Hospitals in SP predict an increase in sick children with the arrival of autumn

“Our emergency room is providing care through a contingency plan, which prioritizes children with more serious clinical conditions”, reads the message that appears since Monday (28) on the home screen of the Hospital Infantil Sabará website, an institution private company that operates in the central region of São Paulo.

According to hospital data, there was an increase in cases of respiratory syndrome considered urgent in March, with 1,267 patients, compared to the month of February (1,025).

The number, however, is below the one recorded in January (1,658), when there was an explosion of cases of Covid-19 in children, driven by the ômicron variant.

The survey, with numbers until Monday (28), indicates a number of urgent patients equal to that of March 2019, pre-pandemic period.

The increase in demand for emergency care and hospitalization of children, in the comparison between the most recent weeks, has also been noticed in other private hospitals in the capital of São Paulo.

Santa Catarina Paulista, in the central region, and Sabará are preparing a contingency plan for the fall, the time of year when care for children is traditionally increased, that consists of increasing beds.

The first states that it will create an ICU with ten beds to care for children with viral infections. The second implemented, this year, 19 new beds in an external unit of the hospital, to receive patients of lesser complexity.

Like Sabará, Hospital Santa Catarina Paulista says that, compared to February, the month of March registered an increase in demand for children. At the institution, the growth was 61% in pediatric care with respiratory syndrome.

Hospitalizations, however, remain stable. Last month, there were 101, with 19 in ICU. In this one, there were 118 hospitalizations, 20 of which in the ICU, until this Wednesday (30).

The Children’s Hospital, from Rede D’Or, recorded, between January and March, a 125% increase in emergency room visits. Most are cases of respiratory syndrome, not Covid, resulting from the arrival of autumn.

The institution says that it is “a typical seasonality of pediatrics for which the hospital is always prepared”.

Marco Aurélio Safadi, infectious disease specialist, pediatrician and president of the immunization department at the São Paulo Society of Pediatrics, says that in early autumn there is traditionally an increase in pediatric patients.

“March and June is when, historically, we have a greater number of consultations and hospitalizations consistently, as they are the autumn and winter months, when respiratory and gastrointestinal viruses appear”, says Safadi, who works at the Sabará Children’s Hospital and in the Holy House of Mercy.

He states that the profile of patients in March is different from those who sought hospitals in January, when many children were hospitalized for Covid-19.

“It’s still too early to say what the main cause this year is, but it’s not Covid”, he explains, who says that there has also been no significant increase in cases of influenza or bronchiolitis. “They are different viruses without a protagonist at the moment.”

Therefore, Safadi attributes the increase in demand to the historic scenario of hospitalizations in the beginning of autumn. In addition, he says, there has been a return to face-to-face classes and, to a large extent, to normality.

“We live in a scenario in which people forget about the daily routine, and this increase in demand for hospitals is what we hope will happen. Flexibility brings this scenario.”

Renato Kfouri, a specialist in pediatric infectious diseases, also highlights that the increase in cases of Srag (Acute Respiratory Syndrome) is normal with the arrival of autumn and temperature variations.

According to him, the cases that have reached hospitals, for the time being, are generally bronchiolitis, caused by the respiratory syncytial virus. “It is a normal period of increase”, he reinforces.

According to him, there is an expectation that, with the arrival of winter, there will be a greater circulation of other viruses that cause respiratory diseases, such as influenza.

“We come from two years in which these viruses had a lower circulation due to isolation. In addition, young children were not able to go to school, which is where they are normally infected and create immunity.”

He also recalls that the country had an atypical circulation of influenza at the end of December and January, which can change the transmission behavior of the virus in winter. “What we can do is what we already know to be effective, move forward with vaccination for both flu and Covid.”

Pediatrician at Santa Catarina Hospital, Werther Brunow de Carvalho also recalls the situation in December in the country.

“At the end of the year, we had a high in cases of influenza, but now it is different. Now, it is a behavior that we expect from this seasonality”, he says.

To avoid getting sick in this period, he highlights, parents and guardians need to be aware of prevention, such as constant hand washing, use of alcohol gel and avoid contact of children with people who have flu symptoms.

In addition, it advises that people frequent ventilated environments and that adults do not smoke in environments with children, as smoking can irritate the airways.

Despite the drop in Covid numbers, experts say the infection is not off the radar of hospitals.

“Cases of Covid in pediatrics have dropped a lot this year. This makes us a little calmer, but does not rule out the possibility of a diagnosis of Sars-Cov-2”, says Carvalho.

Medical manager and infectologist at Sabará hospital, Francico Ivanildo analyzes that the hospital’s medical team is attentive to check early if there is a new peak in Covid-19 cases.

“Mainly due to the liberalization of masks and the entry of a colder and drier period”, he summarizes, who calculates that the vaccination of children aged 5 to 11 years is still below the desired level.

“Although the city of São Paulo is above the national average, we still haven’t achieved the same adhesion that we had for teenagers and other adult groups.”

Sought, the Municipal Health Department of São Paulo said not to observe discharge for now in cases in the municipal network.

“In 2022, from the week [epidemiológica] 7 (February 13 to 19) it is possible to observe a drop in the number of hospitalizations from 0 to 18 years old due to respiratory problems, with four more cases in week 11 (3/13 to 3/19), compared to the previous week, but dropping again in week 12 (3/20 to 3/26).”