In the waning months of 2022, the first northern hemisphere autumn with the nearly full relaxation of public health precautions related to the COVID-19 pandemic, hospitals in the United States and Canada[1] began to see overwhelming numbers of pediatric care patients, primarily driven by a massive upswing in respiratory syncytial virus (RSV) cases, but also flu, rhinovirus, enterovirus, and SARS-CoV-2.

[5][6] In late 2023, a similar pattern of pediatric illness appeared to emerge with Mycoplasma pneumoniae in China during the first full autumn and winter season following relaxation of its stringent Zero-COVID policies.

[12] The pediatric care crisis in the United States began to be visible in statistics with high late-summer, August 2022 hospitalization numbers of children infected with rhinovirus and enterovirus, which are both acute respiratory illnesses and often indistinguishable without molecular sequencing or via a specific rRT-PCR assay.

[14] By late October, staff infections with respiratory illnesses had compounded the previous staffing shortages in Ontario causing many emergency rooms and other departments at multiple hospitals to close.

[21] One US state, Oregon, had already declared a public health emergency related to the pediatric care crisis several days prior to the national appeal.

[24] Days later, on November 17, the Canadian Medical Protective Association (a legal defense fund for doctors) issued advice to its members about practising out of scope due to the "unprecedented overcrowding occurring in pediatric hospitals across the country".

Devos also had to turn away patients and could only accept children who were severely ill.[29] The UK's spike in severe pediatric Strep A infections also began to spill over into the United States in December 2022, with Colorado, Texas, and Arizona reporting atypically high numbers of cases in children's hospitals, including two deaths in Colorado, while the World Health Organization noted that the Netherlands, Ireland, Sweden, and France had also begun experiencing unusually high levels of Strep A infections.

[30] A study released on 7 February 2023 found that 40 percent of US households had experienced infection by one of the three primary drivers of the pediatric crisis in North America during the 2022–2023 winter season.

Pediatric beds have also been occupied by greater numbers of young people experiencing mental health emergencies during the COVID-19 pandemic, who have been admitted to ICUs following suicide attempts.

Accordingly, with cases of RSV at 300% more than would be expected in a normal season and rising numbers of adult infections together with increased COVID-19 hospitalizations, some public health professionals have expressed alarm at the potential for spillover into a widespread medical crisis, not confined solely to pediatric care.