NHS: Respiratory Syncytial Virus Infections

Baroness Wheeler Excerpts

Thursday 9th June 2022 Grand Committee

[Baroness Wheeler (Lab)]

My Lords, I too thank my noble friend Lady Ritchie for her excellent speech and her tenacity and determination in drawing this important issue to the attention of the Committee. Her warning was timely when she last raised her concerns, earlier this year, about the serious impact of the Covid-19 pandemic on the epidemiology of other seasonal viruses such as flu and RSV, pushing them out of sync. It is vital that plans are in place to ensure that the NHS has the capacity and resources to cope with a potentially extended, or more than normally prolonged, winter season, in particular of RSV.

As noble Lords have underlined, raising awareness among parents about RSV and how to spot the more severe symptoms is crucial. I pay tribute to the Sanofi Pasteur Together Against RSV campaign and its excellent report from last November highlighting the costs to the NHS of RSV, which were outlined so ably by my noble friend and the noble Baroness, Lady Brinton. The Mumsnet baby health website is also doing a great job in supporting parents and linking them to the Sanofi guidance and briefings. However, the fact that its recent survey showed that 37% of parents feel that they have a lack of understanding on how to manage their child’s respiratory illness from home, while 69% have found online information from various health sources overwhelming or confusing, shows the scale of the work still to be done.

Earlier this year, the Minister assured the House that the NHS has plans in place for raising awareness of RSV among parents and at schools. I look forward to hearing the detail of those plans from him. How will be Government support the Together Against RSV awareness-raising campaign among parents? When will government guidelines be updated to adopt the much more user-friendly and accessible information provided by this campaign and parent support organisations, such as Mumsnet?

The pressures on NHS primary care from RSV in children, in terms of GP visits, hospitalisations and antibiotics prescriptions, as highlighted in the Sanofi report and demonstrated by my noble friend Lady Ritchie, are pretty stark: 450,000 GP visits, 125,000 ear infections, 416,000 prescriptions and 30,000 hospitalisations in an average UK RSV season. Hospitalisations and GP visits are substantially higher among younger children infected with RSV than among those who have flu. Last year, the British Lung Foundation warned parents of young children to be alert for signs of RSV after a sharp rise in cases. It estimated that 1,000 children in England alone had needed hospital care for it in just three months. I thank the noble Baroness, Lady Brinton, for explaining her experience with her own grandchildren and underlining how serious RSV can become, as it did in the case of her granddaughter; I am glad that she is now recovering.

Noble Lords have also underlined the global effect of RSV. Experts behind the recent Lancet study, which showed that RSV kills more than 100,000 children worldwide, believe that more children are likely to be affected in future because lockdown and mask-wearing have meant that they have little or no natural immunity to it. Again, my noble friend Lady Ritchie referred to this reduced immunity point.

In the UK, we know that 92% of hospitalisations are estimated to occur in infants under the age of two. During winter months, one in six of all UK paediatric hospital admissions are bronchiolitis-related, with RSV estimated to be the cause of 60% to 80% of those admissions. As the Sanofi guidance warns:

“It is not only the infected child who feels the burden of RSV: families, carers and the health systems are all impacted. The seasonal and contagious nature of this infectious disease has raised national concerns over the possible impact on healthcare capacity at a time when it is already over-stretched … the UK faces a future with co-circulating RSV, Covid 19 and other respiratory viruses”.


What is the Government’s latest assessment of the impact of these co-circulating viruses on primary and secondary care, and on workforce capacity?

We also know that the very young and elderly are at the greatest risk from RSV. The Government guidance points out:

“Only a minority of adult infections are diagnosed, as RSV is not widely recognised as a cause of respiratory infections in adults.”


It also explains:

“Elderly patients are frequently not investigated microbiologically, as there are fewer viruses present in their respiratory secretions compared with children.”


As a result, adult infections are underestimated. Older adults are at greater risk of serious complications from RSV than younger children because our immune systems weaken as we get older. This can lead to exacerbations of underlying lung and cardiac disease. Can the Minister explain what action is being taken to improve testing, reporting and treatment for older adults?

Obviously, the good news is that RSV infection causes mild respiratory illness for most people and can be reduced or prevented through the standard infection control measures that we all got so used to—and, I hope, permanently wedded to—for Covid, of respiratory hygiene, handwashing and cleaning surfaces. My noble friend stressed the importance of working with the devolved Governments on tackling RSV and increasing awareness of the threat it poses. I hope the Minister can reassure us on this, and on how learning, awareness-raising, prevention and treatment are being shared across the UK.

I understand from an article I read in Nature of 21 December last year that there is also hopeful news in the development of a vaccine for RSV after what researchers have called decades of failure. There are four vaccines in late-stage clinical trials involving stabilising the F protein that the RSV virus uses to fuse with cells and infect them. The structure of the F protein has been identified as the best target for making vaccine-induced antibodies that could prevent the virus entering human cells. I understand that these trials are initially testing older people aged over 60. Does the Minister have any further information on this? Can he tell us what research into and funding of RSV are currently taking place?

This has been a valuable debate, and it is clear that there must be action to stop the rampant spread of RSV post Covid—especially this coming winter—causing poor health, soaring costs for the NHS and particular threats to young children. I look forward to hearing the Government’s future plans for addressing this infectious but not widely known about virus.