Wave of colds in daycare centers

In the second fall without Oktoberfest, many thought Munich would be spared the traditional Wiesn flu wave. But now it's clear: coughs, colds, scratchy throats - everything is back. All kinds of pathogens are rampant, especially in daycare centers and kindergartens, and a conspicuously large number of children are ill. The pediatricians' offices are working at their limits, and the clinics are also full. It is an unusual situation for which the coronavirus is not directly responsible, but it does have something to do with the pandemic.

Since September, the Robert Koch Institute (RKI) has already recorded an increase in respiratory infections throughout Germany. This is earlier than in previous years when many viruses and bacteria did not really take hold until the turn of the year. Young children are particularly affected this fall. According to the RKI, colds, bronchitis, pharyngitis, and tonsillitis, as well as cases of flu, have been diagnosed among them significantly more frequently than in the previous year, when the institute recorded what was probably the weakest influenza season in decades due to the Corona protection measures.

A large proportion of infants and young children are infected with the respiratory syncytial virus (RSV), a respiratory tract infection that affects the bronchial tubes and can trigger pneumonia. Last year, many were spared infection because other germs can also be well curbed by reducing contact, spacing out, ventilating, and wearing masks. And so the 2020 and 2021 cohorts are now experiencing their first infections at the same time.

"Many parents are unsettled because their children have not been sick for a long time," says Ludwig Schmid, who works in a group practice in Obersendling. Usually, he says, the illnesses are harmless, but they can last for a few weeks. "Many people think children's immune systems are weak, but the opposite is true," he says. The child's immune system needs the infections to be trained, he says. "Exercising: That's what it's doing right now." Just a few months earlier than usual, where practices didn't fill up until December.

"Among zero- to four-year-olds, more than 20 percent of the age group currently suffer from respiratory infections, which corresponds to an incidence of more than 20,000 for normal respiratory infections," says Michael Hubmann, state chairman of the Bavarian Association of Pediatricians and Adolescents (BVKJ). He supports a move by the Bavarian Ministry of Family Affairs to allow children with a cold to attend daycare and kindergarten with a negative rapid test result from home with immediate effect. Until now, a PCR or PoC antigen rapid test had to be presented in order for a child with mild symptoms of the disease to be allowed to attend.

That should ease the burden on pediatricians. "The practices are flooded with inquiries and patients. It's almost unbearable," says Gabi Haus, chairwoman of PaedNetz München, an association of a good 100 Munich pediatrician and adolescent practices. The pediatrician has a practice on Candidplatz in Untergiesing. In recent weeks, she says, children with trivial infections have been presented there more frequently again, because parents need certificates for kindergarten, daycare, school, or employers. "Zettelitis," she calls it, which unnecessarily holds up doctors and physicians. "We have to triage quite a bit. That hits some people harder," she says, prioritizing children according to the severity of their illness rather than how long they've been waiting.

This leads to resentment among staff and patients. 15 to 20 infections per year is normal for small children, says doctor Haus. She advises parents to be patient: "If a cough hasn't gone away after two days and there are no dangerous symptoms such as fever, you don't need to go to the doctor," she says, and adds demand to politicians: "All the ballast has to go away. All the rules should be considered in tandem and then communicated in a timely manner. The pandemic will be with everyone for some time, she adds. And, "I don't know any colleague who sits there and has nothing to do."

This is also reflected in Munich's hospitals. According to the Intensive Care Register of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), almost all pediatric hospitals have reported only limited capacities or no vacant intensive care beds at all. The statistics change daily, beds become vacant, patients are discharged or transferred. Even before Corona, hospitals were often so full during the winter months that young patients had to be turned away. That's why this year the bed call starts as early as October.