Your child's sick. When is it time to go to the hospital? A Yukon pediatrician explains

There are a lot of bugs going around in the Yukon right now — just ask any parent, or pediatrician.

"We're just seeing, you know, really huge levels of circulation of all sorts of viruses," said Dr. Katharine Smart, a Whitehorse pediatrician.

"Lots of the families I've been seeing have felt like their kids have just been sick continuously over the last few weeks."

Smart says Influenza A is hitting Yukon especially hard right now, along with other common respiratory viruses. 

"I think it's really just because, as we're coming out of the pandemic, we're getting away from the public health protections that we were using more routinely," she said.

"There's a whole cohort — really three years of children — who have had a lot less exposure to these common viruses and now they're back in circulation and the impact is many, many kids being quite sick."

Smart spoke to Yukon Morning host Elyn Jones about how families should deal with the "huge whammy" of illnesses — and when it's time to see the doctor.

This interview has been edited for length and clarity.

How are these illnesses affecting the families you're seeing?

I've just finished seven days of call at the hospital. We're admitting more kids than we probably ever have, with various complications from viruses as well as secondary bacterial infection.

So of course, for those families, it's incredibly stressful to have your child ill enough to have to be hospitalized. And for families whose kids are sick but not necessarily needing hospitalization, I think it's also been really stressful.

A lot of missed school, missed work for families, and just that stress of not quite knowing, you know, how worried should you be? How many days of being sick is too many? How high is the fever before you should be concerned? These types of questions are really on the minds of people and I think it's been really challenging.

What sort of things should people consider when deciding whether or not to take their sick child to the hospital?

That's a really important question. There are really four scenarios that I always want families to be aware of, which are times when you really need to seek medical care.

The first is if you have an infant who's three months or younger with a fever, that really needs to be seen by a physician. The risk of significant illness is much higher in younger babies. So we want to see those kids.

And then there's really three other situations for older children where we're worried.

The first is work of breathing or any respiratory distress. So if you're looking at your child, and they're breathing quickly or they're having [chest] indrawing, meaning you're seeing them using the muscles in between the ribs, sucking under the ribs, above the ribs, like it's hard for them to breathe or they're going off colour at all — that's a definite sign that you need to be seen at the hospital.

The second is their overall appearance. Most kids when they're unwell with a viral illness will have periods of being OK and then of course periods of not feeling as well. What you'll see as a parent is that sort of up-and-down, and moments of feeling like your child's acting more normally. A really sick child will become really lethargic, where they're just not responding normally to their parents or their environment. And you'll look at your child and it's like, wow, I'm just not seeing those moments of my child perking up,or feeling better — that's always really concerning, and that's another reason to seek care.

The third is hydration. Kids can get dehydrated from illness, both from vomiting and diarrhea, but also other respiratory illnesses if they're just having trouble with their intake. So then you're going to notice: no tears when they cry, dry mucus membranes inside the mouth, and maybe not peeing as much. Most children should pee at least two to three times a day. So if those things are changing, that's another reason to seek medical care.

What kind of stress is all this putting on our health-care system in the Yukon right now?

Definitely a very busy emergency department, and again they're seeing a lot more children than we would typically see.

We've certainly been very busy on the pediatric service. We've had a lot of sick children. So that's always challenging because of course we don't have a lot of people. There's one of us who's on call for a week at a time.

But what's amazing here is we really have an incredible team of health professionals. People really rally to help each other and it's an incredible team environment at the hospital. So I really think that people are doing their best to make sure that families are getting the care that they need.

What kind of changes, though, could be put in place to maybe make things better?

Well, I think what's really important in terms of the messaging right now for families is, you know, please get your flu shot if you haven't had it yet. It's also important to have the COVID vaccine, but right now it's really influenza that's causing the issue. So if you haven't been vaccinated, please get vaccinated.

Only about one in four kids in the territory is vaccinated. And I can tell you the kids I've been seeing in hospitals that have been really ill, have all been unvaccinated. So that's a key thing.

Staying home when you're unwell and keeping your children home when they're unwell is important, really good hand hygiene, and I'd really encourage people to think about masking when they're in indoor spaces right now.

It's all those things together that can help blunt those surges of respiratory viruses and protect the most vulnerable among us, which are really young children under five, and older adults.

What should people think about, if they're getting together with family and friends over the holidays?

I think going into the holidays, you know, if everyone is vaccinated, that's really going to be helpful.

Of course in the holidays we want to be together, but if you're not feeling well, really, strongly consider staying home. You know, what might be a mild cold for an adult can be a very serious illness for a young child or an elder. So I think we need to be mindful of that going into these holiday gatherings.

And again, I think masking, and good hand hygiene before you go into these events is helpful because it's just going to decrease your chance of picking up a virus in the community and bringing it home to your loved ones. So prevention, I think it is really the key right now — because we do want to be able to gather and have that time with people that matter to us.

And the government has added some vaccination clinics for youth in particular, at the convention centre in Whitehorse?

That's right. A lot of families were struggling to get their younger children in. So kids five and under do need to be vaccinated at the convention centre — they're not able to receive a vaccine at the pharmacy and the demand was so high that there were no spots, which was great. It's wonderful to see people so keen to have their children vaccinated.

But public health was able to provide more spots. So please go online and book that.