Primary Children’s Hospital delays surgeries amid ‘unprecedented’ RSV surge

About 10% of non-emergent, pre-scheduled procedures at the hospital were delayed this week.

(Rick Egan | The Salt Lake Tribune) Intermountain Primary Children's Hospital, on Wednesday, Aug. 11, 2021. About 10% of non-emergent, pre-scheduled procedures were delayed at the Utah children's hospital this week as the hospital deals with an "unprecedented" surge in RSV cases.

Primary Children’s Hospital announced Monday that it is delaying some pre-scheduled surgeries and inpatient procedures as cases of the respiratory illness RSV surge among local children.

About 50 such procedures have been delayed at the Intermountain children’s hospital this week, amounting to about 10% of previously scheduled procedures, hospital spokesperson Jennifer Toomer-Cook said Monday afternoon.

These delayed procedures are non-emergent, but would have required a young patient to recover in a bed for more than a day, such as with certain extensive orthopedic procedures or complex abdominal procedures, for example, Dr. Andrew Pavia, a pediatric infectious diseases expert with University of Utah Health and Primary Children’s, said.

“We are not going to delay any surgery that is going to endanger any child,” Pavia said, “but we know it will cause some inconvenience, and maybe some expense.”

An ‘unprecedented’ surge

The goal of the move announced Monday is to free up beds for incoming sick patients. That’s why pre-scheduled procedures that don’t require an overnight stay in a hospital bed are not being delayed at this time, Pavia said.

“We don’t take this action lightly,” Pavia said in a Monday news conference. “We have many measures that we put in place to deal with a surge, and we deal with surges every year.”

Those measures have included putting two hospitalized children in rooms meant for one patient, as well as converting other clinical spaces into inpatient rooms, Pavia said. But he called this year’s RSV surge “unprecedented.”

“In spite of all that, we are absolutely chock-full,” he said Monday of the hospital. “Everyday, it’s a question of finding ways to get some children home so we can admit others.”

As of Monday, the bulk of Primary Children’s patients were hospitalized with RSV, or “respiratory syncytial” virus, Pavia said. RSV is a common respiratory virus and typically causes mild cold-like symptoms, according to the Centers for Disease Control and Prevention.

But in children younger than 1, RSV is the most common cause of pneumonia as well as bronchiolitis, or inflammation of the small airways.

This surge in local RSV cases is accompanied by a substantial recent increase in influenza cases among children, along with an increase in COVID-19 cases, Pavia said. Some children currently hospitalized are sick with more than one virus.

An ongoing staff shortage is exacerbating the issue, he said, noting that hospital staff, like staff at other facilities, have been operating at “full speed” for the better part of three years. “People are tired and people have left,” he said.

“We’ve taken this action really as a way to provide the best and safest care to the kids who need it,” Pavia said. “Unfortunately, it does provide inconvenience for some families who are having scheduled surgeries canceled.”

What warning signs should parents look out for?

Children most at risk for serious complications of RSV often cannot communicate that they are having trouble breathing.

Pavia advised concerned parents to watch an infant’s chest to check that the skin between and under a baby’s ribs is moving. Infants that do not latch onto a breast or bottle for long, which can make them dehydrated, also may have difficulty breathing.

Any of these warning signs are reasons to call your child’s doctor, Pavia said.

RSV can present like a common cold in some children under 2. But the congestion an infection may cause could also lead to wheezing and other signs of breathing difficulty and should be assessed, Pavia said.

It’s unclear why the recent RSV surge is hitting children so badly right now. Pavia surmised that many community mitigation measures that were in place in 2020 and 2021, including social distancing and masking, may have helped children avoid such viruses.

Now, he advised that parents of infants keep their children home and not let sick loved ones visit. Even mild symptoms in an adult, like a scratchy throat, can present in much more serious ways in young children if a virus is transmitted.

In the meantime, he advised that people get their flu shots, as influenza is hitting adults hard locally as well. And he recommended that people get up to date on their COVID-19 vaccines, including getting the recent bivalent booster.

“Having had a child who’s had multiple surgeries at Primary Children’s, I know how difficult this is going to be for some of our families,” Pavia said of the announced procedure delays Monday. “We wouldn’t do it if we had any other choice.”