Lakes DHB to open more children’s beds with oxygen and increase staff as RSV explodes

Rotorua and Taupō hospitals are planning to open more children’s beds with oxygen and suction support and increase staff as RSV cases explode.

Since the first case of respiratory syncytial virus (RSV) was diagnosed on June 11, between five and seven children are admitted every day to the Lakes District Health Board area hospitals, a spokeswoman said.

More than 90 per cent of under-2s brought into ED had respiratory concerns, she said.

As of Tuesday, 59 children had been admitted this year with a few briefly being admitted to ICU.

Two years ago, a total of 141 children under 9 years old were admitted for the year.

Last week, the health board had been between 20 and 30 likely RSV presentations to the emergency department daily.

As a result, it announced it was restricting visitors to its children’s, special care baby, and intensive care units last week.

It came after 48 children visited the Rotorua Hospital emergency department with respiratory illnesses on Monday. On average, 120 patients visit the department each day.

Of the 17 children in the Children’s Unit today, 16 children have RSV.

There are plans to open more beds to a maximum of 24 at both hospitals with oxygen and suction services as well as increase the staff roster to match the demand.

The health board spokeswoman said staffing was a challenge as it was school holidays which impacted the availability of the nursing workforce.

“If children did not need to be in Rotorua or Taupō Hospitals please don’t bring them.

“We do not want well children coming into hospital as they are then at risk of picking up an infection and taking it back home.”

In the Children’s Unit, SCBU, and ED, both parents or consistent primary caregivers of a child stay during the day with only one allowed overnight.

No other visitors, including siblings, were allowed in order to manage the infection.

In the Bay of Plenty, an adult with underlying medical conditions has died, 16 patients have been admitted to ICU and hundreds admitted to Tauranga Hospital.

Bay of Plenty District Health Board cases have exploded with 270 cases. It is more than double the 107 cases in the same time period in 2019, and more than the total 216 for the 2019 year.

Children across the country are being admitted to intensive care with some hospitals around the country postponing elective surgeries because of the outbreak. Earlier this week the Herald reported a 63-year-old north Auckland woman died after contracting the virus.

A Bay mother's experience

A Pāpāmoa mum has spoken of the rough days that saw her 22-month-old end up in hospital relying on a feeding tube and intermittent oxygen to see her through.

The woman, who has chosen to remain anonymous, said the virus took control of their daughter “pretty fast”.

The baby was fine on Friday, a little off on Saturday morning, and “not herself at all” on Sunday.

Snotty, coughing and lethargic, the baby who normally took a nap about midday had fallen asleep on her father at 9.30am.

She vomited at least four times from coughing. Unable to eat, the pair made sure to keep her fluid intake up.

“We put her to bed on Sunday night and she spewed all through her bed from coughing again. We called Healthline who said we had done all the right things.”

Her temperature was okay, the bed was elevated and the humidifier on and because her breathing was fine, Healthline suggested keeping an eye on her.

“On Monday morning she was like a shell of herself.”

The mother booked her in at the doctor who sent them straight to the hospital.

The mother said her little girl was a tough cookie and had been discharged by Tuesday night.

“We had to have a feeding tube put in which was horrible and oxygen on and off during the night.”

However, while on the children’s ward, the Pāpāmoa parent wasn’t alone. She said the ward was busy with children all struggling against the virus.

What RSV can teach us about other outbreaks

Malaghan Institute of Medical Research director and immunologist Professor Graham Le Gros said the rise in cases across the country gave a clear-eyed insight of what a Covid-19 outbreak would look like.

“[It] is an important ‘wake up call’ of how vulnerable health systems are to serious infectious diseases that get into communities of susceptible people.”

In contrast to other winter illnesses that affect the head and sinuses, Le Gros said RSV gets into the chest and lungs, causing pneumonia-like symptoms in children and the elderly.

“It’s an illness that affects your lungs and reduces your breathing capacity and you could be coughing for five weeks afterwards,” he said.

“It will get into an old person’s home and go through everyone. People used to think it was influenza but it was probably RSV.”

He said the severity of this year’s outbreak was likely due to weakened immunity due to lockdowns, prior to an opening up of the transtasman bubble with Australia.

“We don’t understand the full significance of why RSV is coming across as worse – is it a worse variant, or is it just because we missed a year due to extreme lockdown of boosting up our immunity by being exposed to the RSV going around?”

Meanwhile, senior lecturer at the University of Auckland nursing school Natalie Anderson said the outbreak was taking a toll on health staff.

“Caring for children and babies with breathing problems due to RSV is challenging, requiring both isolation precautions and close monitoring. Even where sick infants do not need hospitalisation, exhausted and anxious parents need guidance, reassurance, and support.”

Lakes District Health Board paediatrician Dr Steve Bradley described RSV as a “really nasty and highly contagious” virus that affected but was not isolated to children.

“While it causes a fairly mild cold and maybe a mild chest infection in adults, young children and particularly babies can get really sick with it as it causes narrowing of the breathing tubes, which are already tiny in small babies.”

Children could present with what starts as a cold and a runny nose but it would soon spread to the lungs, causing wheezing and difficulty breathing.

Health advice

If your child does not currently have symptoms then there is

• No medical advice needed if child doesn’t currently have symptoms.
• Make sure you keep your children, especially if they are aged under 2, away from those with symptoms and do not bring them up to hospital to visit relatives.
• If your child develops a cough or cold symptoms but is behaving, feeding and drinking normally, keep them at home and away from other kids or relatives.
• If your child develops a cough or cold symptoms but is not working hard to breathe or has wheezy breathing, keep them at home and away from other kids or relatives.
• If your baby is under 3 months, watch them carefully for any brief pauses in breathing. Take them to ED.
• If your child appears unwell, is not feeding or drinking as usual, and has noisy or difficult breathing then seek medical attention.

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