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They opened up a zone in the hallway where we transported patients down to the emergency and put beds there so that we could keep seeing patients. I've heard this from other PICU nurses in other parts of the country. We're seeing a shortage of pediatric nurses across the countryNot everyone can be a travel nurse. I work with a healthcare company that supplies travel nurses, and we have seen 100% uptick in the request for pediatric nurses and PICU nurses. I think that's due to a lot of PICU nurses during COVID taking care of adult patients.
Canada Confronts Shortage of Children’s Pain Relievers
  + stars: | 2022-11-11 | by ( Vipal Monga | ) www.wsj.com   time to read: 1 min
TORONTO—Canada is confronting a shortage of children’s Tylenol and Advil just as flu season begins and the country’s hospitals are struggling with a surge of pediatric respiratory viruses. The shortage has left drugstore shelves empty and is forcing Canada’s government to issue emergency orders to allow for the import of acetaminophen and ibuprofen supplies from the U.S. and Australia.
The answer is likely to frustrate parents: There is no obvious reason some healthy babies get so sick with RSV that they must be hospitalized, on oxygen, while others do not. That means babies who have never been exposed to a virus like RSV may be hit harder than older children who've had previous RSV infections. A study published Thursday in The Lancet Respiratory Medicine found that in Europe, about 2% of healthy children under age 1 who get RSV require hospitalization. The U.S. is in an unusual surge in respiratory viruses, including RSV, that have overwhelmed children's hospitals. “They’re experiencing their first RSV virus at the same time as other viruses,” including rhinoviruses that cause the common cold.
CNN —About half of the US – 22 states, along with Washington, DC, New York City and Puerto Rico – is reporting high or very high respiratory illness activity, as flu season sweeps through the country weeks earlier than usual. “Among the people who study flu, there’s a little saying: ‘If you’ve seen one flu season, well, you’ve seen one flu season,’ ” said Dr. William Schaffner, a professor in the Division of Infectious Diseases at Vanderbilt University Medical Center and medical director of the National Foundation for Infectious Diseases. Although the numbers are especially high for this time of year, experts say the trends are otherwise following an expected pattern, and the early arrival of flu season doesn’t necessarily mean it will last longer or be more severe. It’s not like we’re seeing a lot of hospitalizations without a lot of illness.”Flu activity has been highest in the South, CDC data shows. And millions fewer flu vaccines have been distributed this season than at this point in previous years.
Even healthy infants face a considerable risk of hospitalization from respiratory syncytial virus, according to a large European study published Thursday. Dutch and British scientists, in a study published in Lancet Respiratory Medicine, found that 1.8% of healthy infants are hospitalized with RSV before their first birthday. This means about 1 in 56 healthy infants are hospitalized with the virus annually. The scientists found that a majority of the infants hospitalized with RSV were younger than 3 months. About 1 in 18 infants hospitalized with RSV required treatment in the intensive care unit.
Rhode Island is among the states most severely affected by the aggressive, nationwide surge of pediatric respiratory infections. As of Monday, 76% of pediatric hospital beds were full nationwide. Like most states, Rhode Island is seeing cases of flu, respiratory syncytial virus (RSV), Covid and other respiratory viruses all at the same time. Weed said Rhode Island is unique in that "many states have more than one pediatric hospital, and we only have one." Overly said his hospital might benefit from Rhode Island declaring a state of emergency related to the surge of pediatric respiratory viruses.
CNN —Comedian and actress Amy Schumer has revealed that her young son, Gene, was admitted to the emergency room this week with RSV. “This was the hardest week of my life,” wrote Schumer in an Instagram post published on Sunday. Gene, Schumer’s 3-year-old son, is now home and doing better, according to her post. Respiratory syncytial virus, or RSV, has been spreading rapidly in the Unites States this respiratory virus season. The disease typically causes mild, cold-like symptoms, but it can also cause serious illness, especially in older adults and infants.
The rise comes as other respiratory viruses, including respiratory syncytial virus, or RSV, are also spreading early and rapidly. Common winter viruses tend to peak in December and January — not October and November — though it's unclear how the early and intense spread of respiratory viruses will ultimately play out this season. It's the first time since the beginning of the Covid pandemic that run-of-the-mill respiratory viruses are again circulating widely. Other respiratory viruses, including rhinoviruses and enteroviruses, are also circulating widely, and could account for some of those illnesses. "We'll probably start seeing cases rise on the West Coast in the coming weeks," said Dr. Meredith McMorrow, a pediatrician and team lead for Enhanced Surveillance Platforms at the CDC.
Across the United States, cases of respiratory syncytial virus, or RSV, and influenza are increasing. Influenza activity continues to increase in the US – the number of flu illnesses, hospitalizations and deaths so far this season nearly doubled in the past week. RSV cases are also increasing nationally, although there are regional differences in the circulation of these viruses, Romero said. In the South and Mountain West, RSV cases appear to have peaked in October. There are signs that RSV cases are slowing in the southern region of the US, but test positivity rates and cases continue to rise in other regions, especially the Midwest.
The U.S. is facing the highest flu hospitalization rates in more than a decade with children and the elderly most at risk, according to the Centers for Disease Control and Prevention. Flu and respiratory syncytial virus had receded during the Covid-19 pandemic due to mitigation measures such as masks and social distancing. About about 3 patients are being hospitalized with the flu out of every 100,000 people with the virus right now, which is the highest rate since 2010. Seniors and children younger than age 5 face the biggest risk right now, with hospitalization rates about double the general population, according to CDC data. In the Mid-Atlantic and Midwest, H1N1 flu viruses are growing in circulation, he said.
And though you might not want to think about it, testing positive for Covid just before one of those gatherings could put a real damper on your holidays. There's a short answer and a long answer, experts say. The short answer is simple: Don't go, even if you don't feel sick at all. But health officials still warn of a winter Covid surge that could wreak havoc, just like last year's winter wave of omicron cases. Here's a guide for what to do if you test positive for Covid right before a holiday gathering with loved ones:
Fauci, in a radio interview Thursday, said the pandemic has clearly eased since last winter but deaths, which average more than 2,600 per week, remain far too high. At the same time, the new omicron variants are knocking out key tools used to protect the most vulnerable. As we're entering into the cooler months, we are starting to see the emergence of sublineage variants of omicron," Fauci said on the Conversations on Health Care radio show. The omicron subvariants BQ.1 and BQ.1.1 are of greatest concern. Fauci said hospitals could face a "negative trifecta" this winter from emerging Covid variants as well as resurgent flu and respiratory syncytial virus.
An earlier study in adults showed that the drug did indeed help with weight loss. “We’ve entered the phase where we are seeing the kind of weight loss where teens come to us in tears. In addition to the weight loss, the drug reduced some cardiovascular risk factors, including waist circumference and bad cholesterol. As it turns out, even when people get weight loss surgery, “three years out, there is significant weight gain,” Li said. When a weight loss drug like this is prescribed to patients, that shouldn’t be the end of things, Li said.
Expert advisers to the U.S. Food and Drug Administration met virtually on Tuesday to discuss improvements in standards for pulse oximeters. Imarc Group market research firm forecast the global pulse oximeter market reaching $3.25 billion by 2027. Pulse oximeter problems "suddenly became enormous" during the pandemic, said Dr. Philip Bickler, director of the University of California, San Francisco's (UCSF) Hypoxia Research & Pulse Oximeter Test Facility. Current rules require that pulse oximeters be tested in a minimum of just 10 subjects, only two of whom must be "darkly-pigmented." While the devices are still useful, UCSF's Bickler said, doctors "should not base patient care only on pulse oximeter findings."
The Centers for Disease Control and Prevention on Monday issued a health advisory about waterborne bacteria in dental plumbing systems after children who visited pediatric dental clinics were infected with nontuberculous Mycobacteria. The cluster of suspected NTM infections identified in March arose among patients of the same pediatric dental facility. The year before, 24 children got NTM infections after receiving dental care from a clinic in Georgia. "Dental providers should consult with the dental equipment manufacturer for appropriate methods and equipment to both maintain and monitor the quality of dental water," the CDC said. If left untreated, dental water can also breed other bacteria, including Legionella.
An experimental RSV vaccine for pregnant women from Pfizer is effective at protecting newborns against severe illness for at least six months, the company said in a press release Tuesday. The vaccine was also about 70% effective against severe infections through the first six months of life. Pfizer said in a statement that it is currently not conducting an RSV vaccine trial in infants. Pfizer's RSV vaccine could be "a major step forward so that we can attack this last really bad communicable disease of the neonatal period," Schaffner said. Aside from pregnant women, Pfizer is testing its vaccine in older adults, who are also at risk for severe RSV infections.
U.S. FDA warns of tracheostomy tube shortage
  + stars: | 2022-10-31 | by ( ) www.reuters.com   time to read: 1 min
Oct 31 (Reuters) - U.S. Food and Drug Administration (FDA) said on Monday there was a shortage of tracheostomy tubes, a surgical device that helps patients to breathe, including those manufactured by ICU Medical (ICUI.O). The agency said the shortage was due to difficulties in raw material procurement and would most likely impact pediatric patients. They will be affected by the limited supply of tubes with similar functionality as ICU Medical's Bivona, that are made from flexible silicone and easier to use in children. The health regulator has recommended reusing tracheostomy tubes after following proper sanitary procedures in order to deal with the current shortage. Reporting by Khushi Mandowara; Editing by Shinjini GanguliOur Standards: The Thomson Reuters Trust Principles.
Flu Hospitalizations Hit Decade-Plus High for October
  + stars: | 2022-10-28 | by ( Brianna Abbott | ) www.wsj.com   time to read: 1 min
A flu vaccination in Chicago recently. There have been at least 880,000 cases of flu this season. The U.S. flu season is off to a fast and early start, with hospitalization rates the highest for this time of year in more than a decade, federal data showed. Centers for Disease Control and Prevention estimates showed Friday that there have been at least 880,000 cases of flu this season, some 6,900 hospitalizations and 360 deaths, including one pediatric death. The data is through the week ending Oct. 22.
Pharmacies across the United States are reporting shortages of one of the most widely used antibiotics, raising concerns that the medication will be in short supply for the upcoming winter season. Three key amoxicillin manufacturers — Hikma Pharmaceuticals, headquartered in the United Kingdom; Sandoz, based in Switzerland; and Teva Pharmaceutical Industries Ltd., headquartered in Israel — are reporting shortages of the antibiotic, according to the American Society of Health-System Pharmacists, which maintains a database of drug shortages. Because amoxicillin is an antibiotic, it is not used to treat infections caused by viruses, such as Covid, the flu or RSV (respiratory syncytial virus). Pharmacists said they are worried if the shortage lingers through the winter, when infections can surge and antibiotic use typically increases. “However, there are a number of factors that can cause or contribute to drug shortages that are out of the FDA’s control.
There are early signs that this year's flu shot appears to work well at keeping people out of the hospital. A report on Chile's flu season, released Thursday by the CDC, found the vaccine was 49% protective against flu-related hospitalizations. That might seem low, but from 2015 to 2020, flu shot effectiveness in the U.S. ranged from 29% to 48%. It's unclear whether this year's flu shots in the U.S. will be as effective as was found during Chile's flu season. Only about half of the population gets an annual flu shot, typically.
CNN —Flu season has ramped up early in the United States, and flu hospitalizations are worse than usual for this time of year, according to data published Friday by the US Centers for Disease Control and Prevention. It’s been more than a decade – since the H1N1 swine flu pandemic – since flu hospitalization rates have been this high at this point in the season. “We’re in a bit of a race with the virus,” he said, with the flu season starting at least a month earlier than usual. “The flu season will be with us for at least a few more months. And the flu season is ramping up amid the surge of RSV that is filling pediatric hospitals and an ongoing Covid-19 pandemic.
“We’re extremely overwhelmed,” said Dr. Rishi Lulla, director of pediatric hematology/oncology at Hasbro Children’s Hospital in Providence, Rhode Island. Seasonal respiratory viruses fill children’s hospitals every year, but the number of beds that are full now is well above the average. Driving much of the current need for beds at children’s hospitals is a spike in cases of RSV, which are 60% higher than at 2021’s peak. Nurse turnover is up 50% across the country since 2019, according to Mark Wietecha, CEO of the Children’s Hospital Association. Get CNN Health's weekly newsletter Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.
A federal judge on Tuesday dismissed a wrongful death lawsuit that claimed TikTok was responsible for the death of a 10-year-old who took part in the so-called Blackout Challenge. The challenge, which encourages participants to choke themselves until they pass out, had appeared on the child’s TikTok For You Page, according to court documents. The lawsuit was among several that have been filed related to the Blackout Challenge in the last year. In July, the families of two young girls also sued TikTok after their children, aged 8 and 9, died of self-strangulation while participating in the Blackout Challenge. A TikTok spokesperson told NBC News that the challenge had never trended on the platform and predates the app’s existence.
That there is no RSV vaccine for kids is not for lack of interest, experts say. But a trial gone wrong many years ago and a tricky target protein have made developing an RSV vaccine difficult. Researchers’ attempts to develop an RSV vaccine go back decades, according to Dr. Ofer Levy, the director of the Precision Vaccines Program at Boston Children's Hospital. In August, Pfizer announced that its experimental RSV vaccine was nearly 86% effective in preventing severe illness in adults ages 60 and older. GSK, however, said it abandoned its efforts last year to develop a pediatric RSV vaccine, because trials suggested it wasn't effective.
A possible convergence of flu, RSV and Covid-19 has doctors worried. Flu cases are rising earlier than usual, and pediatric hospitals are seeing surges of respiratory syncytial virus, commonly known as RSV. There are also signs that Covid-19 cases are increasing in parts of the country as Americans head into the cooler months.
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