Corewell East's RSV hospitalizations drop among children, rise in adults

Sarah Rahal Carol Thompson
The Detroit News

Leaders of Corewell Health East, formerly known as Beaumont Health, are reporting a decline in respiratory syncytial virus (RSV) pediatric hospitalizations while adult patients treated for RSV are up slightly.

The development came as state data showed pediatric intensive care unit occupancy in Michigan had increased to 91% through Monday, up from 89% in early November. Pediatric bed occupancy includes patients for RSV and other diseases, such as COVID-19. Adult ICU bed occupany is at 77%.

Over the last few weeks, Corewell East's Royal Oak hospital has added visitor restrictions as the spread of respiratory viruses soars across the country.

Corewell Health East leaders noted Tuesday that pediatric RSV hospitalizations have been declining since peaking the week of Oct. 31-Nov. 6, when the number of children hospitalized and in the emergency centers of Corewell Health East with RSV reached 577. The hospital system had move some pediatric patients into adult units.

The week of Nov. 7-13, the number fell to 520. For the week of Nov. 14-20, cases dropped again to 302.

The numbers bode well, said Dr. Whitney Minnock, pediatric chief of emergency at Corewell Health William Beaumont University Hospital, formerly Beaumont Hospital, Royal Oak. The declining numbers may be temporary or permanent, and may be based on the outbreak's natural progression, she said.

"I would say this year we probably have peaked based on the past week's numbers," Minnock said. "But again, we are still very busy. There's other viruses other than RSV that are circulating. We are starting to see some influenza spread. I think we all still kind of have to keep our guard a little bit."

A Michigan Health and Hospital Association spokeswoman similarly urged caution.

"It’s important to note that even where hospitalizations have receded, many of our members continue to face severe space and staffing challenges," MHA spokeswoman Lucy Ciaramitaro said in a Tuesday email. "By taking the steps necessary to slow the slow the spread of respiratory illness, Michiganders are supporting our hospitals and health systems who either currently have limited bed availability or are at risk of being overwhelmed by cases of RSV, adenovirus, flu and even COVID in the coming weeks and months."

Minnock advised families to remain home if any of them are feeling ill since Michigan is continuing to experence a significant number of RSV cases and hospitalizations. In addition, people should be washing their hands often; getting vaccinated for COVID-19 and the flu; having a supply of COVID-19 tests and masks at home; and finding out eligibility for treatment options if they become sick, said Lynn Sutfin, spokeswoman for the Michigan Department of Health and Human Services.

Among those hospitalized with RSV in October at Corewell Health Beaumont Troy Hospital was the infant son of Melissa Parker, a pediatric nurse and mother of three. He was about three weeks old.

“It happened very quickly,” said Parker, whose oldest child, age 3, likely brought the virus home from preschool to 6-month-old Owen and his 20-month-old brother. RSV is especially rampant in preschools and daycares, according to the hospital's press release.

“We noticed Owen became lethargic and wasn’t eating. When his upper lip started turning blue, we took him to the emergency room right away,” Parker said in a statement provided by Corewell East. “And thank goodness we did. Infants and young children have no reserve and can decline rapidly.”

RSV symptoms peak between days three and five, Parker said during a Tuesday Zoom presentation. Waiting for Owen to reach that peak and for his symptoms to improve was "nerve wracking," she said.

Because of the seriousness of his case, Owen was outfitted with a high-flow nasal canula and a nasal-prong ventilator, both which provided oxygen, and a feeding tube. He experienced a lingering cough, something that is typical. But since returning home Oct. 31 from the hospital, his condition has stabilized and he continues to gain weight and grow stronger, the hospital said.

"You need to be very diligent about monitoring symptoms at home," Parker warned parents. "With babies, they tend to have no respiratory reserve. So once they start to decline and need help with their breathing, it tends to go relatively quickly."

While the trajectory of pediatric cases is promising, the number of adult RSV patients at Corewell East is up slightly from the prior week. From mid-September to the end of September, 11 adult patients were treated, compared with the weeks of Nov. 7 and Nov. 14, when those numbers grew to 84 and 90 adult patients, according to Corewell East.

“It’s still too early to know if we are over the hump,” Minnock said. “Post-Thanksgiving numbers will provide more information. But we are moving in the right direction. With other states already experiencing a surge in influenza, we are expecting flu to become a concern in Michigan as well.”

For subscribers: How pandemic isolation fueled RSV surge among young children in Michigan

(From left) Fourteen-month-old son Elijah Jackson is comforted by his mother Aleah while fifteen-month-old Scarlet is comforted by her mother Kali, inside the pediatric unit at Corewell Health Beaumont Hospital Troy, November 16, 2022. Both children were admitted to the hospital after being diagnosed with RSV.

Minnock is urging families to balance caution while doing normal activities. People gathering with elderly and immunocompromised people should be especially careful, she said.

“If we head into the holidays and everybody is scared, that is not good for mental health,” said Minnock, who also has four children. “I plan on being with my family this Thanksgiving. But some important precautions will be part of our celebration. Older adults and those with compromised immune systems are at increased risk for complications from RSV and flu.”

Specifically, Dr. Minnock recommends the following Thanksgiving holiday safety precautions:

  • If you are experiencing cold or flu-like symptoms including fever, runny nose and cough, refrain from attending in-person gatherings. RSV can linger for up to a month, but the highest viral load continues up until 24 hours after the fever has broken. For best results, limit one-on-one contact with others during this time. 
  • Wash your hands. Proper hand hygiene is essential to stopping the spread of disease.
  • Don’t kiss or touch the face of infants or small children.
  • Get the flu vaccine.

What to look out for:

Parents should seek immediate medical attention if their child has difficulty breathing, a high fever, or a blue color to the skin, particularly on the lips and in the nail beds, said Dr. Matthew Denenberg, chief of pediatrics for Corewell Health East and chair of the Michigan Hospital Association’s Council on Children’s Health. Additional signs and symptoms of severe RSV infection in infants include:

  • Short, shallow and rapid breathing.
  • Struggling to breathe — chest muscles and skin pull inward with each breath.
  • Cough.
  • Poor feeding.
  • Unusual tiredness (lethargy).
  • Irritability.

srahal@detroitnews.com

Twitter: @SarahRahal_