Editor’s Note: Susannah Hills is a pediatric airway surgeon at New York-Presbyterian Hospital and Columbia University Medical Center. She also serves as assistant professor of otolaryngology-head and neck surgery at the Columbia University College of Physicians and Surgeons. The views expressed in this commentary are her own. View more opinion on CNN.
I was in the pediatric ER when I was on call a couple of weeks ago, treating a child with respiratory distress, when I looked up at the census board and saw “RSV+COVID.” This was the first time I’d seen this combination of Covid-19 and respiratory syncytial virus – one of the most prevalent pathogens that can damage the airway and lungs in young children. It was concerning.
As a pediatric airway specialist, I always dread RSV season, which typically begins in the fall and early winter. While RSV usually causes cold and flu-like symptoms, it also causes approximately 58,000 hospitalizations and 100 to 500 deaths in the US each year among children under the age of five. This year, RSV is peaking early, and data from the US Centers for Disease Control and Prevention has been showing a rise in cases across the country since June.
This RSV peak is hitting amid surges of Covid among children across the country, and hospitals are beginning to see patients with both infections at once. Just two weeks ago, there were nearly 30 cases of simultaneous RSV and Covid reported at Texas Children’s Hospital.
We are still trying to understand how this combination will affect children, and whether they are more likely to be hospitalized or put on a ventilator. Regardless, both RSV and Covid can be dangerous and are causing overwhelming numbers of children to end up in the hospital. And while political leaders in states hardest hit by these viruses should be using all of the tools available to them to protect our children, some are actively fighting and banning the protective measures we have in order to score political points at the expense of our children’s health.
Just over a week ago in Texas, more than 230 children were hospitalized with Covid, the highest number since this pandemic started. That figure will continue to rise as Texas averages 35 new hospitalizations of children with Covid every day. And according to the Texas Tribune, only 33% of eligible children 12 to 15 are fully vaccinated against Covid-19.
At the same time, RSV cases have been surging across Texas since June. Texas Children’s Hospital has diagnosed more than 1,600 cases of RSV in the past three months compared to fewer than 30 cases a month during a typical summer, according to Texas Monthly. On August 19, 93% of pediatric beds in the Dallas-Fort Worth Hospital system were full, W. Stephen Love, president and CEO of the Dallas-Fort Worth Hospital Council, said in a statement.
To make matters worse, schools are now reopening and the Texas health care system is stretched to its limits. In the face of this crisis of pediatric infections, Texas is also battling another crisis – a crisis of failed leadership. Gov. Greg Abbott continues to fight against the public health measures that would protect children in his state, doubling down on contentious legal battles to enforce his executive order banning protective mask mandates. A Dallas County court ruled against Abbott’s mandate ban last week, and he responded by digging in his heels and reissuing his executive order banning government entities from requiring vaccines that could slow the spread of the virus.
Florida is also facing a crisis of failed leadership that has contributed to the state being the #1 spot for Covid-19 infections in the country. Despite the fact that Florida has had more cases and hospitalizations than any other state last week, Gov. Ron DeSantis has been actively fighting public health measures that could provide relief. Data from two weeks ago showed a record high number of daily Covid deaths in the state. Like Abbott, he has banned vaccine passports. And like Abbott, he has been fighting to maintain his executive order against mask mandates, going so far as to threaten the salaries of the superintendent and school board members. Further, when a circuit court judge ruled against the governor’s ban on mask mandates in schools last week, DeSantis pledged to appeal the case and continue to fight against one of the most critical protective measures available to schools.
DeSantis has also been spreading misinformation throughout the pandemic, frequently making unsubstantiated and inaccurate claims about Covid-19. Earlier this month, he continued to downplay the impact of Covid-19 on children, saying at an August 11 news conference, “Covid, I view, is a very minor risk … RSV is more serious … that’s a much more significant risk than Covid has proven to be.”
Tell that to the parents of the 5,887 children hospitalized in Florida with Covid this month.
Both of these viruses are bringing children into the hospital, putting them on ventilators, and causing mortalities. At this point, it doesn’t make sense to compare them or debate which is worse – political leaders should be using all of the tools available to them for prevention.
Politicians like Abbott and DeSantis don’t know what they are talking about – not when it comes to public health or treatment of infectious disease in children. And when a child is sick with RSV or Covid, or both, no one is going to call them for help.
As a pediatric airway surgeon, I have seen many young children with RSV struggle to breathe. When medications, oxygen and respirator masks aren’t enough to relieve the heaving and gasping for air, I have to insert a breathing tube or perform surgery to open the airway.
I have also seen the full spectrum of Covid-19 in my own pediatric patients. I have seen infected children with mild or no symptoms in my office, and I have seen children with lingering symptoms months after contracting Covid-19. I have also treated – and lost – pediatric patients with this illness in the intensive care unit.
Children could be at higher risk for infection with both Covid and RSV as they return to school this year. While we wait for Covid-19 vaccines to be approved for kids younger than 12, political leaders must allow our school systems access to the essential protection of mask mandates. They must also facilitate strategies to help vaccinate every eligible person – instead of obstructing these efforts.
In the meantime, where elected officials fail to protect the health of our children, doctors, nurses and health care providers will stand, and we will care for you and your family. We just need misguided politicians like DeSantis and Abbott to get out of our way.