As vaccination rates lag and the new delta variant increases, rates of Covid infection in children have increased and children’s hospitals are seeing an increase in the need for medical care in young patients.
The Covid outbreak also adds to an unusual spike in respiratory illnesses among children, typically seen only in winter. This has further reduced the number of beds in children’s hospitals and increased the relentless demand for doctors and nurses.
“It’s scary, especially for kids who don’t quite understand what’s going on. They are hungry for air, struggling to breathe and it’s just scary, ”said Dr. Kelechi Iheagwara, medical director of the pediatric intensive care unit at Our Lady of the Lake Children’s Hospital in Baton Rouge, in Louisiana. “You have the disease, the fear, they can’t breathe, they’re isolated – it’s hard for anyone to understand, but can you imagine what that is for a child? “
His hospital has treated Covid in children aged 3 weeks to 17 years old in recent weeks. Iheagawara said that over the past month his unit had to treat 25 or 26 patients in a space designed for 20 people. Things continue to get worse.
Several doctors in the half-dozen children’s hospitals that NBC News has contacted to say they have seen children infected because a member of their household, often a parent, is bringing the coronavirus home. Often, this is because an adult in the home is not vaccinated.
“Absolutely, domestic infections are the start of this pandemic, which is a major driver of the spread of infections. We see it often in households, from parents to children, ”said Dr. Jim Versalovic, chief pathologist and acting chief pediatrician at Texas Children’s Hospital in Houston. “We have certainly seen siblings – more than two sometimes – with infection at the same time, so the spread within households is certainly a very real phenomenon. “
The Covid peak hit the hospital in mid-July and brought its monthly total to 75 cases – the highest number of coronavirus hospitalizations during the entire pandemic. With 27 children admitted to the emergency room in the first four days of August, the hospital has already recorded more child hospitalizations than in the entire month of June.
Combined with the increase in viral infections out of season this summer, the hospital has been at bed capacity for weeks and the number of Covid cases in children is expected to increase over the next two to three months. It remains particularly worrying because children under 12 remain the most vulnerable to Covid since they cannot yet be vaccinated.
“We’re also a trauma center, so we have to be available for kids who have car crashes and things like that,” said Dr Trey Dunbar, president of Our Lady of the Lake Hospital. “My fear is that with our staff shortage, if this increase continues, how will we continue to care for the children we need beds for? “
Children’s hospitals in areas with an increase in Covid cases are experiencing the same pattern: more children are arriving with symptoms of Covid just before the start of the school year. Bed shortages and overworked doctors and nurses in children’s hospitals are becoming commonplace.
- Arkansas Children’s Hospital in Little Rock welcomed 23 patients under the age of 18 into its system last week. Ten were in intensive care and five were on ventilators.
- St. Louis Children’s Hospital in Missouri saw 13 children go to the emergency room for Covid in the last week of July, then saw 20 who needed beds in the first week of August.
- At Texas Children’s Hospital in Houston, rates of Covid positivity have risen from around 3% to over 10% in children. The number of children hospitalized was in single digits several weeks ago, but rose to more than 30 last week.
- Louisiana Governor John Bel Edwards said on Friday there were 13 children hospitalized with Covid at New Orleans Children’s Hospital, including six children under the age of 2. Four children are in intensive care, including a 3-month-old boy, 23-month-old girl, an 8-year-old girl and a 17-year-old boy.
‘Children in Louisiana have died from Covid and more, sadly, will die,’ said pediatric infectious disease specialist Dr John Vanchiere as he stood next to Bel Edwards at a press conference this week last. “Now is not the time to play politics, fight or threaten lawsuits against masks. Masks save lives. And if you’re a pro-life Louisiana resident like me, wear your mask. “
In the United States, at least 81 children died from Covid between March and July, according to the Centers for Disease Control and Prevention, and many doctors warn the situation is likely to worsen.
Local reactions to these growing numbers, however, are mixed. The governors of Texas and Florida, who are both Republicans, refused to change course on their opposition to the use of masks and any other precautions, even after President Joe Biden pleaded with them to “please help.” Or “get out of the way.”
Meanwhile, the Covid outbreak and the resulting hospitalization rate have risen so much in Arkansas that Gov. Asa Hutchinson, a Republican, recently pleaded for a mask term in schools there. It comes months after signing a bill banning state and local mask warrants.
Doctors and experts said children who returned to school last year did so successfully because Covid precautions were in place. But as the CDC and state and local governments relaxed their guidelines earlier this year, many of those safeguards have evaporated.
“This new variant is a major contributor, but a major problem is that people’s behavior has changed,” said Gigi Gronvall, senior researcher at the Johns Hopkins Center for Health Security. “I don’t think we can absolve people and leaders of this responsibility because it gives them a pass. The reason children are infected is that we do not have these precautions and parents and households are infected. “
Many doctors interviewed expressed frustration that large numbers of people in their community remained unvaccinated and even openly hostile to the measure. This has a negative effect on morale, according to many, especially as the work increases again.
“When I say they’re tired, they’re beyond that. They tell me, “I’m done,” said Dr. Jason Newland, a Washington University infectious disease physician at St. Louis Children’s Hospital. “People say they just don’t want to do it anymore, so we are increasingly limited in bed capacity. Hospital administrators are trying to understand these staff shortages – hats off to them – but these conversations are difficult because it is about the children and those families who need to be cared for. “
Children under 12 are particularly in need of this care because they are the only group that remains completely unvaccinated. The Food and Drug Administration has not issued an emergency clearance to allow them to be vaccinated, fueling concerns as many children are expected to start school in the coming weeks.
Versalovic, whose hospital in Texas is involved in the Pfizer and Moderna vaccine trials for children under 12, said they didn’t plan to send their data to the FDA until well after the start of the school year.
“I hope there will be an emergency clearance soon after the data is released, but we have to face the reality of starting the school year without it,” he said. “We plan to have vaccines available for children during the first half of the school year, but for children under 5 this should happen later in the year, maybe early. by 2022. It will be an ongoing effort. “
It’s hard to hear for many, even in places where Covid outbreaks haven’t recently increased. In areas experiencing only a moderate increase in cases, children’s hospitals remain concerned as they battle a wave of respiratory viruses while dealing with the looming school year and a large population that remains unvaccinated.
Dr Cameron Mantor, chief medical officer at Oklahoma Children’s Hospital in Oklahoma City, said they were struggling with a number of children in hospital beds with respiratory illnesses normally seen in winter, as well as of a depleted workforce. An increase in Covid cases, like what they saw earlier this year or what the northeastern part of the state is currently fighting, could overwhelm them.
“Our challenge is to understand how we don’t get back to the situation we had months ago,” he said. “The big question is, how do you get all these people vaccinated? How do you let them know it’s safe and very effective? How to dispel all the myths?