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Germany: RSV infection wave overloads children's hospitals

December 2, 2022

Emergency doctors in Germany say the pediatric intensive care system is close to collapse. With COVID-19 restrictions largely eased, rates of a common but potentially fatal childhood disease have soared.

A doctor put a stethoscope on a baby lying on his back during a medical checkup
Image: Matej Kastelic/Zoonar/picture alliance

German doctors are warning that a surge in pediatric infections and a shortage of staff mean the country is critically short of intensive care beds for children. 

The massive wave of respiratory illnesses has been particularly exacerbated by the human respiratory syncytial virus (RSV), a highly contagious virus that infects babies and toddlers.

Why are health workers alarmed?

The warning was raised by the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) after a survey revealed the extent of the bed shortages.

It found that, in pediatric intensive care units, there were on average only 0.75 free beds per hospital — less than one per site.

Of the 110 hospitals that were surveyed, 43 facilities also had no vacant beds available for children in their ordinary wards. 

One in two hospitals surveyed said they had to turn away a child in the past 24 hours after a request from the ambulance service or emergency department.

"This is a catastrophic situation, there is no other way to describe it," said DIVI General Secretary Florian Hoffmann. "We, therefore, demand the immediate optimization of working conditions in the children's hospitals, the establishment of telemedical networks between the pediatric facilities and the establishment of specialized children's intensive care transport systems. We have to act now."

Why is RSV a threat?

RSV (or respiratory syncytial virus) is among many viruses that cause illnesses of the nose, throat and lungs. 

This 1981 photo provided by the Centers for Disease Control and Prevention (CDC) shows an electron micrograph of Respiratory Syncytial Virus
The RSV virus has rebounded after periods of lockdown and restrictions meant it could not spread as normalImage: CDC via AP/picture alliance

It usually spreads from late autumn through to early spring. Almost all children catch RSV at least once before they are 2 years old and, for most healthy children, the symptoms are no more severe than a cold. However, some children get very sick with RSV.

Mask-wearing and physical distancing mean there were far fewer cases of RSV during lockdowns and even later, when COVID-19 restrictions remained tight. Since the relaxation, the disease has spread once again, at a time — also because of the pandemic — when children's immune systems aren't primed to fend off the disease.

"The RSV wave continues to build up and makes treatment with respiratory support necessary for many children," said Sebastian Brenner, head of the pediatric intensive care unit at University Hospital Dresden.

Health minister promises help

German Health Minister Karl Lauterbach urged support measures for the acutely overburdened sector.

He announced that the government would ease some regulations to make it easier to transfer nurses to pediatric units and provide an additional €600 million ($630 million) to pediatric hospitals over the next two years.

"The children need our full attention now," said Lauterbach, himself a trained epidemiologist, and added the news was "very worrying."

"We are confronted with a situation where Germany has fewer than 100 intensive care beds available for children."

The minister also made an appeal to adults. "If you feel cold symptoms, then please wear a mask, especially if you are in contact with children under the age of two," he said.

However, Lauterbach said that, while the RSV wave was not over, the situation was under control and would be helped by the planned measures.

rc/dj (dpa, Reuters)