Hospitals in China are being overwhelmed by patients with respiratory illnesses

Hospitals in Beijing and other cities in northern China are currently struggling with a surge of respiratory illnesses among children, which has led hundreds of patients to wait hours to see a doctor or get treatment.

At Beijing Children's Hospital, an official said the hospital is seeing an average of over 7,000 patients a day, which "far exceeds the hospital's capacity." Similarly, the largest pediatric hospital in the city of Tianjin recently set a new record, with more than 13,000 children visiting its outpatient centers and EDs.

"Right now, we have a lot of kids here," said a staff member at Beijing Friendship Hospital. "Those who booked an emergency appointment yesterday still weren't able to see the doctor this morning."

According to a spokesperson for the country's National Health Commission (NHC), the recent clusters of respiratory infections are being driven by common viruses, including influenza, rhinoviruses, RSV, the adenovirus, and bacteria such as mycoplasma pneumoniae.

NHC has asked local authorities to open more fever clinics and strengthen their case management and treatment systems. The health ministry has also recommended that people wear masks and that parents avoid large hospitals, which could have "long wait times and a high risk of cross-infection."

"Efforts should be made to increase the opening of relevant clinics and treatment areas, extend service hours and increase the supply of medicines," said NHC spokesperson Mi Feng.

The current viral surge is not due to a novel pathogen

Last week, the World Health Organization (WHO) formally requested China provide information on the increase in respiratory cases and clusters of pneumonia in children after several media reports and data from ProMed, a global outbreak surveillance system, shed light on the uptick.

According to AP/ABC News, the emergence of new flu strains or other viruses typically begin with undiagnosed clusters of respiratory illnesses. Both SARS and COVID-19 were initially reported as unusual forms of pneumonia.

However, the Chinese data provided to WHO indicates that the increase in outpatient consultations and hospital admissions among children is due to mycoplasma pneumoniae and common seasonal viruses, such as RSV, adenovirus, and influenza. WHO also noted that Chinese authorities said there have been "no detection of any unusual or novel pathogens or unusual clinical presentations."

Other health experts monitoring the situation in China have also said there is no evidence of a novel pathogen being behind the rise in respiratory illnesses.

"We don't think there is an unknown pathogen hidden somewhere," said Jin Dong-yan, a virologist at the University of Hong Kong's School of Biomedical Sciences. "There's no evidence for that."

"The fact that only children are affected suggests this is most likely to be an existing pathogen," Dong-yan added. "If it's a new pathogen it should mostly hit adults. It looks like it's something adults have got accustomed to."

Similarly, Francis Balloux, a professor at the University College of London Genetics Institute, said that "China is likely experiencing a major wave of childhood respiratory infections now as this is the first winter after their lengthy lockdown, which must have drastically reduced the circulation of respiratory bugs, and hence decreased immunity to endemic bugs."

The increase in respiratory illnesses in China is "expected," said Maria Van Kerkhove, acting director of WHO's department of epidemic and pandemic preparedness and prevention. "This is what most countries dealt with a year or two ago. We asked about comparisons prior to the pandemic. And the waves that they're seeing now, the peak is not as high as what they saw in 2018-2019."

Although a novel pathogen is unlikely to be causing the surge in respiratory illnesses, health experts have called on China to share more information with the public and said that continued monitoring is important.

"[I]n the context of the pandemic due to a relatively new virus such as (the novel coronavirus) and the potential for other new viruses or mutations to cause respiratory tract illness, prompt reporting and monitoring are essential," said Christine Jenkins, a professor of respiratory medicine at UNSW Sydney. (McCarthy/Gan, CNN., 11/24; Bloomberg, 11/26; Faberov, New York Post, 11/27; Reed, Axios, 11/24; Wang, New York Times, 11/25; AP/ABC News, 11/26; Chatterjee et al., BBC, 11/23; Branswell, STAT, 11/24)

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