Surge in respiratory illnesses among children overwhelms Beijing hospitals following Covid
Hospitals in Beijing and northern China are overwhelmed as a surge of respiratory illnesses hits children, following the relaxation of Covid-19 measures nearly a year ago
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Hospitals in Beijing and northern China are currently facing an increase in respiratory illnesses among children as the country experiences its first winter season since easing Covid-19 restrictions nearly a year ago.
Wait times at children's hospitals in major cities across northern China are reaching hours, with hundreds of patients waiting to see doctors, as reported by CNN and Chinese state and social media. An official at Beijing Children's Hospital stated that the current average of over 7,000 daily patients far surpasses the hospital's capacity. Additionally, the largest pediatric hospital in Tianjin received over 13,000 children at its outpatient and emergency departments, setting a new record.
CNN contacted the Beijing Friendship Hospital to inquire about appointment availability and was informed by a staff member that it could take an entire day to secure an appointment with a pediatrician. The staff member explained that due to the high volume of children needing care, even those with emergency appointments from the previous day were unable to see the doctor that morning.
Health authorities in Beijing and other major cities in northern China have reported that common seasonal illnesses such as influenza, respiratory syncytial virus (RSV), and mycoplasma pneumonia are the leading causes for the recent increase in cases. This trend in northern China is consistent with the rise in seasonal respiratory infections in the northern hemisphere, including the United States, where RSV is currently spreading at alarming rates among children.
However, global concern was raised after the World Health Organization (WHO) requested China to provide more information on the rise in respiratory illnesses and "reported clusters of undiagnosed pneumonia in children," based on a report from open-source surveillance system ProMED. Following discussions with Chinese health and hospital officials, the WHO concluded that the data indicated an increase in outpatient consultations and hospital admissions of children due to mycoplasma pneumonia in May and common seasonal illnesses RSV, adenovirus, and influenza virus since October.
WHO reported that while some of these increases in cases are occurring earlier in the season compared to historical patterns, they are not surprising given the relaxation of Covid-19 restrictions, which has been observed in other countries as well. Additionally, the agency stated that Chinese authorities have not identified any new or unusual pathogens or clinical presentations.
External specialists monitoring the situation have also observed that there is no indication of a new pathogen causing the situation, but have urged China to disclose more information concerning the situation to the public.
"We do not believe that there is an unidentified pathogen present," explained Jin Dongyan, a virologist at the University of Hong Kong's School of Biomedical Sciences, in an interview with CNN. "There is no supporting evidence for that."
Catherine Bennett, an epidemiologist from Deakin University in Australia, expressed concern about the possibility of a new pathogen or increased disease severity causing the rise in childhood pneumonia. "As of now, we have not received any reports of either," Bennett stated, emphasizing the need to monitor sources of infection in order to address these concerns.
Children receive intravenous drips at a children's hospital in Beijing on November 23, 2023.
Jade Gao/AFP/Getty Images
Crowded hospitals
In recent weeks, Chinese parents have been expressing their frustration on social media regarding the overcrowding at hospitals. They have reported long wait times for their children to see a doctor, as well as extended waits for necessary procedures such as blood tests or receiving an intravenous drip.
Due to China's underdeveloped primary care system, individuals often turn to hospitals or emergency rooms as their initial contact for medical care. This has resulted in overcrowding, especially during peak seasons.
A photo widely circulated on the Chinese social media platform Weibo displayed a hospital screen indicating a queue of over 700 patients and an estimated wait time of 13 hours. At a pediatric hospital in Beijing affiliated with the Capital Institute of Pediatrics, the crowded halls were captured in viral videos, showing children with IV drips sitting on their parents' laps and others lining the hallways on folding stools.
Chinas national health authorities and hospital officials have consistently advised parents against immediately taking their children to large pediatric facilities. Instead, they are advised to seek initial diagnosis and care at other health centers offering primary or general services. The National Health Commission (NHC) cautioned parents about the long wait times and potential risk of cross-infection at large hospitals, and suggested seeking triage at different types of facilities.
The NHC has instructed "all localities" to improve their case management and treatment systems, specifically in identifying severe cases among the increasing number of patients.
Meanwhile, the Beijing municipal government has reissued a state media article that includes a doctor advising parents against immediately requesting intravenous fluids when a child has a fever.
The WHO on Thursday said Chinese officials reported that "the rise in respiratory illness has not resulted in patient loads exceeding hospital capacities."
Post-Covid surge
The increase in hospital visits aligns with China's initial winter season without its "zero-Covid" restrictions, which enforced strict social distancing and mask wearing. These regulations were suddenly eased in December following rare protests against the pandemic measures, which included strict lockdowns.
It's unclear whether there has been an increase in respiratory illnesses or severe cases among children compared to pre-pandemic years due to the limited public data released by China. According to Jin, a virologist at Hong Kong University, the prevalence of these common respiratory diseases may have been underestimated during the zero-Covid period when people avoided hospitals, and incidence was low due to social distancing measures.
"It is perfectly normal for there to be a significant increase this year compared to last year. However, whether it is a substantial surge compared to 2018 or 2019 is still uncertain," he explained.
Jin also mentioned that social factors may be affecting the current situation, as parents might be more concerned about their child's health after the pandemic, leading more of them to seek medical assistance.
Since the emergence of the coronavirus pandemic in late 2019, there has been increased focus on disease outbreaks. Calls for greater transparency, including from China, have been made due to accusations of hindering investigations into the virus origins and withholding early information about its spread.
According to Christine Jenkins, a professor of respiratory medicine at UNSW Sydney, the increase in viral respiratory tract infections in children during this time of year is a familiar occurrence that has been observed globally for many decades with the onset of winter.
She emphasized the importance of timely reporting and monitoring in the midst of the pandemic caused by a new virus like the novel coronavirus, as well as the potential for other new viruses or mutations to lead to respiratory tract illness.
