Renewed prevention steps in order as RSV patients fill beds

For the first time in months, a “masks required” proviso accompanied an event announcement.

Call it hasty or overly-cautious, or call it a sign of the times.

It’s different, of course, thfroman the state-mandated mask requirements of 2020-21, which, while reviled in some quarters, were necessary steps for public safety, and a step beyond the “masks encouraged” or “optional” signs that stand as reminders that the pandemic is not behind us. And it could be we return to a mandate, or at least the widespread practice of wearing masks in public.

That may very well be a good idea, considering the spike reportedly just down the pike.

“Now that we’re beyond COVID” is a common refrain, yet one we might want to, well, refrain from using.

Meanwhile, a better common refrain is: “How are you feeling this morning?”

For parents, this may be the most important question they can ask their kids this season.

Health concerns are rising in general consciousness, or they should, as multiple threats increase from flu, respiratory syncytial virus (RSV), and, of course, COVID.

As reported in our Nov. 29 edition, “As a crisis in pediatric hospital beds worsens, Oregon health officials are asking people to wear masks, keep their children home when sick, and stay home themselves when sick.”

Health officials across the Pacific Northwest are warning people to be especially cautious this holiday season in the face of COVID-19, the flu and RSV.

An increase in severe respiratory infections this season is putting pressure on Oregon’s already-strained hospitals as the holidays approach. But health officials say people can take simple steps to avoid exposure — and the need for an emergency department visit — as they gather for celebrations.

After RSV hospitalizations of children younger than 5 tripled in early November, Governor Kate Brown declared a public health emergency directive to provide support and flexibility to hospitals to staff beds for children.

RSV is a common respiratory virus, usually seasonal and mild, but it can pose particular risk to infants and toddlers younger than 2, children with underlying diseases, and older adults. It spreads through droplets from coughing and sneezing, and from touching contaminated surfaces.

“We want people to remember the holidays as a festive time of family, friends, food and fun events, not because of a severe case of RSV or other respiratory virus,” said Dr. Dana Hargunani, a pediatrician and Oregon Health Authority’s chief medical officer. “Common-sense vigilance this season can help keep you and your loved ones safe and out of the hospital.”

According to OHA data as of Wednesday, the RSV hospitalization rate for children nearly quadrupled between Oct. 29 and Nov. 5, from 2.2 to 8.7 per 100,000 population. The rate dropped slightly by Nov. 12, to 5.7 per 100,000, but that was still double what it was two weeks earlier.

OHA offers the following tips for staying healthy and avoiding an unnecessary hospital visit during the holidays:

1. Get a flu shot and stay up to date on COVID-19 vaccinations, including new bivalent boosters.

2. There is no vaccine or treatment for RSV, but people can protect themselves by covering coughs and sneezes, cleaning high-touch surfaces, and regularly washing their hands with soap and water or using hand sanitizer.

3. Consider wearing a mask during indoor holiday gatherings and events. Anyone at risk for getting severely ill from RSV — young children and older adults — should consider wearing a mask when indoors with people who are not in their household.

4. Because children younger than 2 are too young to safely wear a mask, parents and caregivers should consider asking those around them to wear a mask.

Other facts to consider: Oregon has been sending some children to Idaho, for lack of beds in this state. OHSU has run out of beds, and is implementing crisis standards of care. The situation at all hospitals is worsened by lack of staff, with most facilities in the middle of a staffing crisis, resulting in more patients assigned per nurse — never a good prescription.

It goes beyond kids at severe RSV risk. What happens when all the beds are full? What about the needs of children treated for cancer, or when there’s a crash that leaves children badly injured?

It should be stressed that people experiencing mild symptoms of RSV should stay home from work or school, and avoid holiday gatherings and events, and rehydrate.

“Over the holidays, it is especially important that we maintain the vigilance that served us so well during the COVID-19 pandemic,” Hargunani said. “Get vaccinated, avoid large gatherings and wear a mask in crowded indoor places. Doing so will help us all have a happy and positively memorable holiday season.”

Mask wearing should be at the very least be something the public considers again as we work as a community to stay well and help others do the same. Get used to seeing more and more people masking up.

Brown’s RSV emergency announcement felt buried in the last rush before the election season. No one votes for getting sick nor experiencing spread of disease, but you could say of complicated pandemic that, rather than being “over,” is now in mid-terms.