With respiratory syncytial virus (RSV) surging coast to coast across Canada, children’s hospitals have been reporting long wait times and overwhelmed emergency rooms due to unprecedented cases of the highly contagious illness, which causes cold-like symptoms in older children but can be very serious in infants.
“RSV is a virus that normally you probably are in contact with every year or every other year, and so you sort of accumulate an immunity over time. And what we’re seeing is this cohort of kids who have had much less exposure to viruses as would have had in the past years,” she said.
‘Immunity Gap’
According to a commentary published July 14 in The Lancet medical journal, the predictable seasonal circulation patterns of many endemic viral illnesses in children changed due to non-pharmaceutical interventions (NPIs) and societal behavioural changes during the COVID-19 pandemic, and these viruses are now resurging in unexpected ways.“Decreased exposure to endemic viruses created an immunity gap—a group of susceptible individuals who avoided infection and therefore lack pathogen-specific immunity to protect against future infection,” wrote the authors, who include Dr. Kevin Messacar, associate professor of pediatrics at Children’s Hospital Colorado in Denver, and Rachel Baker, assistant professor of epidemiology at Brown University in Providence, Rhode Island.
Changes in NPIs or societal behaviours—such as ongoing mask-wearing, working from home, and social distancing—leading to even moderate alterations in viral transmission rates “could greatly impact the magnitude of future outbreaks” in children, the Lancet study said.
RSV Season Came Early
A CHEO spokesperson told The Epoch Times that the hospital is in an emergency situation due to RSV and is operating with “all hands on deck.”President and CEO Alex Munter said at the briefing that in the last week of October, the hospital had 10 times the average number of admissions for RSV than it had pre-pandemic. Peak viral season came early, driven by acute viral respiratory infections, at levels never before seen in the hospital’s 48-year history.
Joining Munter and Langevin to discuss the reasons RSV is on the rise this year were Dr. Chuck Hui, chief of infectious disease, immunology, and allergy, and pediatrician Dr. Anne Pham-Huy.
Hui said CHEO’s experience with RSV admissions reflects what’s happening across the rest of Ontario as well as south of the border in the United States.
“We’re seeing a significant number and an increased number of RSV cases, and also a significant increase in RSV hospitalizations. And this is an early surge,” he said.
Langevin said children under age 2 or 3 are going to be more susceptible to symptoms and that “RSV tends to be more severe if you’re exposed to a higher viral load.” She said it’s possible kids are being exposed to multiple people with a higher viral load and slightly more severe symptoms.
“It’s like the perfect storm,” Pham-Huy said, as “you have the combination of both a larger susceptible cohort of kids, in combination with behavioral stuff, to back to school and circulation of all the mix of viruses at the same time.”
“RSV is here earlier than it usually is,” she added, “and so we’re seeing the cases and the surges.”
“We are definitely feeling that wave,” said Langevin. “What’s important to know is that this is something we know well. RSV is part of our regular bread and butter.”