'Tridemic' threatening to overwhelm healthcare systems – PBS NewsHour

November 25, 2022
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A so-called “tridemic” is threatening healthcare systems across the country. It’s essentially a triple threat from the spread of flu, RSV and COVID. More than three-quarters of pediatric hospital beds nationwide are occupied, seniors are hospitalized at a higher rate for respiratory illness and flu hospitalizations are at a decade-level high. Dr. Megan Ranney joined Judy Woodruff to discuss.
Judy Woodruff:
A so-called tridemic is threatening to overwhelm health care systems across the country. It’s essentially a triple threat from the combined spread of flu, RSV and COVID, and it’s already having a major impact.
More than three-quarters of pediatric hospital beds nationwide are at capacity. And some states are reporting that more than 90 percent of pediatric beds are occupied. Seniors are also being hospitalized at a higher rate for respiratory illness. And hospitalizations from the flu are at a decade-level high.
Dr. Megan Ranney is a practicing emergency room physician. She’s also academic dean at the Brown University School of Public Health. And she joins me now.
Dr. Ranney, welcome back to the “NewsHour.”
Tell us about the caseload at the hospital where you are and hospitals across the country.
Dr. Megan Ranney, Emergency Physician, Brown University:
Here in Rhode Island, like across the Northeast, Judy, it is — a we are seeing a dramatic rise in the number of patients with respiratory viruses.
Our pediatric hospital is excusing caseloads that are 125 percent of anything we have ever seen, even in the midst of the COVID pandemic, and we are seeing rising numbers of adults with respiratory illnesses as well. Unfortunately, this is on top of an already full hospital, consistent understaffing.
We have lost nurses, doctors, techs, housekeepers over the course of the pandemic. And it really feels like we are just pouring buckets of water into an already overflowing Tuberville. There is simply no space to take care of these very sick patients right now.
Judy Woodruff:
So, we heard the pleas reported a few minutes ago from Dr. Fauci and from Dr. Jha.
What does it — happened to lead to this, in your view?
Dr. Megan Ranney:
You know, we have had decades of underfunding and underpreparedness of the emergency system in this country.
We called it out over and over again during COVID, whether it was calling for PPE or calling for staffing during Omicron. These are not new problems. Unfortunately, they have worsened, because we have lost staff, because we have seen hospitals, and particularly pediatric beds, close over the course of a pandemic.
And now we have all these folks that are coming and seeking care, and there’s not as many people left to care for them. Add that on to a stronger-than-usual season of respiratory viruses that started earlier than usual, and we just have a perfect storm of overwhelm for emergency departments across the country right now.
Judy Woodruff:
Well, let me ask you about children first.
We are seeing, as you said, as we reported, pediatric beds filled up around the country. What should parents be on the lookout for? We know there’s some overlapping symptoms when we talk about RSV, flu, COVID. What should parents be looking for?
Dr. Megan Ranney:
I’m a parent myself and had two kids home sick from school last week, so I feel your pain. It feels like my kids are back in day care all over again, even though they’re middle schoolers.
For parents, particularly parents of little ones, you want to be watching out for them not eating or drinking, not making wet diapers, not making tears when they cry, breathing much more quickly than usual, their fever not coming down, despite ibuprofen or Tylenol.
And, at the end of the day, if you’re worried, call your pediatrician, go to an urgent care or, yes, come to the emergency department. That’s what we’re there for. But come knowing that you will likely have to wait.
Judy Woodruff:
And — but the symptoms that should cause parents to go to the hospital are what?
Dr. Megan Ranney:
So, symptoms that should cause parents to go to a hospital is if your kid is not making urine or wet diapers, is not making tears when they’re crying, if they’re breathing quickly, or you see them using their extra muscles in their chest or in their belly in order to breathe, if they’re not able to sleep or eat or drink, or, honestly, if they’re just not acting like themselves, even after you get that fever down.
Those are all reasons to seek care.
Judy Woodruff:
And what about seniors? We have been reporting more seniors are being hit with a flu, presumably also with COVID.
What should family members be on the lookout for there?
Dr. Megan Ranney:
So, as we head into this Thanksgiving holiday, the first and most important thing is to make sure that your older relatives or you yourself have gotten that bivalent booster and have gotten your flu shot.
It’s a little late to do it today to protect yourself for Thanksgiving, but it’ll still help protect as we go further into the holiday season. The next thing is, as you’re traveling to visit your family members, wear a mask if you’re going on a plane or a train or other crowded public transport to help reduce the chance of you bringing something into the household.
I do recommend still that folks test for COVID the morning of Thanksgiving to make sure they’re not bring something into the celebration. But, also, if you’re not feeling good, stay home. I know we all want to be together after so many years apart, but help protect your loved ones, whether they are old or young or immunosuppressed, by staying home if you are coughing or sneezing or otherwise feeling under the weather.
Judy Woodruff:
And, in general, I mean, this goes back to what you were saying about parents being on the lookout for their children, but when you think about going to a crowded emergency room, what should tip the scale of it? I mean, what should family members think about? What should someone think about when they think, can I treat this at home, or do I need to go into that hospital, even if I have to sit in an emergency room?
Dr. Megan Ranney:
So, the first and biggest thing is, we are there 24/7/365.
I certainly want folks to try to take care of themselves at home, to call their primary care physician if they have one. But if you are in doubt, that’s what we’re there for. I will say, we saw increased rates of death at home because people were so scared to come to the E.R. in the worst of the COVID pandemic. So I don’t want to dissuade people from seeking care.
That said, if you are able to eat and drink, if you’re able to get your fever down with ibuprofen or Tylenol, if you’re able to get up and walk around, even if you’re a little achy or tired, you’re probably OK to stay home.
But if you’re feeling really lightheaded when you stand up, if you can’t keep fluids down, if you aren’t thinking the way that you normally do, those would all be things that would make me want you to come in and see me.
Judy Woodruff:
And you mentioned a moment ago be patient with — for people who go into the hospital to be patient with the people who are working there.
Remind us what they’re dealing with in many of these overcrowded situations.
Dr. Megan Ranney:
Thank you.
So, the folks that are on the front lines in emergency departments right now, nurses, doctors, techs, they are people that have been there for the last three years. They have stuck around when so many others have left. They want to take good care of you. They know how difficult it is to wait, and they wish they could see you faster.
So, please be kind. Know that we are doing our best. Bring a charger if you can, so that you keep your phone charged. Certainly, bring a mask. And bring someone with you, if they will let you bring a visitor in, to help explain what’s going on.
Judy Woodruff:
I’m sure a good reminder, especially on this Thanksgiving week, when we do have so much to be thankful for.
Dr. Megan Ranney, thank you very much.
Dr. Megan Ranney:
Thank you, Judy.
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