Why Kids Are Getting Sick With RSV, Flu, and Flooding ERs

• There are multiple reasons why so many kids are sick right now.
• The idea of an immune “debt” isn’t quite accurate — childrens’ immune systems are fine.
• Testing, in-person daycare & work, fewer hospital beds, prior COVID, and other factors all play a role.

Children with viral illnesses including RSV, flu, and COVID-19 are flooding ERs and urgent care centers. Federal labor data shows a record number of parents in the US have been skipping work this fall to take care of sick kids. 

Doctors, nurses, and epidemiologists say there are several things at play contributing to the big viral soup — and they are wary of dismissing it with any one simple explanation, like “immunity debt.”

Over the past two years, the term “immunity debt,” a phrase which was never previously used in scientific literature, has taken off. In academic position papers, on TV, and even in PediaSure pamphlets, “immunity debt” has quickly become a catchall phrase used to suggest that some kind of “gap” in infections brought on by pandemic masking and isolating is to blame for the current wave of respiratory illnesses. 

But in conversations with eight leading infectious disease experts, Insider found five complex and interwoven factors that may be driving the viral trends — and none can be easily summed up as an immune deficit.

We are testing for, and paying attention to, RSV more than we ever have before

Ask any doctor, nurse, or public health expert and they’ll tell you: one key reason we’re seeing more RSV this year is because providers are looking for it.

“We’re definitely testing for RSV more than we used to,” pediatrician Manuela Murray, medical director of the Pediatric Urgent Care Centers at the University of Texas Medical Branch, told Insider. “Before the pandemic, even though the test for RSV was available, we didn’t use it that much,” largely because “knowing that it’s RSV is really not going to change anything that we do.” 

There is no specific medicine that can treat RSV, and no vaccine yet either.

When COVID came along, viral testing became more ubiquitous.  

“Perhaps there were a lot of kids out there in previous years, years prior to the pandemic, that had RSV — we just didn’t know,” Murray said. 

RSV has always been a bad illness for little kids and older people. It’s especially dangerous for newborns under six months old, whose tiny airways can quickly become obstructed with mucus and inflammation. 

RSV has long been “the number one cause of hospitalization for infants,” Dr. Pedro Piedra, a professor of molecular virology and pediatrics at Baylor College of Medicine, told Insider. “That has not changed.”

The pandemic threw off RSV’s typical seasonality patterns