Abstract

During the COVID-19 pandemic, pediatric respiratory infections dropped drastically worldwide. However, in the 2023 fall-winter season, these diseases re-emerged in an unusual manner, placing significant strain on the healthcare system. Comparing 2023 data with the five-year pre-pandemic data from the Department of Health Statistics and Information (DEIS) of Chile, we observed that the magnitude and frequency of pediatric respiratory diseases were similar. However, the stress on the healthcare system was due to the early demand, the synchronicity of age groups, geographic heterogeneity, and global and local response capacity. In the Metropolitan Region (RM), cases did not increase but presented 4 weeks earlier. In the central, south-central, and southern regions, cases appeared earlier and over a shorter period, resulting in a peak of up to 4 times more hospitalizations and emergency visits. The effectiveness of public policies, such as changes in annual school schedules and immunization against respiratory syncytial virus (RSV), requires an objective and multisectoral analysis. Policies need adjustements to avoid overrepresentation of the RM and to promote publicprivate collaboration to improve data on RSV burden, thus improving standards of care, treatments, and their availability throughout Chile. © 2025, Sociedad Chilena de Pediatria. All rights reserved.