Influenza, RSV put pressure on Alberta Children's Hospital as case counts climb

Alberta Children's Hospital is facing an influx of kids sick with respiratory viruses so it's adding capacity in an effort to meet demand.

"The emergency departments are quite full, very busy," said Dr. Stephen Freedman, an ER physician at the hospital.

As case counts in the province spike, he's seeing a lot of children with influenza and RSV (respiratory syncytial virus). There are some cases of COVID-19, too, he said.

"Does it take away from other resources and capacity to do other things? For sure it does. Is it straining our ability to provide care to all the children as efficiently and as expeditiously as we want? For sure," said Freedman, who is also a professor of pediatrics and emergency medicine at the University of Calgary.

"But is it the same as last year? Is it as overwhelming as last year? I would say no, not at this point in time."

Care was delayed, staff were redeployed and surgeries were postponed when Alberta's pediatric hospitals were slammed by an unprecedented wave of very sick children during last year's respiratory virus season.

In response to this fall's surge, Alberta Health Services (AHS) has added six surge beds to the hospital, bringing the total to 162.

"This year is similar to prior years, but given the preparedness of the teams with the experience of last year's increase in respiratory cases, the volumes are being managed, and pressures are not as significant as this time last year," an AHS spokesperson said in an email.

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"AHS is working hard to ensure we can continue to provide care to anyone who needs it."

The health authority said no surgeries have been delayed at Alberta Children's hospital, and other departments, such as outpatient clinics, have not been impacted.

Earlier this year, the provincial government dedicated $12 million in its budget to increase capacity at children's hospitals and help address seasonal spikes. 

The funding provided 10 surge beds and six pediatric intensive care beds as well as 61 permanent front-line staff positions at Alberta Children's Hospital.

Influenza, RSV

According to Freedman, children are showing up in the emergency room with cough, runny nose and fever. There can be vomiting and diarrhea, and some kids have trouble breathing.

The main culprits currently are influenza and RSV.

"I don't think the severity of illness is any different than we have seen in prior years, even those years prior to the pandemic," said Freedman.

"We definitely historically have always seen some children get quite unwell from influenza. Some require hospitalization."

RSV, he noted, mostly affects very young children.

"They tend to develop difficulty breathing, sometimes low oxygen levels and often requiring hospitalization for oxygen therapy and supportive care until they can get over the illness."

While they are seeing some cases of COVID-19, Freedman noted those children need to be admitted to hospital less often.

According to the province's respiratory dashboard, 218 Alberta kids and teens have been hospitalized and 22 have been admitted to ICU due to influenza so far this season.

The data for RSV is not available.

COVID-19 has led to 194 hospitalizations and 19 intensive care admissions since the end of August for those 19 and under.

Serious complications

Dr. Cora Constantinescu, a pediatric infectious disease specialist at Alberta Children's Hospital, wants parents to understand influenza can lead to serious complications.

"The flu takes out so much of your own innate immune responses and barriers to other bacterial infections, and that's how kids end up in hospital with tubes inside their lungs," she said.

"Influenza does a lot of damage to the airways. It also takes down the immune system. So those two things combined allow the bacteria that we harbour in our noses and our pharynx to take over," said Constantinescu.

When that happens, bacteria can get into the lungs (causing pneumonia), the blood (causing sepsis) and the brain (causing meningitis).

Constantinescu is watching case counts closely and she's worried the respiratory virus season has yet to peak.

"I suspect that even come January we're not going to be out of this red zone of respiratory virus hospital admissions," she said.

While the school break will provide some relief from transmission, she said, indoor gatherings will likely be a hot spot. 

It's not too late to get vaccinated, she said.

"We do have influenza and COVID vaccines and they're all available to children as well.… That's one big part of prevention," she said.

"It's the unimmunized children who end up in hospital, who end up with these severe infections."