RS virus wave sweeps children’s hospitals – transmissions across the country

Thirty beds are occupied and there are babies and children under the age of five who all have difficulty breathing: this is what the children’s hospital in Zurich currently looks like. Christoph Berger, Head of Infectious Diseases at Kispi, says:

The respiratory syncytial virus, RSV for short, is a common cause of serious illness, especially in babies: because the blood vessels in their lungs are still narrow, shortness of breath occurs more quickly and they often have to be artificially fed. The virus can cause bronchitis in young children, while it is usually harmless in adults.

In Geneva’s teaching hospital, the HUG, an increase in severe RSV cases with bronchitis was even found, without any explanation. Christoph Berger, on the other hand, finds it difficult to say whether this is generally the case. He assumes that cases of the disease will soon return to normal.

Berger already warned in the winter of 2021 that the situation in children’s hospitals would not remain so calm because as soon as the corona measures were lifted, two-year-old children would come into contact with viruses for the first time. Already in the summer of 2021, many small children were hospitalized, but now the situation is even more precarious, all over Switzerland.

“Such RS waves have been difficult to handle in the past,” says Berger. These extremes are now affecting hospitals, which are experiencing more staff shortages than before the pandemic. Only in the canton hospital in Baden and in the children’s hospital in eastern Switzerland has so far been said that there is no staff shortage. Children from other places could be admitted regularly. There are expected to be 23,600 children’s emergency rooms in Baden this year – up from just 15,000 in 2019.

The only thing is that the children’s ward in Baden is now fully occupied. Moreover, there is no intensive care unit for children there, but what to do with the transfers? At the university hospital in Basel, beds are in the corridor, which is why even western Switzerland is being considered. Bottlenecks in the children’s ward of the Canton Hospital Lucerne became known in October due to too many absenteeism and overworked staff. In the children’s clinic at the Inselspital in Bern, operations have to be postponed, even for urgent operations, spokesman Didier Plaschy reports. “It is difficult for the affected families. But many show understanding.”

The hospitals always worked together regionally in case of bottlenecks, but now sick children are transferred all over Switzerland. Berger says, “Basically, each region needs to see for itself that it can take care of its patients.” But the Kispi in particular is currently very dependent on free beds elsewhere, and the contact lists of all children’s hospitals are now hanging in the office. Last week more than one child was flown to intensive care in Chur and there were even transfers to Friborg and Biel.

“It’s like a Tetris game,” says the Kispi staff. Little help can be expected from the city hospital: in the middle of the pandemic, the number of beds in Triemli was reduced from 18 to 8 a year ago because demand had fallen, as it was said at the time. According to the communications department, it is now due to a lack of skilled workers.

And the Children’s Hospital of Zurich, as a highly specialized center, is not always able to transfer its patients: it is here that the most complicated cases are found, including children with heart defects. Yet the shortage of staff here is particularly high – and partly self-made. Bettina Kuster, Director of Nursing, recently told the “Tages-Anzeiger”: “We have to be self-critical. We relied too heavily on child benefits and this year the competition has become much fiercer.” Other hospitals have raised wages to attract staff or are offering more vacation days.

As a result, many people had wanted to work in the renowned children’s hospital for a long time and that had an impact on wages. That’s over now. The staff shortage also has an impact on calamities: because the children cannot always be transferred to the ward, the staff there are also overworked.

The parents of sick children also bear a greater burden, not only when waiting, but especially when the child has to be transferred to a hospital far away. “In addition, parents with crying children crawl under the wheels,” notes a pediatrician. In the past, a crying child could sometimes be taken care of, in extreme cases to relieve the parents for a night and to defuse a situation. Even children with non-specific abdominal pain often cannot be held overnight.

This week, however, the Kispi managed to expand the department by ten beds – also with temporary workers.

Christoph Berger appeals to the parents of hospitalized children for their understanding: “We are very grateful for your help and patience. If a lot has to be postponed and reorganised, it is more difficult for everyone.” Some babies with RS viruses can leave the hospital after three days, for others it takes up to ten days. Only a few have to be artificially ventilated in intensive care.

But once the RSV wave abates, the problems in Switzerland’s children’s hospitals will not be solved. “The challenges of paediatrics and adolescent medicine in the Swiss health system are mostly structural,” says Didier Plaschy of the Inselspital. In Switzerland, cost-effective medical care is not possible in this age group. A socio-political consensus is urgently needed that the services provided are properly remunerated. (cpf)