December 2, 2022
Multnomah County Health officials are urging everyone, including in K-12 schools and child care centers, to wear masks in public indoor spaces until at least January 1, 2023 due to the increase in winter respiratory viruses.
The recommendation is voluntary and there is no expectation that organizations change their masking policy, Dr. Jennifer Vines, health officer, said Thursday. But the action is needed to slow the flow of sick children into Portland hospital emergency rooms and pediatric intensive care units.
“All our emergency departments are full,” said Dr. Vines at a press conferenceDecember 1st. “Hospitals and emergency level care are at risk of going beyond the supplies we have locally.”
Respiratory viruses such as RSV and influenza usually increase in the winter. They are especially virulent this year after shutdowns in schools and childcare in 2020 and 2021 abnormally suppressed the usual cycle of infants, toddlers and young parents exposed to RSV and developing stronger immunity for the following season.
Instead, children under five who have never encountered the common RSV seem particularly hard hit. And older children and adults also spread the disease.
In a Dec. 1 email to Portland school superintendents, Dr. Vines and public health director Jessica Guernsey all recommend wearing a mask to “support hospitals and keep children and staff well enough to continue to attend school in person.”
Although the number of RSV cases “may be approaching the peak,” Dr. Vines said that influenza continues to increase, infecting adults and the elderly. COVID-19 hospitalizations are also increasing.
According to the email, Dr. Vines and Guernsey people to:
- Be aware of flu and Covid vaccines.
- Wash hands well and often.
- Disinfect shared surfaces.
- Stay home if you are sick.
- People at high risk for serious illness avoid large gatherings.
- Have ready access to hand sanitizer.
Dr. Vines said everyone 6 months and older should be vaccinated against flu and COVID, and anyone who is with someone younger than 6 months old should be vaccinated. “It’s never too late to start your vaccine series.”
While hand washing and use of hand sanitizer have become common practice, now more than ever they play an important role in preventing RSV. Dr. Vines said that RSV can remain on unwashed hands and surfaces, and frequent hand washing and wiping of surfaces can help prevent infection.
Local pediatricians weigh in
Dr. Vines was joined in her call to action by two of the state’s top pediatricians, Dr. Wendy Hasson and Dr. Carl Eriksson.
Hasson, medical director of the pediatric intensive care unit at Randall Children’s Hospital, said “Randall [Children’s Hospital at Legacy Emanuel] see historical numbers not only of admissions, but also of emergency room visits.”
According to dr. Hasson is RSV and influenza known viral disease processes for the pediatric care community, and emphasized that the crisis is not of the disease, but rather of the resources.
“What you can do as a community member is to completely prevent yourself from needing care.”
As a parent of two young children, including an infant, Hasson said that she personally wears a mask when in a public space and that her toddler washes their hands regularly.
Only about 10 percent of the sick children who show up at the emergency room are admitted to the hospital, she said. Many have fevers that can be treated with Tylenol, for example. But it’s often hard for concerned parents to know. She recommends that parents look at these three things when making a decision to take their children to the emergency room:
- See how hard the child works to breathe; see if they use any muscles between their ribs or under their neck.
- Determine if the child is dehydrated and needs less than three diapers a day.
- Check their level of alertness. If the child is not interested in eating or playing between fevers.
According to dr. Hasson, if the child meets all three, they should be seen in an emergency room.
Doernbecher Pediatric Specialist Dr. Carl Eriksson said the hospitals are working to do their best to provide the help needed with the resources they have, and parents may experience longer wait times in the waiting room.
Dr. Eriksson said Doernbecher uses all the physical beds in the ICU and will begin using physical beds outside the ICU, and they are constantly identifying children who can be well served outside of the children’s hospital, such as older teenagers who can be cared for in adult beds.
“We want to avoid a situation where we are unable to provide care for children who need it,” said Doernbecher Pediatric Specialist Dr. Carl Eriksson said.