Unprecedented volume of kids showing up in Winnipeg emergency department with flu, RSV

A "high viral burden in the community" is creating a strain at Winnipeg's Children's Hospital as the emergency department continues to be deluged with patients with respiratory viruses, the head of pediatric medicine says.

Staff are still seeing some COVID-19 cases but the main players are respiratory syncytial virus (RSV) and Influenza A, with many patients testing positive for both, Dr. Elisabete Doyle, medical director and section head of pediatric medicine at the Health Sciences Centre Children's Hospital, said during a Tuesday news conference.

The first three weeks of November have seen approximately three times the normal number of influenza patients compared with pre-pandemic levels in November 2019, she said.

"We continue to see an unprecedented volume and acuity of [sicknesses in the children's emergency department] for this time of year," Doyle said.

There have been 34 pediatric patients hospitalized with RSV so far in November — 22 in the past week — and the majority of kids who are admitted with RSV are under the age of three.

Doyle outlined the situation at the Children's Hospital with the following data:

• Sixteen patients admitted among 182 visits on Monday.
• Eight patients in pediatric intensive care unit as of Tuesday morning, three of those with RSV (pre-pandemic baseline for PICU is nine staffed beds.
• Fifty patients, the baseline capacity, in the neonatal ICU.

The reason for the high traffic "has to do with the high viral burden in the community," Doyle said, urging people to get their flu vaccine in order to protect themselves and one another.

"This is very important for our infants who are not eligible for the vaccine," she said, adding that parents need to keep kids home from daycare if they are showing signs of being sick.

"We've always been believers that looking after our children's health is a shared responsibility."

The shortage of children's pain medication, such as Tylenol, has posed some challenges but "we're optimistic that shortage will soon be behind us," Doyle said.

Shared Health has posted advice for parents on how to safely split adult medication, such as Tylenol, if necessary. Most pharmacies will also be able to do that for parents.

To help ease the burden in the emergency department, Doyle reminded parents that common cold and flu symptoms can be managed at home through rest, fluids and keeping cool with light clothing and cool beverages.

"Fever, in itself, is not dangerous. It is the body's natural response to infection and it doesn't typically require treatment," she said.

On the topic of protecting one another, Doyle advised people to:

• Consider wearing a mask in large crowds.
• Sneeze and cough into your elbow instead of your hands.
• Don't share drinks and face towels.
• Clean high-touch surfaces such as doorknobs, taps and countertops frequently.

Those were public health fundamentals practised during the height of the pandemic, "and returning to them will help to get the viruses under control," she said.

Growing cases and staffing shortages

The Children's Hospital is currently facing a staffing vacancy rate of about 20 per cent, Doyle said. Coverage is being provided through call-ins, overtime and moving staff to areas of need.

However, she cautioned, there is staff burnout, especially on the front lines.

"We are working really hard at trying to keep that morale high in emergency and, you know, the bottom line is all of these staff want what's best for the kids in the community," Doyle said. "But it does take a toll."

The future rate of hospital admissions is uncertain, but based on other countries, including Australia, it seems clear Manitobans can expect higher peaks of illnesses that last longer.

Hospital staff are planning for the expected increase in patients, she said, and are working collaboratively with other hospitals in anticipation for a spike. Staff will also be moved around to different areas or work overtime when needed.

"We don't want to be stuck at the last minute with nowhere for our children to go," Doyle said. "We won't break. I'm confident we will find a solution."