Published December 27th, 2022 at 6:00 AM
Julia O’Donnell’s two children have been sick off and on for months.
Arms wrapped around her sniffly kindergartener and cuddly preschooler, O’Donnell also is pregnant with her third child. About 10 days ago, she got sick.
“It’s an unimaginable amount of work and stress,” O’Donnell said between coughs.
Cases of the flu, RSV and COVID-19 have risen in the past month, as have mental health-related visits to the ER. Meanwhile, the support network — at homes and in hospitals — is bogged down.
When she felt dizzy, she could not call on her husband for help. He is an elementary school teacher in Liberty, Missouri, with limited paid time off. The most time off he was allotted was one week.
Between hospital visits and checking school absences to make sure her preschooler keeps their seat, she is juggling a lot.
One child throws up. The other has a cough that has lingered for months.
No matter how sick, O’Donnell keeps the train running. Cue the clean-and-disinfect routine she learned from the early parts of the pandemic.
At school, it is a different story. She has seen sick kids dropped off, coughing and sneezing. The ratio is 30 kids to one teacher, symptomatic of a teacher shortage.
There are no tests for illnesses. There are no masks.
O’Donnell is hyper-aware of the trifecta of children’s illnesses going around. In early December, a neighbor’s baby was rushed to the hospital with RSV.
“At this point, it is actually kind of important to know which (bug) you’re spreading,” she added.
“This is one of the worst flu seasons we’ve seen in recent years,” said Juliann Van Liew, director of the Unified Government Public Health Department, in an advisory issued by the Mid-America Regional Council (MARC).
Flu season also came early.
In 2020 and 2021, viral illnesses like these had been stunted by pandemic mandates and people staying at home. Once restrictions loosened, viral bugs began to spread.
On Nov. 18, regional public health leaders and physicians warned about the “triple-demic” of flu, COVID and RSV.
Then in early December, MARC and local doctors warned of the increase in respiratory illnesses and resulting hospitalizations. Physicians recommend vaccines to reduce the severity and curb the number of folks heading to urgent care centers and emergency rooms.
Deaths linked to flu and RSV have long been a problem in the U.S. A February 2022 study in the National Library of Medicine examined a decade of data, looking at “excess mortality from RSV and influenza.”
“Despite changes in epidemiology, endemic respiratory viruses continue to have a significant death toll in the U.S., especially among infants and elderly individuals,” the study read.
Folks who avoided COVID, the flu and RSV in previous years are facing what some call the “immunity gap.”
Therefore, physicians urged community members to get the flu and booster shots to prevent severe symptoms. With folks hanging around indoors, the spread is more likely to occur.
Viruses like RSV spread through droplets that enter the eyes, nose or mouth, according to the Missouri health advisory. All it takes is a cough, sneeze or even a kiss on the cheek of someone with the virus.
The flu has not yet reached its peak and some health officials predict another winter COVID surge. Health leaders are bracing themselves. Not only are they seeing an influx of patients, but they also lack staff.
“With the shortages, it sure makes our jobs a lot harder,” said Dr. Jennifer Watts, chief emergency management medical officer with Children’s Mercy Kansas City.
“Almost all of us are sacrificing our own families to help take care of the kids that need attention, especially through this surge.”
The strain is most pronounced in specialized care. The latest Missouri Hospital Association report found that respiratory therapists are among the top 10 hospital job vacancies in Kansas City’s hospitals.
RSV, the flu and COVID are all respiratory illnesses.
Further, some ERs in Kansas City have limited beds. ERs are full of families waiting their turn. The physicians and nurses at those ERs are working extra shifts just to keep up.
This time, the surge is brought on by the collision of three illnesses. Health care workers have been in a three-year pandemic loop — faced with intermittent surges, sudden hospitalizations and crises that compound with other issues in their hospitals.
“(There’s) a lot of general fatigue,” Watts said. “We are still going to see the fallout from this for many years to come.”
Tired children, tired parents and tired health care workers.
Watts adds there is an overlooked piece to the puzzle: how the kids are doing mentally and emotionally. Disruptions in school routines a year or two ago are affecting them now.
“The kids are feeling all the same feels and all the same emotions,” she said. “They just may not be putting it out there in ways that adults see.”
This surge comes at a time when friends and families have begun to resume holiday traditions and congregate like they did pre-2020.
Watts supports these reunions and traditions, especially to ease the mental health anxieties brought on by the past three years. But if anyone in the household is feeling ill, she said it is best to stay home for a day or two to stave off the spread.
Traditions and family are an important part of a kids’ life.
“It’s not a blanket, ‘Don’t get together.’ It’s a, ‘Please get together’,” she added.
Community health physicians like Dr. Carlos Gasha Tamashiro work with Kansas City’s underserved populations.
Many of his patients are people who have recently migrated to the area.
“It reminds me a little bit of where I come from,” Gasha said. “The people that I used to help.”
In addition to being their health resource, he has taken pride in providing cultural and educational support for their new lives in the Midwest. This is especially important as new waves of illness are sweeping through the community.
Like many in the region, he has seen an increase in patients with RSV and flu. The week of Christmas, his appointments filled up.
“Today I saw like six (to) seven patients that made the appointment because their kids felt sick yesterday,” he explained.
Over the past month, he has seen about 15 patients. Half had a cold, and the others were suffering from viral infections.
Vibrant Health – a federally qualified health center — works to support underserved populations in Kansas City. The clinics offer sliding-scale payment options and outpatient facilities.
During surges like these, Gasha said he faces a distinct set of challenges. One is misinformation. The second is kids getting unprescribed medicines from their home countries or antibiotics for a viral infection.
If a child is sick with the flu or RSV, he recommends resting, hydrating and giving the body time to recover. Antibiotics are not necessary, he said, since those are for bacterial infections.
“We want to help them. We want their kids to get better. And if we don’t give them medication, there’s a reason behind it,” Gasha said.
While most children will recover from an infection, doctors can decide the proper treatments for a specific illness. It is key to make an appointment at the onset of symptoms.
Delays in diagnosis can be worse eventually. He said this is more common among families who cannot afford to take time off to see a doctor.
For a mom expecting her third child, O’Donnell is unsure what next semester will look like or how she will manage.
She admits she has considered homeschooling her older kids once the baby is born to keep viruses at bay. But she is concerned about what is not talked about: mental health.
In staying home, what mental and emotional toll will it take?
By 2023, she will have had two pandemic babies. She knows how heavily isolation and stress weigh on parents’ mental health.
“All of this is on us,” she said. “(The kids) need so much help and then the moms have no help.”
Suicidal ideation or self-harm, depression and suicide rates rose among pregnant people after the onset of the COVID pandemic, a new global study found. Suicide is a leading cause of maternal mortality. It accounts for 20% of post-partum deaths, however, these cases are underreported.
There has also been a steep increase in suicide, self-harm, depression and anxiety rates among children under 12. So much so, the American Academy of Pediatrics in October urged the Biden administration to declare a state of emergency.
O’Donnell sees a throughline.
If parents are not supported, kids feel it. If educators are poorly equipped, the kids get overlooked. And if health workers, like the pediatricians who are currently stretched thin, are ill-supported, the kids and their families suffer.
For now, O’Donnell is focused on the kids. They are tired and out of sorts, she said.
Her hope is to keep the kids and families safe.
“And the thing is, over Christmas break, parents are going to be trying to decide, ‘How are we going to handle this problem?’”
Vicky Diaz-Camacho covers community affairs for Kansas City PBS.