse before it gets better and lasts longer than a week. Persistent coughing is sometimes common, she says, in children who finish one infection and get another. She recommended honey for children over the age of one and noted that the Canadian Pediatric Society does not recommend cough syrup for children.

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