Some hospitals in Covid-19 hotspots are busy treating children



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“The clinics were packed,” Cadilla said. His hospital has seen a significant increase in the number of children with Covid-19. They also manage an earlier rise than usual in other respiratory illnesses. The kids aren’t sicker with Covid-19, necessarily, there are just more of them, Cadilla said.

“We know how to deal with a lot of these things, including Covid,” Cadilla said. “But it’s a public health crisis because when you overload the system, we can’t do a lot of things well.”

It’s frustrating, she said, because while they can provide supportive care for children, treatments like monoclonal antibodies are not allowed for children under 12, and neither are vaccines. .

What is even more frustrating for her is that some families of her patients tell her that they will not get vaccinated, or that they will not have everyone vaccinated until their child is hospitalized.

“I saw one today who had the brother who was eligible vaccinated, but it’s just a difficult way to learn that vaccines work by hospitalizing a loved one,” Cadilla said. These hospital admissions, she said, are completely preventable.

With the start of the school year, Cadilla is worried if more people do not get vaccinated, her hospital will become much busier.

“We are trying to prepare for the unimaginable,” Cadilla said.

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Nationwide, cases of Covid-19 in children have been on the rise since early July after months of decline. Nearly 94,000 cases in children have been added over the past week, the American Academy of Pediatrics said in what the group described as a “continuing substantial increase.”
The vast majority of cases do not end in hospital. Overall, the cumulative hospitalization rate of children with Covid-19 has remained stable at around 1% since December, according to the AAP, which means that hospitalization is still rare compared to the number of adults who were hospitalized. Nearly 189,000 adults have been hospitalized since the start of the pandemic, according to the CDC.

Yet, on Saturday, the number of children hospitalized increased week-over-week, according to the U.S. Centers for Disease Control and Prevention.

Specifically, there has been an average of 203 children with Covid-19 admitted to U.S. hospitals each day over the past week, according to CDC data. This is an increase of more than 21% compared to the previous week in new daily hospitalizations in Covid-19 patients aged 0 to 17 years old.
“I think in most areas we are approaching or exceeding the capacity of pediatric intensive care,” said Mark Wietecha, CEO of the Children’s Hospital Association, an association that represents more than 220 children’s hospitals. Hot spots for children’s cases are pretty much everywhere where adult Covid-19 hot spots are, he said.

Wietecha said hospitals are also overburdened to deal with other illnesses, including respiratory syncytial virus (RSV) cases, which he says are much higher and much “nastier” this year. He said those hospitals have also handled severe spikes in pediatric behavioral health or mental health cases throughout the pandemic. This will likely increase as well, as it usually does, when school resumes.

“There were a lot of things that add up that added all this pressure on the beds,” Wietcha said. “We don’t have a great national surge capacity in pediatrics.”

“This is a big problem and an immediate problem.”

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As of Monday, there were also at least 542 pediatric deaths linked to Covid-19, according to the CDC. Child deaths are still considered rare, and seven states in the United States have not reported any child deaths. While this may not seem like much, given the more than 614,000 deaths in the United States overall, the death of a child from any disease is generally incredibly rare.

When asked if children should really get vaccinated, CDC director Dr Rochelle Walensky put these deaths into perspective during a hearing for the US Senate Committee on Health, Education, work and pensions at the end of July.

“One thing I just want to note with children is: I think we fall into this mistaken thinking of saying that only 400 of those 600,000 deaths from COVID-19 have occurred in children. Children are not supposed to die , so 400 is a huge one, ”Walensky said.

“Things are moving a little too fast”

Justin Senior, CEO of Safety Net Hospital Alliance of Florida, which represents several children’s hospitals in Florida, said they are seeing an overall hospitalization of 1-2% among pediatric patients and this has been fairly consistent throughout the year. pandemic. Miami Children’s Nicklaus Hospital has 24 patients, including seven in intensive care, for a total of 39 patients. At the Johns Hopkins All Children’s in the Tampa Bay area, there are 15 children in the intensive care unit.

“These recent surges are a really dark cloud, just very, very bad,” Senior said. “But at the same time there are some bright spots and one is that this virus – touching wood – still doesn’t seem to impact children as much as it does adults and that’s a good thing. . ”

In the Miami area, Dr Aileen Marty, an infectious disease expert at Florida International University, said children’s hospitals were overwhelmed.

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“Our pediatricians, nurses, staff are exhausted. And the children are suffering,” Marty said. “It’s absolutely devastating… We’ve never seen numbers like this before.”

Experts say it’s still not clear whether the Delta variant causes more serious illness in children, despite being more communicable.

Dr Amy Edwards, an infectious disease specialist at Cleveland University Hospitals, said it is clear from the data that Covid-19 is now sending more children to hospital.

What is not clear, she said, is whether it’s because more children get the virus, or if the virus somehow makes the children who catch it sicker than it does. before, requiring treatment in a hospital.

“Things move a little too fast, and we know full well that, especially with kids, we don’t test enough to really understand exactly what’s going on,” she said.

Edwards said her hospital was not yet flooded, but she expects them to see more cases in a few weeks. The Children’s National Hospital in Washington, DC could be on the same path. He saw a slight increase in the number of children testing positive for Covid-19, but said the increase had not yet had much of an impact on the number of hospital admissions. The Lurie Children’s Hospital in Chicago is also monitoring cases closely.

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“We expect Covid-19 activity to increase over the next few weeks,” said Dr. Larry Kociolek, associate medical director of infection prevention and control at Lurie Children’s Hospital in Chicago.

Wietecha, with the Association of Children’s Hospitals, said people need to be careful when they think children have escaped Covid-19.

“I think the idea that kids are healthy and well is a unicorn,” Wietecha said.

Children are not immortal, he said, and it should be very rare for a child to need to go to the hospital. The fact that even a few hundred have it is too much.

“I think a lot of parents think their kids are somehow safe and unfortunately we find out otherwise,” Wietecha said.

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