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'All at once': Regional health systems respond to surge in RSV cases, hospitalizations among children

Across Southeast Minnesota, pediatricians are extending their appointment hours to accommodate an unusual early surge in RSV infections this year.

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Mayo Clinic Hospital-Saint Marys Campus on Second Street Southwest in Rochester on July 23, 2021. The Saint Marys Campus is home to Mayo Eugenio Litta Children's Hospital, where physicians are seeing and treating patients with RSV amid a surge in cases.
Andrew Link / Post Bulletin file photo
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ROCHESTER — Southeast Minnesota health systems are seeing an influx of pediatric respiratory syncytial virus (RSV) cases in their clinics and hospital rooms as a recent surge in infections affects the U.S.

"It's definitely not a new virus," said Dr. Sarah Lallaman, a pediatrician at Winona Health in Winona. "It just seems to have hit all at once."

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"We're seeing it a bit outside of the typical seasonal pattern," added Dr. Marcie Billings, pediatrician and division chair for Community Pediatric and Adolescent Medicine at Mayo Clinic. "Most likely due to kind of what COVID has done over the last few years has kind of changed the landscape of our typical infectious seasons."

While RSV infections for most adults can produce relatively mild, cold-like symptoms, Lallaman said young children and infants can have a harder time fighting the infection.

"For younger children and especially infants, this congestion gets into their lungs and produces a tremendous amount of mucus and congestion," Lallaman said. "And they have a really hard time clearing it, and it causes a hard time breathing."

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This means that children are more likely to need extra care or hospitalization when they get sick with RSV. This surge in cases is reflected in the current availability of pediatric hospital beds in the region; per the Minnesota Department of Health's Nov. 17 COVID-19 update , only four pediatric hospital beds are available in Southeast Minnesota, 8% of region's capacity. For pediatric intensive care unit beds, only one bed (4% of the region's capacity) was available in the last week.

At Winona Health, Lallaman said two children have been hospitalized there for RSV this fall, as of Nov. 15. One patient is receiving treatment in Winona, and the other was transferred to a different hospital.

Lallaman
Dr. Sarah Lallaman, a pediatrician at Winona Health Hospital in Winona.
Contributed / Winona Health

While there has been an uptick in RSV hospitalizations, the brunt of this early surge is being felt the most in pediatric clinics — both Mayo Clinic and Winona Health have seen increased demand for appointments and are adjusting clinic schedules to accommodate that heightened need.

"We are just frontline with having to see these kids in the clinic and urgent care," Lallaman said. "We're just swamped with it and having to triage: How are these kids? Are they well enough to be managed at home? I don't recall a year that has been this bad so far."

Lallaman said she and other pediatric providers at Winona Health have added additional appointments to their usual schedules and had to push back some routine appointments for other patients. Mayo Clinic is doing something similar at its clinics in across the region .

"In the outpatient world, what we're trying to do is really assist with those higher acuity patients," Billings said. "Opening up better access within the community, our evening clinics, which we've already had, we're adding providers and adding appointment times. We're increasing the same on our Saturday clinic where we're increasing the number of providers and the number of appointments. Then, we've added a Sunday clinic as well."

The RSV surge is coinciding with an anticipated early influenza season and the potential for more COVID-19 cases to arise during the winter. According to the University of Minnesota's Center for Infectious Disease Research and Policy, national reported cases of the flu are already on the rise this month. Because of this, health care providers are bracing for another tough winter.

"I think that, mentally, we're preparing for a bad season and then working with our supply chain to make sure that we've got as much as we can for testing and supplies," Lallaman said. "I do think it's going to be a rough flu season, and then I just saw one of the worst COVID cases in (an) adolescent that I've seen. I think we're just kind of getting beat down and just seeing different things maybe stacking on top of each other."

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To help mitigate the spread of RSV and other respiratory diseases, Billings said the two biggest things people can do is to get vaccinated and stay home when they're sick.

"We have vaccinations to prevent two of those three infections, influenza and COVID, and I would strongly advocate for that," Billings said.

Staying in contact with your primary care provider can also be helpful if you or your child is sick, Billings said.

"If your child is having any respiratory distress or concerns that you feel are emergent, then absolutely we're recommending that your child can go to the emergency department," Billings said. "But we're saying that there's a lot of other available opportunities that we're expanding on to be able to see your children in a more appointment-based (setting) without having to go to the emergency department. We know it's really helpful to be reassured about how your children are doing when they're sick, but not every kid needs to be seen, either. Kids can usually do well with these viruses."

The Post Bulletin reached out to Olmsted Medical Center and Gundersen Health System for comment but did not receive additional information or statements from those health systems by deadline.

Dené K. Dryden is the Post Bulletin's region reporter, covering the greater Rochester area. Before joining the Post Bulletin in 2022, she attended Kansas State University and served as an editor for the student newspaper, the Kansas State Collegian, and news director for Wildcat 91.9, K-State's student radio station. Readers can reach Dené at ddryden@postbulletin.com.
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