Shortage of pediatric ICU beds amid early flu season, RSV cases

SA Metro Health “It is fair to believe that there is less immunity”

San Antonio – Two-month-old Kehlani Perez had been gasping for air and vomiting when her mother, Natalie Torres, brought her to University Hospital on Friday afternoon.

The culprit turned out to be rhinovirus, a type of respiratory infection. Although Torres knew by about 3 p.m. that Kehlani would need to be admitted, it took another 10 hours of waiting before they had a pediatric intensive care unit bed for her.

“We had to wait for a discharge in people because there wasn’t enough rooms,” Torres said.

The backup they faced isn’t unique. A Texas Department of State Health Services dashboard, updated Monday afternoon, shows just 42 staffed pediatric ICU beds available across the state.

In San Antonio’s region, which covers nearly 2.9 million people and stretches to the border, there were only nine available.

University Health Chief Medical Officer Dr. Bryan Alsip said the flu and respiratory syncytial virus (RSV) are playing a significant role in their bed shortage. Lingering effects of COVID-19 may play a role, he said, though local statistics on Monday showed only 14 COVID-positive patients in Bexar County hospitals, which includes adults.

“I mean, the COVID numbers that we’ve been seeing in the past couple of weeks are probably, at least in the inpatient environment, some of the lowest we’ve seen in the past three years, which is great. And we’re excited about that and happy about that,” Alsip said. “But it seems that’s simply opened the door for some of these other respiratory pathogens that are now affecting a lot of people.”

Flu and RSV can be dangerous for children when they have a hard time breathing.

“Particularly young infants start breathing rapidly because they’re not oxygenating well. Sometimes they start to turn blue,” Alsip said.

San Antonio Metropolitan Health District data shows the flu is already “widespread,” and health care visits for flu-like illness, which includes RSV and rhinovirus, are trending upward.

“This is by far the earliest season on record for us,” said Dr. Anita Kurian, Metro Health deputy director.

Kurian said flu season normally ramps up by the first week of December and peaks somewhere in mid-January to mid-February.

SA Metro Health reports tracking healthcare visits for Influenza-Like Illness show a much earlier flu season than the previous two years. Data from Week 45: Nov. 6 - Nov. 12, 2022 (City of San Antonio)

Metro Health doesn’t know exactly what’s driving the early flu season, but Kurian notes that other respiratory illnesses were “greatly impacted by COVID-19.”

“So it is fair to believe that there is less immunity in that population,” Kurian said.

Metro Health’s data on flu-like illness visits show the 2020-2021 and 2021-2022 flu seasons were light and steady -- a far cry from what they’re seeing now.

Part of the reason may be because of the numerous precautions people took during the pandemic against COVID-19. Masking, social distancing, and hand-washing are effective at stopping the spread of other viruses, too.

But now, most people have returned to their normal, pre-pandemic lives.

“I believe there is ample opportunity for these respiratory viruses, including influenza, to spread very easily as they have done historically here in our community,” Kurian said.

Alsip similarly said it’s important to consider the loss of protective immunity from other respiratory illnesses.

“It’s probably at least one of the major factors, you know, plus the fact we’re doing a lot less of those things than we did in years before. I think a combination of those things together makes a big difference,” Alsip said.

Alsip said some of the same precautions, like handwashing and masking in crowded settings, could help slow the spread of respiratory illnesses, and flu shots are available, too.

The very young, the very old, and people with underlying medical conditions are the ones to worry about most, he said.

“They’re the ones that if we were focused on them, the other -- those of us that have hopefully, you know, less compromised medical conditions aren’t so much at risk by comparison,” Alsip said.

Find more local flu coverage from KSAT here

About the Authors:

Garrett Brnger is a reporter with KSAT 12.