Flu infections are raging among children and treating them across Canada, pediatricians say calling for an urgent and long-term solution.
At the weekend, hospitals across the country were forced to reduce regular services to deal with a spike in influenza illness:
The CHEO in Ottawa said the Red Cross would be deployed to help cope with the spike in cases.
A Resuspension Care facility in Calgary was closed to transfer staff to a children's hospital.
BC Children's Hospital declared a 30-minute state of emergency on Saturday to rapidly increase capacity and resources.
Newfoundland and Labrador Children's Hospital canceled several scheduled surgeries and appointments.
Doctors say the move reflects a surge in influenza on top of longstanding pressure on children's hospitals and community care providers. Meanwhile, cases of respiratory syncytial virus (RSV) have stabilized after surging earlier this season.
For the week ending November 26, Public Health Agency Canada's FluWatch reported 223 influenza-related hospitalizations among children aged 16 and under.
That's up from an average of 11, with a maximum of 35, in children's hospitals from 2014-15 to 2019-20, said Dr. Jesse Papenburg, pediatric infectious disease specialist at Children's Hospital Montreal.
"This suggests that we have experienced an early and intense influenza season this time of year, which has hit the child population especially hard," he said by email.
Likewise in the U.S., Rochelle Walensky, director of the Centers for Disease Control and Prevention, said Monday that the flu was at the highest level the U.S. had ever seen. for a decade. So far this season, 14 youths in the US have died.
Federal health officials have not released the exact number of influenza deaths among those aged 16 and under so far this season, but say it is less than five. The number of deaths for this age group was in the single digits each year before the COVID-19 pandemic.
Bend the curve with the flu shot
Influenza "really ... causes a lot of problems," especially for young children, says Dr. Fatima Kakkar, pediatric infectious disease specialist in Ste. Justine Hospital in Montreal.
But not necessarily the flu, that's all the trouble, he said.
Instead, the children caught the flu, which made them susceptible to "very significant bacterial infections", such as pneumonia - and that was when they were admitted to the hospital.
Kakkar said he would like to see an emphasis on influenza vaccination for children, including a publicity campaign.
"I'm saying this because I think it's not too late and especially in parts of the country where influenza hasn't spread yet, I would really like to see people encouraging and making it easier for parents and their children to get vaccinated."
Whitehorse-based pediatrician Dr. Katharine Smart called it "deeply concerning" that children who were terminally ill and needed attention quickly had trouble accepting it.
But there are other, bigger issues across the child health care system that deserve attention, he said.
Smart, former president of the Canadian Medical Association, cites the waiting time for surgery for young people with scoliosis, or curvature of the spine, as an example.
"I have had patients who had to put their high school plans on hold because they didn't know when they would have surgery and recovery," says Smart. "They say, 'Well, how did I go to college if I didn't know that I now have to have massive spinal surgery and be out of commission for weeks or months?'" he says. "Some of these [teenagers] have been waiting three to four years for this operation."
Effective vaccine
Other health care needs for children provided outside the hospital are especially important in the first years of life, such as autism services. Some children cannot access services to improve their speech, social skills and cognition. Once a child is in kindergarten, they may no longer be eligible for certain assistance because the developmental window for intervention has closed.
"This is a problem we see across the country," said Smart. He suggested strengthening nursing and retention staff.
He also wants to see more use of the flu vaccine among both children and adults, to "bend the curve" for an overwhelmed healthcare system.
The good news, Papenburg said, is that the influenza A H3N2 strain circulating primarily in Canada is now genetically the same as the strain in this year's influenza vaccine. "That bodes well for good vaccine effectiveness, although it needs to be assessed in the field studies that are now being conducted."
In the long term, researchers are evaluating newer vaccine technologies for better and longer-lasting flu immunizations, he said.
Like Smart, Papenburg suggests governments "invest in the capacity of our child healthcare system, so that we can better manage these kinds of unpredictable spikes in infections in our child population."
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