Pediatric and neonatal intensive care units are filling up with children with bronchiolitis in Andalusia

Pediatric and neonatal intensive care units are filling up with children with bronchiolitis in Andalusia

That burst of cases of bronchiolitiswith a peak in cases recorded in early November, has contributed to the unexpected surge in other viral infections of the respiratory type children population in Andalusian hospitals. Emergencies and pediatric and neonatal intensive care units they are complete. Most patients are children suffering from respiratory infections. The public health services and their professionals in this sensitive area have been under great stress for days.

Pediatric emergencies have increased by 35-40% compared to the cases registered in Andalusian hospitals last November, in a general situation that affects the entire national area,” explains the doctor Maria Jesus Sanchez AlvarezSecretary of the Spanish Society for Pediatric Emergencies (SEUP) and Director of Pediatric Emergencies at the Virgen del Rocío Hospital (Seville).

The “behaviour” of the virus changes

Children have always had respiratory viral infections and they were usually distributed in the coldest months, but this year we have observed epidemiological changes,” warns Dr. Sánchez Álvarez and notes this “It is not possible to predict” how this winter will go in children’s hospital areas. “We had a peak of bronchiolitis in the month of May, something that had never happened before the pandemic,” says the pediatrician.

That bronchiolitis The virus, caused by respiratory syncytial virus, affects infants (0 to 2 years old) and spread every December until the outbreak of Covid-19. The changes caused by the pandemic have influenced the behavior of this and other typical winter viruses. So RSV no longer follows the usual seasonal patterns that it is not possible to predict with certainty how this infection will develop in the coming months.

Until the arrival of Covid-19, Respiratory illnesses in the child population usually began in October and lasted until February, which coincided with the winter period. However, this year there was Bronchiolitis peaks in spring (May) and fall (November)while even falls fail Summer In Andalusia.

We cannot predict what epidemics will look like. What happened to the respiratory syncytial virus will surely happen later to the influenza virus. We expect the flu to start in December but we can’t confirm it because we don’t have experience. What happened during the pandemic was an epidemiological experiment,” he says.

unvaccinated children

SARS-CoV-II, and the measures to contain it like Detention and masks made the viruses go away that spread before the pandemic, such as influenza and respiratory syncytial virus, among other respiratory infections. “Ever since the masks were removed, these viruses are reappearing, but now they do not follow the usual seasonal epidemiology‘ says the expert.

Likewise, younger children had no opportunity to be vaccinated by reducing your exposure to germs that cause respiratory infections and other health problems.

“We don’t know why, but The ecological niche has changed; The children are not vaccinated. For example, even a pregnant woman passes antibodies to the baby, and since we haven’t had exposure to these viruses, neither have these smaller children. What happened? The seasonality of the epidemics has changed,” explains the SEUP secretary.

Training in the use of public services

That new epidemiological reality it contributes to the social changes related to the pandemic. “Now the population has the need Immediacy to solve problems. Pediatricians see a generational change: parents see the fever set in and go to the pediatrician, if the fever persists the next day, they go back to the pediatrician. There are processes that take your time“, claims Dr. Sánchez Álvarez, appealing for the need to “re-educate” “parents” in the use of health care.

Society demands instant answers for almost everything, including health issues. “The health system has to assume this but such instant answers cannot be given and you can’t even predict it,” he concludes.

More skilled workers are needed

the deficit endemic of primary care professionals who are unable to adequately respond to demand for care impacts hospital services. Patients suffer from delays in pediatric emergency departments in Spainnot only because of the spread of viruses, but also because of staffing and space problems in the observation units themselves, in hospital wards, as well as in intensive care beds.

The Spanish Society for Pediatric Emergencies (SEUP), a professional society integrated into the Spanish Association for Pediatrics (AEP), warned days ago by saying “worry and uncertainty due to the unexpected increase in the volume of care in pediatric emergencies throughout the Spanish territory in recent months and the delays in patient care that this has caused”.

contingency plans

Pediatricians consider it necessary to start Emergency plans that include both structural and personnel measures:

  • Create spaces where pediatric patients can be seated while waiting Having beds in hospitals or intensive care units
  • Activate pre-registration roomswhere minors can wait reasonable conditions
  • Integrate rapid tests for detection of respiratory syncytial virus (RSV), influenza and Covid (point of care) and from Lung ultrasound at the bedside to speed up the care cycle
  • Reinforcement of health workers at all levels

Emergency pediatricians are professionals with great versatility, since they can take care of patients with the most diverse reasons for speaking in a very short time. “It is important that in times of greatest nursing overload, the reinforcement is carried out with competent staff from both paediatricians and nursing staff,” explains the Scientific Society.

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