Kids sick with Covid are filling up children’s hospitals in areas seeing spikes

As vaccination rates lag behind and the new delta variant rises sharply, the number of Covid infections among children has risen and children’s hospitals are seeing a spike in the medical care needs of young patients.

The Covid wave is also piling up on an unusual spike in childhood respiratory disease typically seen only in winter. This has further reduced the bed space 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’re 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, Louisiana. “You have the disease, the fear, they can’t breathe, they’re isolated — that’s hard for anyone to understand, but can you imagine what it’s like for a child?”

Kelechi Iheagwara, the medical director of the Our Lady of the Lake Children’s Hospital Pediatric Intensive Care Unit.Our Lady of the Lake Children’s Hospital

Her hospital has been treating Covid in children aged 3 weeks to 17-year-olds in recent weeks. Iheagawara said her department has had to treat 25 or 26 patients in the past month in a room designed for 20. And things are getting worse.

Multiple doctors at the six children’s hospitals contacted NBC News 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 house has not been vaccinated.

“Absolutely, household infections are the start of this pandemic, which is a major driver of the spread of infections. We often see it in households, from parents to children,” says Dr. Jim Versalovic, chief pathologist and interim chief of pediatrician at Texas Children’s Hospital in Houston. “We’ve definitely seen siblings — sometimes more than two — with an infection at the same time, so spreading within households is certainly a very real phenomenon.”

The Covid-19 spike hit Baton Rouge Children’s Hospital in mid-July, bringing the 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 seen more children’s hospitalizations than in the entire month of June.

Coupled with the increase in off-season viral infections this summer, the hospital has been running at bed capacity for weeks and the number of Covid cases among children is expected to grow over the next two to three months. It remains particularly worrisome as children under 12 remain the most vulnerable to Covid as they are not yet able to receive the vaccinations.

“We’re also a trauma center, so we need to be available to kids who get into car accidents and things like that,” says Dr. Trey Dunbar, the president of Our Lady of the Lake Hospital. “My fear is that with our staffing crisis, if this wave continues, how can we continue to take care of the children we need beds for?”

Children’s hospitals in areas with an increase in Covid cases experience the same pattern: just before the start of the school year, more children come in with Covid symptoms. Bed shortages and overworked doctors and nurses in children’s hospitals are becoming commonplace.

Arkansas Children’s Hospital in Little Rock had 23 patients under the age of 18 enrolled in the system last week. Ten layers in the ICU and five layers on the ventilator. St. Louis Children’s Hospital in Missouri saw 13 children come to the emergency room for Covid the last week of July, and then it saw 20 needing beds the first week of August. 3 percent to above 10 percent in children. The number of children hospitalized was in single digits a few weeks ago, but soared to more than 30 last week. Louisiana Gov. John Bel Edwards said on Friday that 13 children with Covid have been admitted to Children’s Hospital New Orleans, including six under the age of 2. Four children are in the ICU, including a 3-month-old boy, a 23-month-old girl, a girl aged 8 and a boy aged 17. Mark Toney, chief of the Hospital Pediatrics Program at Wolfson Children’s Hospital in Jacksonville, Florida, talks to medical students and nursing staff during rounds of one of the pediatric wards on Aug. 6, 2021. Toney and his associates are dealing with an increasing number Covid-19 Infected Children .Bob Self/Florida Times-Union via USA Today Network

“Children in Louisiana have died from Covid and unfortunately more will die,” said Dr. Child infection specialist John Vanchiere, when he stood next to Bel Edwards at a press conference last week. “This is not a time for politics, for fighting or threatening lawsuits over masks. Masks save lives. And if you’re a pro-life Louisiana resident like me, wear your mask.”

At least 81 children in the US have died from Covid between March and July, according to the Centers for Disease Control and Prevention, and many doctors are warning that the situation is likely to get worse.

However, local reactions to these growing numbers have been mixed. Texas and Florida governors, both Republicans, have refused to change course over their opposition to the use of masks and other precautions, even after President Joe Biden pleaded with them to “please help” or “get out of the way” .

Meanwhile, the Covid wave and resulting number of hospitalizations have gotten so bad in Arkansas that Governor Asa Hutchinson, a Republican, recently called for a mask mandate in schools there. This comes months after he signed a bill banning state and local mask mandates.

Doctors and experts said children who returned to school last school year successfully did so because Covid precautions had been taken. But when the CDC and state and local governments relaxed their guidelines this year, many of those safeguards evaporated.

“This new variant is an important contributor, but a major problem is that people’s behavior has changed,” said Gigi Gronvall, senior scientist at the Johns Hopkins Center for Health Security. “I don’t think we can fire people and leaders for this because it gives them a pass. The reason children get infected is because we don’t have those precautions and parents and households get infected.”

Wearing masks to prevent the spread of Covid, elementary school students walk to classes to start their school day in Godley, Texas, on Aug. 5, 2020.LM Otero / AP

Many of the doctors interviewed expressed frustration that a large number of people in their community were unvaccinated and even openly hostile to the measure. It has a negative effect on morale, many said, especially now that work is on the rise again.

“When I say they’re tired, they aren’t anymore. They say, ‘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’re getting more and more limited in bed capacity. Hospital administrators are trying to figure out these staff shortages – hats off to them – but these conversations are difficult because it comes down to the children and these families who need to be cared for.”

Especially children under the age of 12 need this care, because they are the only group that is completely unvaccinated. The Food and Drug Administration has not released an emergency clearance for them to receive the injection, fueling concerns as many children will be attending school in the coming weeks.

Versalovic, whose Texas hospital is involved in the Pfizer and Moderna vaccine trials for children under 12, said they don’t expect to send the FDA their data until long after the school year starts.

A child watches as a nurse administers an injection of the COVID-19 vaccine during a pop-up vaccination event at Lynn Family Stadium in Louisville, Kentucky, on April 26, 2021. Jon Cherry / Getty Images file

“Hopefully there will be an emergency clearance soon after we release the data, but we have to face the reality that we have to start the school year without it,” he said. “We expect vaccines to be available for children in the first half of the school year, but for children under 5 that will likely be later in the year, possibly early 2022. It will be an ongoing effort.”

That’s hard for many to hear, even in places where Covid outbreaks haven’t increased recently. In areas with only a moderate increase in cases, children’s hospitals are still concerned as they fight a rise in respiratory viruses as they face the approaching school year and a large population that has not been vaccinated.

dr. Cameron Mantor, the chief physician at Oklahoma Children’s Hospital in Oklahoma City, said they are battling a number of children in hospital beds suffering from respiratory illnesses that normally occur in the winter, and a depleted workforce. A wave of Covid cases like what they saw this year or what the northeast of the state is fighting right now could overwhelm them.

“Our challenge is to figure out how not to get ourselves back into the situation we had months ago,” he said. “The big question is, how do we get all these people vaccinated? How do we let them know it’s safe and highly effective? How do we dispel all myths?”

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