RSV infections in Munich children’s hospitals: Dramatic situation – Munich

“It’s no longer a wave, it’s a tsunami,” says Dominik Ewald. He is the Bavarian state chairman of the Association of Pediatricians – and he speaks about the massive increase in infectious diseases, especially in infants and small children, which is currently burdening pediatric surgeries and children’s clinics and is sometimes exceeding their capacity.

All children’s hospitals in Munich report occupancy far in excess of actual capacity – with the result that new patients are either sent home or have to be relocated to other cities. Jochen Peters, chief physician at the children’s clinic in the Third Order Hospital in Obermenzing, reports a case where a small patient had to be transferred to Nuremberg, and that was the closest bed in all of Bavaria.

Even more dramatic: an infant with a life-threatening inflammation of the cranial bone could only be operated on 24 hours late because, despite hours of phoning around, no hospital in Bavaria had the capacity for such an operation. In addition, there is the problem that the rescue service no longer leaves the city area at night, so that the parents of the small patients have to take care of the transport themselves – or are sent home until the next day.

The patient statistics of the Third Order Clinic speak a clear language, even if they are not yet complete: In the whole of 2022, 78 patients were treated there for an infection with the respiratory syncytial virus (RSV) – 39 of them, however, i.e. exactly half in the past two weeks. “The fact is,” says Jochen Peters, “that infants are often so affected that they develop severe shortness of breath and need oxygen and fluids – and that’s only possible in hospital.”

The sick stay in the hospital for five to seven days

The Schwabing Clinic is also reaching its limits – a spokesman says: “In addition to waves of infection from RSV, we are also seeing frequent infections with other respiratory viruses (rhinovirus, parainfluenza virus, other corona viruses and influenza). Almost all beds are currently occupied and the hospitals are therefore helping each other each other with takeovers.” This is a proven and functioning system – but now the capacities are running out: “The fact that available beds are temporarily running out can be explained on the one hand by the lack of care in Germany and on the other hand by false incentives in the financing system.” The treatment of children is much more complex and time-consuming, but is paid too little for it. That is why there is a larger supply of beds in “more lucrative” medical areas than in pediatric medicine.

The pediatrician Dominik Ewald also confirms this for resident physicians: “We have a lot to do. But that is primarily due to the lack of skilled workers.” And Chief Physician Jochen Peters says: “The problem is not the virus. The problem is the nursing shortage.” In earlier years, more than 100 children were often treated in hospital at the same time without any difficulties. “Today, however, we can only occupy 50 percent of these beds because there are no nursing staff.” The sick stay in the hospital for five to seven days. During this time, however, new patients arrive every day until they are overloaded.

Due to the closure of daycare centers and the obligation to wear masks, immunization was lower

Experts also see a reason for the enormous increase in RSV infections in the corona restrictions of the past two years: Normally, people come into contact with the RS virus in early childhood and thus develop natural immunity – one reason why adults rarely fall ill with RSV, at least not severely. However, due to the closure of daycare centers, kindergartens and schools, lockdowns and the obligation to wear masks, this method of immunization was no longer available, so that the cases are now occurring more frequently, while in the past two years the big waves have almost completely failed to appear. There is no causal therapy against the disease, only the symptoms are treated: through the administration of oxygen and fluids, through drugs that reduce swelling of the mucous membranes. A vaccination does exist, but it is so expensive that it is only recommended for patients at risk – it is usually unnecessary, precisely because nature itself provides the immunization.

Because the virus mainly spreads among children, experts expect the situation to calm down in the approaching Christmas holidays. But after that it could start again. Dominik Ewald: “We will see the next wave in mid-January or early February.”

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