As people gathered for Thanksgiving, hospital workers in St. Louis were on high alert and they remain so.
Emergency rooms are crowded with people sick with respiratory illnesses, and doctors are worried that more people will get sick as people mix during the holidays.
The St. Louis region, along with the rest of the country, is experiencing an early, gnarly flu season. Childhood respiratory illnesses are also on the rise. The increase in patients is coming as more health care employees leave their jobs, putting more strain on the workforce that remains.
While RSV has hit children hard across the country this fall, there is evidence older adults are catching the respiratory virus at a higher rate than normal.
Dr. Jessica Ericson is a pediatric infectious disease specialist at Penn State Health Children’s Hospital in Philadelphia. She said the 2022-2023 RSV season seems to have started very early, with cases showing up in August and September.
“Also, what’s really different is the number of children who have these viruses and who are sick enough to be admitted to the hospital,” she said in a Penn State news release. These are “children who need oxygen and need to be admitted to the intensive care unit,” Ericson explained.
It’s most probably a “backlog” of sorts happening: Kids who normally would have contracted RSV over the past two seasons instead were sequestered at home and told to wear masks and distance themselves if they did mingle. “Now that we’ve stopped doing that, those children are now encountering RSV and other viruses for the first time,” Ericson noted.
While RSV has hit children hard across the country this fall, there is evidence older adults are catching the respiratory virus at a higher rate than normal.
The Centers for Disease Control and Prevention said about six out of every 100,000 seniors has been hospitalized with RSV.
It’s a much lower rate than in children, but for seniors it is about 10 times higher than in years before the COVID-19 pandemic.
Earlier this year, the CDC introduced new metrics to measure the spread of the coronavirus. The federal agency reports St. Louis and St. Louis County have a “medium” COVID-19 risk. The agency takes case numbers and hospitalizations into account to calculate this measurement.
However, the CDC also reports the level of community transmission in the region is high. That means even if people aren’t hospitalized, the virus is being spread widely. Doctors say people in the region should take both metrics into account before visiting elderly or immunocompromised family members for the holidays.
According to the St. Louis Metropolitan Pandemic Task Force, about 250 people were hospitalized with COVID-19 in the region’s hospitals last week. That’s fewer than at this time in 2021 and 2020.
During last year’s omicron variant-fueled surge in late December, there were nearly 1,500 people in the hospital with COVID-19. However, the region did not see a dramatic rise in such cases until after Thanksgiving, indicating that holiday gatherings fueled the huge spike.
During the first two years of the pandemic, the public lost a certain amount of immunity, said Dr. Howie Mell, an emergency physician at HSHS St. Elizabeth’s Hospital in O’Fallon, Illinois. People weren’t going into work as much, and kids weren’t in school.
For example, he said, most kids get RSV when they’re young. But now, many children of many ages are contracting it at the same time, because for the past few years, there wasn’t much opportunity to catch it.
“We’re absolutely crushed,” he said. “And I think the general consensus is that this is three years all brought into one, right? Because we for so long had social distancing, we had masking, we had all of these things, which protected kids from being affected.”
If trends continue, patients could overwhelm workers, Lawrence said.
“If this continues to increase at the rate that we’re seeing for another, say two, three, four weeks, that could really put some hospitals in a more serious situation of having that strain and capacity of the ER being full, or having hospital beds that are filling up,” he said. “We are watching carefully and certainly keeping our fingers crossed that it doesn’t continue at this pace.”
Hospitals dealing with more patients already were facing a lot of health workers leaving the profession.
Earlier this year, the Missouri Hospital Association reported that nearly 20% of nursing positions in the state’s hospital were vacant, the highest since the survey began and up from 12% in 2021.
Staff turnover for other positions, including respiratory therapists, also is high, the report found.
Health workers have dealt with an increased workload since the pandemic started, said Sarah Dewilde, a nurse at St. Louis University Hospital who is a steward for the nurse’s union there. Many workers feel they weren’t getting paid enough to keep them at such a demanding job, she said.
“Nurses have finally given their notice,” she said. “They’re like, ‘Look, we’re not willing to put up with this. We deserve to make more money for what we’re doing.’ Because in every job, if you were to take on more responsibilities, you would take on more money, right?”
Staff members who haven’t left are absorbing this year’s big increase in patients with respiratory illnesses.
“If something doesn’t get done … it’s inevitably put onto the nurse, because the nurse is the one that has to ensure that it gets done,” DeWilde said. “So we’re getting calls from doctors asking ‘Hey, why isn’t this done?’ It’s like, ‘We know there’s no lab techs this evening. I can’t draw labs on five patients, as well as take care and clean all of them up.’”
This article originally appeared here.