D.C. Children’s Hospitals are full of respiratory illnesses
Pediatricians locally and nationally reported an increase in respiratory illnesses from RSV and rhinovirus — the common cold virus — that hit earlier for the second year in a row and made children sicker than usual. At the same time, coronavirus Circulation continues, and hospitals are preparing for a serious flu season
“We’re treating too many critically ill children,” said Sarah Combs, an emergency medicine physician at Children’s National.
At one point Tuesday, 18 children were waiting for a bed in the pediatric intensive care unit, or PICU, at Children’s National, which has 323 people. Inpatient bed and primarily serves the greater Washington area. The system cares for children as far away as Virginia and Maryland as well as Pennsylvania and Delaware. Even as they detailed the crisis, officials stressed that the hospital’s inpatient, intensive care and emergency departments would remain open and that children in need of care would never be turned away.
Experts have speculated that the impact of stopping the pandemic two years ago, when precautions were in full swing, may have meant that children’s immune systems took a break and were not prepared to fight off the illness this year. Even without an epidemic, they say, some viruses are particularly deadly over several years.
When inpatient beds are full, children who come to the hospital through the emergency department and are sick enough to be admitted have nowhere to go and must stay in the emergency room until a bed opens up or they are well enough to go home. The situation is especially critical when a child requires intensive care.
Sophia Teferi, a pediatrician at MedStar Montgomery Medical Center, said Wednesday that she was treating a 4-month-old in the emergency department because she could not find a patient intensive care bed in the area.
“You have to look at the parents and say your child needs ICU-level care but we don’t have a bed for them: it’s a very difficult conversation,” he said. “In the nation’s capital — I’m overwhelmed by the whole thing.”
The situation is not unique to the DC metropolitan area. At the height of the epidemic, in many cases, hospitals converted pediatric beds to treat adults and never returned them. Henrico Doctors Hospital in Richmond off Fewer patients refer to pediatric inpatient and PICU beds this spring. The problem is pre-Covid. MedStar Franklin Square Medical Center off Its inpatient pediatric unit in 2018 for the same reason.
Eric Biondi, chief of pediatric hospital medicine at Johns Hopkins Children’s Center, said the hospital’s 80 pediatric acute-care beds, 20 oncology beds and about 28 PICU beds are “absolutely full.” The hospital has reached this point a few times with pandemics, he said, but this time is different because Covid is not the driver.
“It’s not just a problem with how busy we are at Hopkins, which we are, but it spills over into emergency rooms in remote communities where kids have to be transferred,” he said.
Joanna Fazio, Inova’s vice president of pediatric service lines, said Inova’s LJ Murphy Children’s Hospital also operates at or above capacity at times. Clinicians generally reported shorter than usual intervals of illness in the summer; Instead, in August and September the illness began to increase and did not let up.
About half of the hospital’s 226 pediatric beds are for neonatal intensive care and 26 are pediatric intensive care unit beds, he said. On Tuesday, the PICU was on what Fazio called “capacity alert,” or full, meaning doctors looking to transfer sick babies had to continue looking for beds.
“We have every strategy to try to increase capacity where we can,” he said.
Fazio sees no end in sight. “We’re preparing for it to last through the flu season because we know what our disease patterns are. Our predictions are as good as the next day,” he said.
It is a fact of emergency medicine that non-urgent cases will appear in the emergency room, but due to the overall high volume, the Johns Hopkins Children’s Center has reopened its Covid tent to see low-acuity non-Covid patients and LJ Murphy Children’s is seeing. Doctors advise parents to call their pediatrician or consider going to urgent care if their child does not need acute intervention, as a way to reuse the space. there are many guidelines To help parents decide what to do.
Children’s National’s Combs acknowledged that parents are under a lot of pressure to weather the worst of the pandemic, but she stressed the importance of getting themselves and their children vaccinated against the coronavirus and flu.
He added that two years ago, Covid-19 prevention measures, such as wearing masks, social distancing, hand washing and avoiding large gatherings, resulted in much less RSV, flu and rhinovirus — lessons that parents can apply even as new coronavirus infections decline.
“To give both a sprout of hope and some tiny sense of control, ‘Well, what can I do but panic?’ “Go back to basics, do what you’ve been doing for the last few years of the pandemic: get your vaccinations … and just do your best,” he said.
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