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RSV’s Toll On Health Services – Expert Reaction

A sharp spike in respiratory syncytial virus – a highly-contagious, flu-like illness – is especially affecting kids and babies, and stretching hospital emergency departments.

What are the impacts of this outbreak for New Zealand’s health services now, and how would services cope with a COVID-19 outbreak in the community?

The SMC asked experts to comment on the situation.

Natalie Anderson, Senior Lecturer and Bachelor of Nursing Year 2 Director, School of Nursing, University of Auckland, comments:

“The sharp rise in the number of young children sick with RSV has overwhelmed our Emergency Departments (EDs) this week, with many experiencing a record number of daily presentations. The outbreak is taking a toll on the wellbeing of staff as well as the affected children and whānau. Caring for children and babies with breathing problems due to RSV is challenging, requiring both isolation precautions and close monitoring. Even where sick infants do not need hospitalisation, exhausted and anxious parents need guidance, reassurance, and support. As many nurses have young families or caregiving responsibilities, the RSV outbreak is also exacerbating understaffing.

“ED staff are overwhelmed and experiencing alarming rates of burnout. As highlighted in our recently-published paper, a lack of resources to provide quality patient care is a key barrier to workplace wellbeing for ED staff. Skilled, experienced ED nurses are resigning in record numbers, seeking safer, more-satisfying and better-remunerated roles. Hospitals are now struggling to recruit nurses, with some DHBs reporting hundreds of nursing vacancies.

“Our health system is constantly working at full capacity, with no room for this sort of surge demand. Efficiency may be ideal for an automated factory production line, but the health system depends on humans to provide care to humans. We need to work within a resilient system that allows us safe spaces and adequate time to care. No-one wants distressed children with RSV and their exhausted parents to be cared for on floors or in corridors by overwhelmed staff, but this is the reality in our EDs, right now. Imagine what will happen if we add a COVID-19 community outbreak into this mix.”

Conflict of interest statement: Dr Natalie Anderson is a Senior Lecturer, Emergency Department staff nurse and College of Emergency Nurses New Zealand committee member.

Professor Graham Le Gros, Immunologist, Director (Chief Executive) Malaghan Institute of Medical Research, Programme Director Vaccine Alliance Aotearoa New Zealand – Ohu Kaupare Huaketo (VAANZ), comments:

“The overwhelming effects on New Zealand’s paediatric emergency care from the recent Respiratory Syncytial Virus (RSV) outbreak in New Zealand infants and the elderly is an important ‘wake up call’ of how vulnerable health systems are to serious infectious diseases that get into communities of susceptible people.

“It gives us clear-eyed insight of what a COVID-19 outbreak in the community would look like in New Zealand.

“It is also an important wake-up call that we need to have a vaccine against RSV. There is none available, with the best one currently being trialled here in New Zealand. We need to do everything we can to support safe RSV vaccine development as soon as possible – so that future generations of mums and dads do not have to face the terror of this infection in their little babies.

“RSV is a serious disease that needs to be eliminated from the list of childhood infections that affect our communities.”

Conflict of interest statement: “Professor Le Gros is Programme Director of the Government-funded Vaccine Alliance Aotearoa New Zealand – Ohu Kaupare Huaketo, a partnership between the Malaghan Institute, the University of Otago and Victoria University of Wellington.”

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