Lockdown Consequences: Increased Number of Children Hospitalized With RSV in Australia, Warning in UK

Last April, two California doctors did a lengthy press conference to encourage political leaders and public health professionals to ease lockdown restrictions. Long before the Great Barrington Declaration, two frontline physicians, Dr. Dan Erickson and Dr. Artin Massihi, expressed concerns about the social and emotional costs of isolation and its physical health implications. After discussing the rise in mental health and abuse patients they were seeing, even in April of 2020, Dr. Erickson explained the effects of lockdown on the immune system. As I summarized his comments at the time:

Dr. Erickson explained that the immune system is actually built by exposure to pathogens. Coming in contact with viruses and bacteria in the environment fires the body’s system for fighting infection. Additionally, the normal flora, or good germs we have on and in us all the time, also drop when we isolate.

The combination of reducing regular exposure to pathogens in the environment and lowering the good bacteria that helps us fight off infection, concerns both physicians.

Erickson warned of a rise in opportunistic infections following people emerging from lockdown. Earlier this year, Australia experienced exactly what he predicted. Sadly, it impacted the very same children that COVID-19 largely spared:

Off the back of a year of COVID-19 infections, social distancing and lockdowns, we’re back to a more “normal” year — but with “waned immunity”.

Experts say that because in 2020 we were not exposed to viruses and infections — other than COVID-19 — at the usual rate, many people have become so-called “naive” to them.

This is most apparent in the recent “large resurgence” of respiratory syncytial virus (RSV) — a virus that typically affects infants and young children. RSV presents with flu-like symptoms, such as a runny nose, fever, cough and wheeze.

It is one of the most common reasons for children to be admitted to hospital, and in developing countries it is “quite a common” cause of infant mortality.

Now the medical community in the U.K. is set to issue a warning  that a similar trend is very possible after the lockdown:

The chief medical officers of the four UK nations are set to warn about a surge in admissions of severely ill, very young children later this year, due to the resurgence of a respiratory virus which has been suppressed by anti-covid measures, HSJ can reveal.

Public Health England modelling shows a possible sharp rise in cases of respiratory syncytial virus (RSV), which can cause bronchiolitis, this autumn and winter, several senior sources said. The modelling shows between 20 and 50 per cent more cases needing hospitalisation than normal, HSJ understands.

Official projections conclude that such a surge would require, at least, a doubling of paediatric intensive care beds and a significant increase in other critical care resources for sick children.

According to the Oxford Vaccine Group and Oxford University around 30,000 children under the age of five are estimated to be hospitalised every year in the UK because of RSV. However, most of those expected to be affected by the rise in RSV this year are forecast to be three years old or younger.

In young children, the symptoms of RSV can easily be mistaken for COVID-19. However, we know that young children are rarely symptomatic and become seriously ill even less frequently. Because of the focus on COVID-19 testing, we may have seen a precursor to this in Michigan and missed it. Concurrent with easing restrictions, the state saw an increase in hospitalized children earlier this year. Michigan is the only state to see this type of increase so far, so it is notable:

Pediatric COVID-19 hospitalization rates increased 311% between Feb. 19 and April 20, 2021 in Michigan.

That’s according to data from the Michigan Health & Hospital Association (MHA). The data shows that the number of children hospitalized with severe COVID-19 symptoms hit a high of 70 this week.

That number is twice as many as were hospitalized during the last surge in November 2020. As of Thursday, April 22, the number of hospitalized pediatric patients in Michigan confirmed to have COVID-19 was 52, a slight decrease, per the state’s data.

The public health bureaucracy surmised it could be related to the U.K. variant of COVID-19 circulating. However, research has shown the U.K. variant could be more contagious but was not causing more severe illness or death. Michigan had some of the longest and strictest lockdowns. However, greater freedom of movement in the state also coincided with the regular time of the year when RSV circulates.

In Australia, RSV reemerged off-season, so parents need to be aware of this possibility in states where children have been isolated for prolonged periods. Most children come in contact with RSV in the first three years of life and their bodies learn how to recognize it and fight it off. Some of our kids have missed nearly a year of regular community contact due to lockdowns, so those who would have run into it last year may have been delayed.

If a child under five becomes ill with a respiratory virus requiring medical evaluation, parents should insist on a test for RSV and other common respiratory viruses as well. Get this test even when a positive test for COVID-19 is present, as one does not preclude the other. Parents of all children might see some version of what their children experienced when entering daycare or school. Periodically they start to leak from some hole on their face and may have mild symptoms. This phenomenon is their immune system recoding itself for the pathogens they routinely encounter in their community.

Many doctors and health policy experts warned of the multi-faceted consequences the lockdown orders could have. Perhaps next time we have a health emergency, we should not suppress or ignore these concerns. Instead, they should be debated and discussed. And perhaps, rather than relying on scientists to determine policy, we rely on policy experts who understand the science.

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