Rise in childhood coronavirus cases largely preventable, Utah doctor says

When children are hospitalized with COVID-19 in the pediatric intensive care unit, their families face restrictions on being with their child and a sense of isolation, said Jacob Ferrin, RN at the primary hospital for children.

“I’ve seen parents who have to sleep in the bathroom in the bedroom,” Ferrin said Thursday at a virtual press conference. the environment is.

And when hospitals are at 110% of their capacity during the coronavirus pandemic, “there is no way … everything will be done as well as when it is operating at 75 or 80%, where it is. is designed to work, “said Dr Andrew Pavia, who has joined Ferrin, and is head of the pediatric infectious disease division at the University of Utah Health and director of hospital epidemiology at Intermountain Primary Children’s Hospital.

“We hate to say that,” Pavia said, predicting he would likely receive an email from a hospital administrator berating him for the comment. “But,” he said, “it’s the truth.”

“Everyone must recognize it”, according to Pavie. “Overcrowding our hospitals is a patient safety issue. “

While COVID-19 cases are “increasing dramatically” in Utah, “the proportion of cases in children is increasing even faster,” according to Pavia.

This is largely preventable, Pavie said, if people do two things: get vaccinated and wear a mask.

Cases of COVID-19 in children “are not trivial”

“We’re not doing as well as we should be in Utah,” Pavia said, in terms of adults vaccinated.

New data from the Centers for Disease Control and Prevention shows that the more adults vaccinated in a state, he said, the fewer cases of COVID-19 in children.

“Utah is neither the best nor the worst,” Pavia said. “We’re sort of in the bottom third for immunization rates, and we’re in the top third for infections in children.”

Across the country, 250,000 children were infected with COVID-19 last week, “more than at any time during the pandemic,” according to Pavie.

“It’s the result of a real change in the way we behave,” he said, “not to hide in schools. We do not wear masks in public. “

Children can go to school safely, according to Pavia, “but they really need everyone in a classroom to be masked for this to work.”

Pavia said he and other health care providers take it “very personally when people tell us that [masking] doesn’t work, or masks are a personal choice, as if running a red light… or smoking in an indoor space was a personal choice.

“By not protecting children with methods that we know to work, you are harming children,” he said.

In Utah, during “the worst of last winter, about 12% of all infections were in children.” Now it’s around 25%, ”Pavie said. “One in four cases concerns school-aged children. And this is despite the fact that it is quite difficult to get your child tested.

These “mild illnesses” of COVID-19 in children “are not trivial, as people like to describe them,” Pavie said.

Whenever a child gets sick, “it means a parent is staying home after work” and “the other siblings are quarantined,” he said. “It means this child is missing a week from school” or “their class has to close.” “

The increase in cases is also impacting caregivers, who have been stretched over the past 18 months, according to Pavia and Ferrin, the registered nurse at Primary Children’s.

Ferrin remembers falling asleep on the couch after coming home from a shift. His wife was watching a television report on the coronavirus pandemic where “they played a code blue alarm”.

“We’re all basically programmed to jump in and respond to that,” Ferrin said. So, “I jumped off the couch and was ready to respond.”

His wife was confused and Ferrin assured her he would be fine. “We face so many of these intense situations,” he said.

In the pediatric intensive care unit, “we help patients and families cope with situations that present themselves on the worst days of their lives,” said Ferrin. “And since the start of the pandemic, we’ve seen a dramatic increase in the number of people having the worst day of their lives. “

Primary Children’s serves families in a very large area of ​​Intermountain West, he said.

“If someone lives between Denver and LA and between Phoenix and Canada, we are their last line of defense for children who are between a bad event and a funeral,” Ferrin said.

Surges in primary school

The number of children who become very sick with COVID-19 “is becoming very large”, according to Pavie. In the United States, “a record number of children” – 30,000 – were hospitalized last week, he said.

“At Primary Children’s, the number of children in hospital keeps increasing,” Pavia said. “In May, we spent weeks at a time with almost no children in hospital. We are now on average eight to twelve, many of them in intensive care.

Some people may think that “it’s not that high,” Pavia said, but if it’s “your child who has trouble breathing, who is on a ventilator to help him breathe, you worry every time. instant to know if he will survive. “

“Everything hurts” for a child who has inflammation in his body from COVID-19, according to Ferrin.

“Their eyes can turn very red. It hurts when you touch their arm, ”he said. “… I was helping a child get COVID positive, and just turning around was causing a lot of pain and discomfort.”

Whenever people “do a lot of the fact” that fewer children die from COVID-19 compared to adults, “I can tell you that when we lost a child last week, a teenager [from Salt Lake County], that it was absolutely devastating for the staff here, ”Pavie said.

Doctors and nurses at Primary Children’s treated about 100 children, of whom about 95 were residents of Utah, who had a multisystem inflammatory system, an extreme and rare disease of COVID-19, which, among other problems, ” can cause heart damage, ”according to Pavie. A child needed an emergency cardiac investigation, he said.

“We are putting two children in a room right now” at the children’s primary school and are struggling to find beds in intensive care, according to Pavia. “We had to cancel major surgeries in order to have room in the intensive care unit. “

It’s not all because of COVID-19, he said, but “COVID is literally the straw, or the straw bale, that breaks the back of the camel in your healthcare system. “

Utah is also seeing an increase in respiratory syncytial virus, or RSV, which affects children under five, mostly under 2, Pavia said. Usually cases increase in winter and children are hospitalized, many in intensive care.

“Last winter… there was almost no RSV circulation as the children stayed at home and the masks were pretty much universal,” he said.

Then “something we’ve never seen before” happened, he said, and the RSV “came back at the end of the summer” and kept increasing.

“It’s already at a level beyond an average year,” Pavie said, and “is now reaching a level of one of our worst years … with, so far, no decline actual numbers.

Pavie and Ferrin said they are begging the Utahns to help ease the COVID-19 situation.

“If everyone has some ownership of what they can control, it makes a huge difference overall,” Ferrin said.