Orange County supervisors extended a state of emergency Tuesday because of the sharp rise in respiratory illness that’s filling up local pediatric hospitals with sick children.

Children’s Hospital of Orange County staff said they’re now full – at times sending patients elsewhere. It’s prompting other hospitals to convert their adult beds into those that can treat children.

“Our emergency departments are full,” Dr. Regina Chinsio-Kwong, the county health officer, told county supervisors on Tuesday.

“They are exhausted and overwhelmed.” 

[Read: Respiratory Virus Fills up OC’s Pediatric Hospitals, Officials Declare Emergency]

Local public health officials say it’s driven by a large surge of RSV, or Respiratory Syncytial Virus.

“During the height of the pandemic, RSV and flu cases were diminished. Clearly these cases have come back to new highs,” CHOC’s chief medical officer, Dr. Sandip Godambe, told county supervisors during Tuesday’s meeting.

“We do not know what January and February 2023 will bring – traditionally our highest months.”

The emergency extension allows hospitals to obtain critical medications more easily and get fast-track permission to convert adult treatment areas into those that can treat children, county officials said Tuesday.

It came after an appeal from CHOC and Chinsio-Kwong, and was approved unanimously by county supervisors.

“We’re trying to give CHOC the help it asks us for,Supervisor Don Wagner said at Tuesday’s meeting.

“RSV is a local health emergency right now,” he added. “We are taking our cues from the local health providers, who are saying ‘Help!’”

A Nov. 22 county staff report detailed the impact on pediatric hospitals across Orange County.

“Local licensed pediatric hospitals are operating near/at or beyond capacity,” the report states.

“By mid-day, 100% occupancy,” reads the report.

It’s not just limited to Orange County. 

The nation’s leading group of pediatric doctors – the American Academy of Pediatrics – recently called on President Biden to declare a state of emergency over RSV, citing major capacity problems in children’s hospitals.

State public officials also note an increase in RSV across the Golden State. 

“The reality is that RSV for most kids will cause an inconvenience of a cold … certainly if that’s all it were, we would be a lot less concerned,” said Secretary of the state’s Health and Human Services Agency, Dr. Mark Ghaly, at a news briefing earlier this month. 

But, Ghaly warned, it could cause inflammation in children’s respiratory systems, especially for children two and under. 

And when an illness like RSV surges, officials say local hospitals get impacted.

“The cases we’re talking about here today are serious emergency cases that are unique to children and cannot be treated in a normal emergency room, is that right?” Supervisor Katrina Foley asked Chinsio-Kwong. 

“Correct,” Chinsio-Kwong said, adding that some children require close monitoring by specialized pediatric staff and even ventilators. 

The capacity problems affect all children who need hospitalization, not just those with RSV, county officials said.

Dr. Clayton Chau, director of the OC Health Care Agency, said the state of emergency will also help hospitals treat other children, like cancer patients, by freeing up some space. 

“We’re not only talking about kids with severe respiratory conditions,” Chau told supervisors.

“It’s important to note it’s not just for respiratory disorders, but for other chronic health conditions.” 

At the same time, officials are seeing a rise in COVID and flu cases statewide. 

[Read: Top State Public Health Official Sees Increase in RSV, COVID and Flu]

Locally, CHOC has had to divert some emergency patients to other hospitals, Godambe said. 

“We rarely had to go on diversion, but we had to go on diversion for a few hours a few weeks ago,” he told county supervisors on Tuesday. 

Supervisor Lisa Bartlett asked if hospitals would be constructing tents soon. 

“Rising up tents is the last resort because it requires even more staffing,” Chinsio-Kwong told her.

“All hospitals are encouraged to use every single space they have … before opening a tent.” 

Chau, the county health director, said the RSV cases likely haven’t peaked. 

“I don’t believe the cases are leveled off yet, because we are only in December,” he said. 

“I can’t predict what it is.” 

Spencer Custodio is the civic editor. You can reach him at Follow him on Twitter @SpencerCustodio.

Nick Gerda covers county government for Voice of OC. You can contact him at

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