Flu, RSV and COVID: Families wonder if this winter’s viral stew will ever end : Shots
I wanted to report this story last month, but I’m so tired of COVID. My son gave it to me.
My colleagues on the health reporting team should have solved the story, but they also got sick because of their children. (Just last week, a colleague took her daughter to preschool on the first day of her recovery, only to pick her up the same afternoon, sniffling from a new illness. Oops.)
And we are far from alone in our woes.
“Like a lot of parents out there, you know, my husband and I have been sick all winter. We had sneezing, coughing, fever. It was horrible,” the doctor said. Rachel Pearson, a pediatrician at the University of Texas Health Science Center in San Antonio and University Hospital. She is also the mother of Sam, 2 years old.
“I feel like half the time he has a virus, a runny nose, a cough – to the point where my dad says, ‘What’s wrong with Sam?’ ” she speaks.
With the flu, RSV, cold and COVID all arriving at the same time, it can feel like things are getting worse than ever for parents with young children. But as Pearson tells her father — and the parents of her younger patients — this seemingly never-ending cycle of runny noses is normal, if unfortunately miserable.
“When I advise parents, I say you can get a virus every month. Some children will cough for four to six weeks after contracting the virus. And so they get the next virus before they stop coughing from the last time.”
In fact, if you’ve ever described your baby as an adorable little germ, you’re not wrong, say Dr. Carrie Byington, a pediatric infectious disease specialist and executive vice president of the University of California Health System. And she has hard data to back that up.
Byington said: “We all think so, but it’s unbelievable that there is clear evidence of it.
The “proof” she was referring to came from a research her and her colleagues started in 2009, when she was at the University of Utah. They wanted to understand the role children played in the transmission of respiratory viruses in their homes. So they recruited 26 households to take nasal samples from everyone living in the house, every week, over the course of a year. What they found was eye-opening.
“We found that as soon as a child entered the home, the percentage of weeks an adult had an infection increased dramatically,” Byington said.
And more children means more infections. For families with two, three or four children, someone at home has an infection for a little more than half a year. Families with six children have virus detection rates as high as 87% for the year. On the other hand, households without children only had a virus detection rate of 7% for the year.
(Appropriately, the study is called Utah BIG-LoVE — an acronym for Better Germ Longitudinal Viral Epidemiology.)
The findings also show that the youngest children are the ones who bring the disease home most often: Children under 5 are infected with some respiratory virus 50% of the year – twice that of older children and adults. And although the detection of viruses does not always translate to disease, when they to be infected, the youngest children were 1.5 times more likely to have symptoms such as fever or wheezing.
And that’s just respiratory viruses. As Byington notes, the study didn’t even look at other types of infections, such as strep throat, that are caused by bacteria. “So obviously there could have been other things going on throughout the year that even made it seem worse,” she said.
All of this means that, on the whole, it’s normal for children to contract all of these viruses, Byington said. But now it’s all more intense because of the disruption of the pandemic. She says children are kept at home instead of going to daycare or school, where they are often exposed to viruses and bacteria one after another. So children don’t get a chance to build immunity over time.
When kids get back to normal activities, “there’s a lot of kids ages 1, 2 and 3 who have never really seen a lot of viruses or bacteria,” Byinton said. “And so what may have been going viral over the past 12 months, a year, they’ve now seen it all at once in this very focused moment..”
Byington said the pandemic also disrupted the seasonality of the virus. This year’s flu season came earlier than usual, as RSV and COVID are also circulating. Young children not previously exposed to these viruses have been severely affected.
That’s because children are more likely to get sick the first time they encounter the virus, Pearson notes, before they have some degree of immunity. She said there was a larger group of children this year with no previous exposure.
And have proof that younger children with multiple infections – such as COVID and RSV – at the same time can become more seriously ill than if they had only one virus at a time.
The upshot is that many children’s hospitals and care units have seen an increase in the number of sick children during the fall and winter. That includes University Hospital in San Antonio, where Pearson saw children hospitalized in the acute care unit.
Nationally, “pediatric care is currently at a stressful time,” said Pearson, not only because of the current surge but also because of a lack of investment from before the pandemic.
And “hospitalized children are just the tip of the iceberg,” says Pearson. She said that for every child sick enough to be hospitalized, there are likely to be many other children with the same virus recovering at home.
The good news is that the viral fever seems to be easing. Recent data from the CDC shows that emergency department visits for influenza, COVID, and RSV have fallen to their lowest levels since September for all age groups.
But of course, the respiratory virus season isn’t over yet.
For those families now living in a memorable title dubbed “virus hell,” Byington hopes the findings of the BIG-LoVE study will provide some consolation that this will eventually pass.
“It would be great to do the research and give some real data to families that what they are going through is normal and will pass and their children will be healthy,” she said.