Influenza A data from The Everett Clinic labs.

Flu, RSV cases spiking early in Snohomish County, doctors warn

ER beds for kids are in short supply in part due to an unusual spike in RSV, which is likened to a “cold on steroids.”

EVERETT — Get your children their annual flu vaccine, because pediatric intensive care and acute beds are at capacity or well above it.

That’s the message from Snohomish County doctors and health officials.

Children are showing up at the ER in part because of an unusually early spike in RSV. Respiratory syncytial virus is a very common illness that can cause severe problems for infants, as well as children with certain medical conditions. It’s a “cold on steroids,” said Dr. Ryan Keay, an emergency physician at Providence Regional Medical Center Everett.

Health care workers are concerned about their capacity to meet the community’s needs, Keay said.

Using Washington’s Medical Coordination Center to find pediatric ICU beds elsewhere has become an “almost daily occurrence” at Providence, she said.

For about 1% to 2% of infected young children and infants, RSV can require hospitalization for difficulty breathing and dehydration. There is no vaccine and no medicine to treat RSV specifically.

The Washington State Hospital Association hosted a media briefing Monday about a “pediatric surge” in emergency room visits. Doctors and administrators said a combination of RSV, a growing number of flu cases, delayed care during the COVID pandemic and children with behavioral health crises have led to this surge. Seattle Children’s ER is at 100% capacity almost all day every day, and up to 300% capacity some evenings, said Dr. Tony Woodward, medical director of emergency medicine at the hospital.

According to the U.S. Centers for Disease Control and Prevention data, the RSV weekly case average in Washington has already far exceeded 2021 levels. Preliminary lab results currently show a rolling weekly average of 552 cases. Due to years of COVID prevention measures, fewer children have already been exposed to RSV, health officials said.

While there is no data on RSV across Snohomish County, local doctors report high numbers and busy waiting rooms. And they are concerned that in addition to RSV, the flu season is starting and spiking early.

The Everett Clinic’s labs run about one-third of flu tests in the county, said Dr. Yuan-Po Tu, medical director for Optum’s infectious disease and outbreak response in the state.

Tu expects this week’s influenza A cases to exceed 500 in Snohomish County, compared to just 33 for the week ending Oct. 30. He said typically those high rates of infection continue for 12 to 16 weeks, through the winter holidays.

“I think people are so tired from COVID and they don’t understand the urgency of what we’re talking about,” said Dr. Mary Alice King, medical director at Harborview Medical Center’s pediatric ICU. “We need to flatten this RSV curve and we need to think proactively about flattening the influenza curve because we are out of beds.”

When the ER is full, people go to urgent care and walk-in clinics, Tu said. Their offices are overwhelmed. For much of Tuesday, wait times at all Everett Clinic walk-in locations exceeded four hours.

Experts recommend families do everything possible to try to slow the increase in RSV and flu cases. That includes going back to some COVID practices like:

• Keep kids home when they are sick.

• Cover coughs and sneezes.

• Wash hands frequently.

• Sanitize high-touch surfaces and objects at home.

• Consider masking up again indoors.

Additionally, the Snohomish Health District issued a health advisory on Nov. 8, urging health care providers to emphasize flu and COVID vaccines for children age 6 months and older. Keay and Tu both urged parents and caregivers to get flu shots immediately for everyone who is eligible.

When kids do get sick with a respiratory illness, parents and caregivers should check in with their primary care provider and watch for difficulty breathing or a persistent cough at night that seems to be getting worse. With infants, they might struggle to eat or drink enough, so watch for dehydration.

“The vaccine is way safer than getting infected with influenza,” Tu said.

Find general resources on RSV from EvergreenHealth at

Find tips for when your kids do get sick at

Find flu shot resources from the Everett Clinic at

Joy Borkholder: 425-339-3430;; Twitter: @jlbinvestigates.

Joy Borkholder is the health and wellness reporter for The Daily Herald. Her work is supported by the Health Reporting Initiative, which is sponsored in part by Premera Blue Cross. The Daily Herald maintains editorial control over content produced through this initiative.

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