Begon Fernandez
There is no effective pharmacological cure nor will there be in the short term for the explosion of bronchiolitis which is bringing down pediatric emergencies, but the approval of vaccines for minors and pregnant women is expected in two or three years, who are not a cure in itself but a measure to prevent disease.
This was explained in an interview with EFE by the member of the Spanish Society of Pediatric Emergencies (SEUP), David Andina, who believes that preventive measures such as vaccines will confer immunity to pregnant mothers and children as well as single-administration monoclonal antibodies , which is currently reserved for children with underlying diseases with monthly administration.
Andina, who is an emergency pediatrician at a hospital in the Community of Madrid, insists that bronchiolitis cannot be treated like other respiratory infections and points out that what is done in the emergency room is “to check which children need to be hospitalized because they have difficulty respiratory problems, have difficulty eating or oxygen is very low, in which case they are hospitalized and put on a pair of nasal goggles”.
“Beyond that, we have nothing,” says this pediatrician who points out preventive measures of hand washing, surface hygiene and a mask, especially for caring parents.
Andina comments that the explosion of cases being experienced is “unusual”, bronchiolitis associated with respiratory syncytial virus (RSV) has been brought forward by a few weeks and has led to an alarming increase in hospitalizations of children in emergency rooms and nursing units intensive care (Uci) “much higher than we are used to”.
IF THIS RHYTHM CONTINUES UNTIL CHRISTMAS THE SITUATION WILL BE DRAMATIC
Andina explains that what worries paediatricians the most is that it is not known when the peak of the curve will arrive, as happened with covid, and warns that if the hospitalization rate continues as it has in recent weeks, the situation for Christmas will be in emergencies such as in intensive care it can “get dramatic”.
“It is impossible for the system to be replenished at this rate,” says this pediatrician, who recalls that some hospitals in Aragon, Catalonia and the Community of Madrid are already preparing emergency plans because it is impossible to face the situation with the usual equipment.
In these contingency plans, Andina warns that intensive care beds will need to be set up outside intensive care units and set up spaces that are not usually reserved for childcare, such as areas in emergency services adult areas .
He also believes that to deal with this explosion of cases, non-urgent surgical activity for minors will have to be suspended.
THE PANDEMIC HAS CHANGED THE EPIDEMIOLOGY OF MANY VIRUSES, INCLUDING RSV
RSV bronchiolitis is a typical disease of children under two years of age, although the most serious symptoms are found in children under three months of age and in newborns, who are the most frequently admitted to the emergency room and intensive care unit, for days and even weeks.
The pandemic has changed the epidemiology of many viruses: RSV, which circulated much less for two years, has made more children susceptible to infection, including the older ones.
It is also believed that the mothers of these children who did not come into contact with the virus during pregnancy did not have antibodies with which to protect their children at birth.
This virus is circulating equally in all temperate climate countries in Northern Hemisphere and everyone is experiencing this first outbreak and collapse situations.
Looking to the future, Andina asks the health authorities to activate emergency plans that can stop this expansion because the treatments “will not arrive in the very short term”.
And speaking of the primary care strike, this pediatrician admits it can cause many parents to seek urgent care, but remembers that mobilizing their family colleagues for decent work and more time for each patient “will do everyone good.”
He asks parents of children with bronchiolitis “patience and calm” because the emergency room with the explosion of cases requires longer waiting times.
