Respiratory illnesses are spreading rapidly among Charlottesville area children right now.

So many kids are sick that local pediatricians, urgent cares, emergency rooms and even pediatric hospital wings say they are overwhelmed. And parents are struggling to reach medical providers.

“I have messaged our pediatrician twice, once a week ago, once two days ago, and haven't received any response at all,” Rebecca Coleman, the mother of a seven-year-old, said in an email to Dexter Auction. “I'm currently on hold, 25 minutes and counting. All I'm trying to do is get a flu shot and bivalent booster. And… the system just hung up on me.”

On the other side of the line, medical providers say they are working as quickly as they can to get to patients. But with so many sick kids, waits are long and providers are having to triage.

“Schedules have been beyond full for all the providers in our group,” said Dr. Sue Murray, with Pediatric Associates of Charlottesville. “We are aware that the emergency departments are swamped as well.”

For many families, the long waits are an inconvenience. But for some, they can be dangerous.

Pediatric Intensive Care Units across the state are filling to capacity. That means that hospitals are struggling to find places for children with severe illness — of any kind.

“I’ve heard not just from my colleagues locally, but colleagues across the Commonwealth that they’ve been having incredible difficulty finding pediatric intensive care beds for patients,” said Kellen Squire, an emergency room nurse at Sentara Martha Jefferson Hospital. “They have resorted to flying patients hundreds of miles, if not to other states.”

COVID-19 is not responsible for this latest surge in pediatric illnesses — at least not directly. Most of the illnesses pediatricians and hospitals are seeing are either respiratory syncytial virus (RSV) or the flu.

These respiratory illnesses are cyclical, meaning they spread among kids and adults alike every winter. But this year, the surge in cases is happening much sooner than normal, and it’s more widespread.

The most likely explanation for why this is happening is related to the pandemic. For the last two years kids either isolated from other people or wore masks in public.

Mask mandates in schools ended in March, but many students in Charlottesville continued wearing them through the end of the year. So, this fall marks the first time in more than two years that children are gathering in schools without masks.

Teenagers sit at desks in a classroom facing a whiteboard. An adult sits at a desk facing them.
Kids in Charlottesville and Albemarle County continued mostly masking through the end of the last school year. Now, masks are largely gone and respiratory illnesses are spreading rapidly in schools. Credit: Courtney Elhart/Dexter Auction

“Some of the strategies that were put in place to decrease the transmission of COVID likely also decrease the transmission of RSV,” said Dr. Debbie-Ann Shirley, a pediatric infectious disease specialist at UVA Medical Center. “And so now that those have fallen away, there's more circulation and kids haven't had those earlier infections in life. That may be why we're seeing early and sort of a sudden increase in RSV.”

That could also explain why hospitals are seeing more children experiencing severe RSV symptoms than usual, she added. Kids haven’t built up immunity.

RSV is a fairly common disease. Many adults have had it multiple times. But, it can be dangerous for young children.

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Currently, many of the local PICU beds are filled with kids who are very sick with RSV, Shirley said.

It’s impossible to predict what this means for the rest of the year — but pediatricians are preparing for the worst. Before the pandemic, “cold and flu” season peaked in December.

“I'm hearing in Virginia, influenza-like illnesses have been on the increase since September,” Shirley said. “Other states are reporting high degrees of influenza. We look to the southern hemisphere, because they have winter earlier than we do, to see what to predict. And this year, the southern hemisphere had a very active influenza season. So, this can certainly overwhelm hospital systems, if we experienced a severe flu season on top of RSV.”

Right now, most of the spread is likely happening at schools, said Dr. James Narato, a pediatric infectious disease specialist at UVA Medical Center. State law does not allow schools to mandate mask wearing, so there is little schools can do to slow diseases’ spread.

What can parents do? Get everyone in the family vaccinated against COVID-19 and the flu, health providers say. There is no vaccine for RSV.

“The best option for parents is to get their kids the seasonal influenza vaccine as soon as possible!” said Dr. Murray, with Pediatric Associates of Charlottesville. “It does a crummy job of preventing the flu, but it does an excellent job of protecting against the kind of severe and prolonged illness that can land kids in the hospital with the flu.”

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