Several young children are being treated for respiratory illnesses in recent weeks, with paediatricians linking the early spike of infections to eased COVID-19 measures and an increase in socialising.

While it is normal for respiratory infections, such as seasonal influenza and common colds to increase during the colder months, doctors have noted an increase in young children being admitted to hospitals for respiratory illnesses.

Mater Dei Hospital confirmed an increase in non-COVID respiratory infections in children with approximately a 5% increase in admissions compared to pre-pandemic years.

Most of these respiratory infections are due to adenoviruses (similar to common cold) but are affecting the younger age group, 5 and under, a spokesperson said.

This may be due to the fact that, due to the pandemic, children were not exposed to these viruses due to the preventive measures in place, and therefore they have not yet built an immunity to them yet, a spokesperson told Times of Malta.

This pattern was also observed in the southern hemisphere earlier this year. “It is therefore more crucial than ever to take children to their nearest health centre to take the flu vaccine, which is also available as nasal spray, and to also give older children (12 years and over) the Omicron booster.”

This winter is the first since the outbreak of the pandemic in early 2020, that will see no prevention measures, such as social distancing, use of face masks and regular hand-washing in public life, schools and the workplace.

We are already quite busy in the clinic and in the hospital, but my concern is what will happen once schools start to close their windows because it will be very cold, and influenza season begins? And COVID restarts in schools?

Not only did such mitigation measures control the spread of COVID-19 during the past two years, but they also kept flu cases and seasonal viruses at bay.

As a result of the removal of such measures, health authorities are bracing themselves for what could be a “severe” outbreak of influenza this winter.

This spike is not a local phenomenon.

In recent weeks, the US Centre for Disease Control and Prevention has warned that the country is experiencing a surge of two seasonal illnesses, influenza and respiratory syncytial virus (RSV), much earlier and more intense when compared to previous years.

In Canada, medical experts are already raising the alarm that emergency departments are in a “crisis”, struggling to keep up with the spike in respiratory virus cases.

Last July, health specialists warned in The Lancet that the benefits of pandemic precautions could end up having a negative effect this winter season. Reducing exposure to common endemic viruses such as RSV and flu, experts argued, risked creating an “immunity gap” in people either born during the pandemic or who had not previously built up sufficient immunity against these viruses.

Children previously ‘bubbled’ now catching up with illnesses

Back in pre-pandemic years, paediatricians would see a rise in respiratory illnesses and viruses in children shortly after the start of the scholastic year.

Yet, in the past two years, that trend went out the window.

“In the past two years, children were wearing masks and kept in bubbles, and we hardly saw any of these viruses passing through the community or young children,” consultant paediatrician Prof. Victor Grech said.

Two-year-olds who never faced such viruses before are finally joining playschool and are now sick, week-in, week-out.

“We have concerned parents coming to carry out blood tests on their children to understand what is wrong when what is happening is that their child is catching up with all the illnesses they were not exposed to before.”

Grech said in the past few weeks he and his colleagues have seen unusually high numbers of children with cases of respiratory illnesses, gastric, and even hand-foot-mouth disease.

“The measures were introduced to control and contain COVID-19, a respiratory disease, but the measures also controlled the spread of other respiratory diseases and viruses,” he said.

The government offers the influenza vaccine to everyone for free every year, and this year the government said both the flu and COVID vaccines should be taken at the same time. Photo: Shutterstock.com

Importance of vaccination

Grech’s main concern is how the hospital and clinics will cope once influenza season hits the island and infiltrates the community and schools, as well as a possible resurgence of COVID-19.

“Right now, there are a number of nasty viruses going around, such as RSV, but flu and COVID cases are still relatively low,” Grech said.

“We are already quite busy in the clinic and in the hospital, but my concern is what will happen once schools start to close their windows because it will be very cold, and influenza season begins? And COVID restarts in schools?”

Prof. David Pace, a consultant infectious disease paediatrician, said there is a surge of RSV in several other countries, such as the US.

“Now there is a large proportion of children who are getting the virus for the first time this year. This means more children are becoming ill and spreading the virus compared to previous years.”

Both Grech and Pace urged parents to make sure their children take the flu vaccine, which is also available as a nasal spray, and for the public to take both the flu and COVID-19 booster.

The government offers the influenza vaccine to everyone for free every year, and this year the government said both the flu and COVID vaccines should be taken at the same time.

While aware there is a sense of “vaccine fatigue”, Grech said it is crucial for people to take the jab.

“Right now, children are getting sick, which will then result in the parents getting sick and that illness spreading to more vulnerable people, such as grandparents,” he said.

Both stressed the importance to follow basic hygiene, such as washing hands, vaccination and, if a child is ill with respiratory symptoms, not attend childcare or school until recovered.