How new treatments could quiet the 'perfect storm' of respiratory viruses

As a virus leaves some babies under the age of two wheezing — adding to the pressure on Canada's hospitals — drug makers are working on new treatment and vaccine options for the illness.

Respiratory syncytial virus or RSV gets the "S" in its name for large cells known as syncytia that form when infected cells fuse. Syncytia are prone to die off and plug up airways, leading to respiratory distress, Dr. Clement Lee, a pediatrician at Newton-Wellesley Hospital in Newton, Mass., said in a recent Twitter thread.

For most healthy people though, the highly contagious virus feels like an ordinary cold.

Dr. Rod Lim, medical director for the pediatric emergency department at Children's Hospital in London, said while many infants weather RSV just fine, the virus tends to present in young children almost like asthma, with wheezing.

Before the COVID-19 pandemic, children were commonly exposed to RSV between November and March. By two years of age, it's estimated 90 per cent of us have been infected.

But this year, RSV arrived early in parts of Canada and the U.S., based on swabs of those in the hospital — it even circulated in the summer.

"We're seeing viruses circulate at different times than we have," Lim said at a virtual briefing hosted by the Ontario Medical Association.

"It's a little bit of a perfect storm right now."

Lim's emergency department was built for about 100 visits a day, and on Tuesday, there were 280 visits, forcing staff to look for alternate spaces to care for people, he said.

Staffing challenges and supply chain issues for medications to reduce pain and fever are adding to the burden, he added.

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"If I had an ideal world, [it] would definitely not allow babies to get RSV and to get any kind of infections for the first two to three months," Lim said.

Eram Chhogala, a registered nurse working in emergency rooms in the Greater Toronto Area, said she's seeing families show up with multiple children needing treatment.

"We're talking whole families of four, maybe even six," Chhogala recalled in an interview. "You have, say for example, three kids all with cough and fever. Three patients that require treatment for a fever."