Respiratory viruses: pediatrics and emergency rooms in haywire

Unfortunately, let’s go back to talking about hospitals under pressure due to co-circulation of respiratory viruses: SARS-CoV-2, flu viruses And respiratory syncytial virus (Vrs), especially among the children, for which Vrs is more dangerous. The increase in emergency room visits linked to the simultaneous spread of viruses that cause respiratory diseases was in fact a hot topic this winter, but at the moment it is particularly the pediatric departments. A press release reports it Italian Society of Pediatrics (Sip)which also denounces the undersizing of pediatric intensive care units“few and poorly distributed throughout the territory”, as stated in the press release itself, thus asking for government intervention in the matter.

From north to south, many Italian regions are in trouble

The director of the Maternal and Child Department of theChildren’s Hospital of PalermoGiovanni Corsello, even reports a 300% increase in emergency room visits for respiratory viruses compared to the previous two years, with the vast majority of beds occupied by children with bronchiolitis caused by RSV. “Two conditions are making assistance particularly burdensome – Corsello explains – on the one hand the age of children with Vrs bronchiolitis, especially newborns and infantsand on the other hand, the cases of ‘coinpacks‘ caused by multiple pathogens that simultaneously affect the same organism”. Even Lazio, Tuscany and Lombardy are not free from difficulties: only two vacancies in the pediatric intensive care unit Umberto I Polyclinic of Romeas stated by the head of the Emergency Pediatrics department Fabio Midulla, and a significant increase in accesses to the emergency room also to theSan Paolo hospital in Milan. “The situation is difficult, but the system holds – partly reassures Giuseppe Banderali, vice president of Sip and director of the Neonatology and Pediatrics department of the hospital – albeit with great effort”. Here too, pediatric beds are largely occupied by children with respiratory infections. “Fortunately – says Rino Agostiniani, SIP Treasurer and director Pediatrics and Neonatology Area of ​​the Asl Toscana Centro – the Christmas holidays, with the closure of nursery schools and kindergartens, have given us a little respite, but now we expect a lift. We currently have 53 beds occupied out of 60 and 9 children treated with high-flow oxygen therapy due to bronchiolitis from Vrs, but the intensive care units have a much better situation than about ten days ago”.

The weak link: pediatric intensive care units

Sip especially complains about theabsence of a ministerial code that accurately identifies the Pediatric Intensive Care (TIP), as happens instead for the other welfare disciplines in Italy. The Tips would also be too much few and poorly distributed on the national territory. “Assist children in dedicated intensive care units – explains Annamaria Staiano, president of Sip – it means improving the prognosis compared to those who are admitted to intensive care for adults. This is all the more true the smaller and more serious the child is. The Tips are in fact calibrated on children and have ahigh specificity not only of the devices, but also of the skills of the staff. We ask the Government – concludes – not just their strengthening, with a increase in beds and personnelbut also a commitment to work together with Scientific Societies for one reform aimed at networking all the offer points, so as to guarantee homogeneous assistance to all children in every area of ​​the country. It is also urgent that a ministerial code of discipline at Tip, an essential step to have a precise picture of the current situation”.