Winnipeg children’s emergency department ‘in crisis’ amid spike in respiratory virus cases: medical director

The emergency department at the Winnipeg Children's Hospital is in crisis as it struggles to keep up with a spike in respiratory virus cases, the department's medical director says.

On Tuesday, 178 children showed up at the hospital's emergency department for care — about a 45 per cent increase from the number of kids expected this time of year before the COVID-19 pandemic, Dr. Elisabete Doyle said.

"The children's hospital emergency department right now is actually in crisis," Doyle said outside the Health Sciences Centre Winnipeg's Children's Hospital on Wednesday.

"We're seeing more volume and more acuity than we've seen even pre-pandemic, in large, large volumes. It's unprecedented."

The surge in cases of respiratory viruses in Manitoba over the last few weeks is linked to both how many respiratory viruses are circulating in the community and eased pandemic rules that have allowed those illnesses to re-emerge, Doyle said.

Some kids showing up to the emergency department are also what Doyle called relatively "immune naive" — meaning they haven't been exposed to the respiratory viruses before, so when they do, they get sick.

Care teams have also been seeing kids test positive for more than one respiratory virus at the same time, Shared Health, which oversees health-care delivery in Manitoba, said last week.

'Cocktail' of conditions could be causing strain

Virologist Julie Lajoie said she wasn't surprised to hear how much Winnipeg's children's hospital is struggling, especially as cases of illnesses like RSV — or respiratory syncytial virus — surge among kids across Canada.

Lajoie said the current uptick in cases of RSV is happening earlier in the season than usual. But while the total number of cases is still lower than what Manitoba saw this time last year, the surge in emergency department visits is new, she said.

As for what caused that change, Lajoie said the culprit could be any one of a number of factors — including that with more types of viruses circulating this year, kids are more likely to have multiple infections at the same time, which strains their immune systems.

Many kids also got COVID-19 for the first time in the spring and wintertime, Lajoie said, suggesting those infections could have left their immune systems more vulnerable to other viruses.

And shortages of some children's pain relievers may be leaving some parents with fewer options to stave off an emergency hospital visit, she said.

"So those are possibilities coming all together," said Lajoie, a research associate at the University of Manitoba.

"It's all hypothesis — we don't really know, but it's a cocktail altogether that is not really good right now."

Doyle said the respiratory virus season in Australia, which typically offers an indication of what's to come in Canada, suggests the situation in Manitoba will likely get worse.

Lajoie echoed that sentiment, predicting influenza cases in the province will pick up by early or mid-December — and calling for measures that will reduce that risk now.

"If we don't have a means to decrease risk for infection right now to prevent a little bit [of] that rush of influenza, we are in big trouble both in adult and children['s] hospital," she said.

Bring back mask mandates: virologist

Lajoie said those measures should include more of an emphasis on improving air quality in classrooms — and bringing back mask mandates for spaces like schools and grocery stores.

"Everything that you get in a really crowded space without good ventilation, you should bring back mask[s]," she said.

"Everything that is essential: going to the grocery, going to the drugstore … that should all have a mask mandate right now."

Manitoba lifted its remaining public health orders, including mask rules, in mid-March.

Despite the children's hospital being so crowded, Doyle urged parents to continue bringing their kids to the emergency department for certain symptoms.

Those include if they're very sleepy and difficult to rouse, if they're having a hard time breathing or pauses in breathing and if they're not peeing at least three times in 24 hours, she said.

For most other symptoms, parents can likely avoid the busy emergency departments and instead head to their family doctor or pediatrician, to urgent care or to a connected care walk-in clinic, Doyle said.

She also asked parents to do what they can to help keep respiratory viruses from spreading even more in children.

Those steps include washing their hands properly, covering their mouth and nose when they sneeze or cough, keeping their kids out of daycare or school when they're sick, vaccinating them against illnesses they can be immunized against and bringing them to the right place for care.

"We have a shared responsibility, I think, in looking after our children," Doyle said.

Winnipeg Children's Hospital dealing with spike in respiratory virus cases

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On Tuesday, 178 children showed up at the hospital's emergency department for care — about a 45 per cent increase from the number of kids expected this time of year before the COVID-19 pandemic.