Palivizumab (Synagis) Administration Began September 15, 2021

Seattle Children’s started administration of palivizumab (Synagis) for eligible patients two months early this year, on September 15, due to high RSV rates seen in late summer and an increase in the number of RSV patients admitted to the ICU needing ventilator support. We are providing Synagis to current Seattle Children’s patients who are eligible. We recommend community providers assess their patients for RSV risk and begin administering Synagis to eligible patients.

Updated AAP recommendations continue to recommend five monthly doses for eligible patients, while recognizing the need for monitoring and flexibility during this atypical season. For more information, visit the CDC website and read the AAP update.

Giving the Flu Vaccine and COVID-19 Vaccine Together

AAP recommendations this year allow for coadministration of the influenza and COVID-19 vaccines. Seattle Children’s is now offering flu vaccines to all eligible and appropriate inpatients, outpatients, Urgent Care patients and Emergency Department patients. We are also providing Rite Aid flu shot vouchers to family members and household contacts age 3 and older during patient visits and stays.

Surging Hospital Occupancy at Seattle Children’s and in our Region

  • New cases of COVID-19 remain high locally, regionally and throughout the nation, although it appears the number of daily new cases is decreasing.
  • Likewise, hospitalizations related to COVID-19 in Washington state remain high but appear to be leveling off to decreasing.
  • Many Washington hospitals remain at or above capacity with significant boarding and impacts to patient care.
  • Inpatient staff-able beds at Seattle Children’s continue to be nearly full. We expect bed occupancy to remain high as we are already in RSV season and entering flu season.
  • We have worked hard to improve inpatient flow and have hired on a substantial number of staff to meet the challenges we are facing.
  • At this time we are not rescheduling any elective surgeries, and our visitor policy remains unchanged. This may change as the evolving situation warrants.
  • Please continue to manage patients in outpatient settings whenever possible to help reduce ED visits and hospital admissions.

COVID-19 Testing and Vaccination as of Tuesday, October 5, 2021:

  • Patients tested for COVID-19: 53,418
    • Positive (detected plus inconclusive): 1,593 (3.2%)
    • Negative: 48,114 (96.8%)

Pre-Procedure COVID-19 Testing Must Use an Accepted COVID-19 Molecular Test

As a reminder, patients with a planned aerosol-generating procedure (AGP) at Seattle Children’s require prior COVID-19 testing with a molecular test (NAAT or PCR) that has FDA approval/emergency use authorization and is highly sensitive in both symptomatic and asymptomatic persons. Outside PCR (nucleic acid amplification) test results from NP/middle turbinate swab samples are accepted if the patient was tested within 48 hours, has stable symptoms and is not considered to be at high risk for COVID-19. Anterior nasal swab specimens are also acceptable when obtained from asymptomatic patients.

Tests Accepted

  • Molecular tests (NAAT, PCR) that are “rapid” (e.g., Cepheid, Biofire) or “regular” (e.g., ours, Hologic, Roche, Abbott Alinity, etc.) and performed in accredited laboratories

Tests Not Accepted

  • Any “antibody” test
  • Any “antigen” test
  • Some molecular tests (NAAT, PCR) with known poor performance (example: Abbott ID Now)
  • Any test result that lacks details about the platform or test method

If you are uncertain about the acceptability of a test result from an accredited laboratory, please find the test on the FDA website (link) and call our Microbiology Laboratory (206-987-2102) with the test name and performing lab and ask for “Director Review” of a COVID-19 test platform. For more information contact

Idaho’s and Alaska’s Declarations of Crisis of Care Standards and Impacts on Washington Hospitals

Washington is closely monitoring the situation in Idaho and Alaska, where healthcare systems have declared crisis standards. We are prioritizing taking in pediatric patients from overburdened adult hospitals. Washington hospitals agreed at the beginning of the pandemic to work together to level-load patients across the state to avoid a hospital or region being forced into crisis standards of care. This remains a challenge, as hospitals in Washington are already at or over capacity.

ED Capacity

Seattle Children’s emergency department continues to experience a significant surge due to high numbers of patients with viral respiratory illnesses including COVID-19 and a significant number of patients with behavioral and mental health crises. We are implementing strategies to manage the surge and have erected a second tent in front of the ED in preparation for what is likely to be a busy winter. Please continue to support your patients’ mental health. Resources include: