When kids are hospitalized with COVID-19 in the pediatric intensive care unit, their families face restrictions on being with their child and feelings of isolation, said Jacob Ferrin, a registered nurse at Primary Children’s Hospital.
“I’ve seen parents that have to sleep in the bathroom in the room,” Ferrin said Thursday in a virtual news conference.. “...They’ll go a day or two or three with no sleep because of how intense the environment is.”
And when hospitals are at 110% capacity during the coronavirus pandemic, “there’s no way ... that everything is being done as well as when it’s running at 75 or 80%, where it’s designed to run,” said Dr. Andrew Pavia, who joined Ferrin, and is chief of the division of pediatric infectious diseases 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 probably get an email from a hospital administrator scolding him for that comment. “But,” he said, “that’s the truth.”
“Everyone has to acknowledge that,” according to Pavia. “Our hospitals being overfilled is a patient safety issue.”
As COVID-19 cases “go up dramatically” in Utah, “the proportion of cases that are in children is going up even faster,” according to Pavia.
This is largely preventable, Pavia said, if people do two things: Get vaccinated and wear a mask.
COVID-19 cases in kids ‘are not trivial’
“We’re not doing as well as we should be in Utah,” Pavia said, in terms of adults getting vaccinated.
New data from the Centers for Disease Control and Prevention shows that the more adults are vaccinated in a state, he said, the lower proportion of COVID-19 cases there are in children.
“Utah is neither the best nor the worst,” Pavia said. “We’re kind of in the bottom third or so for vaccination rate, and we’re in the top third for infections among children.”
Across the country, 250,000 children were infected with COVID-19 in the last week, “more than in any other time during the pandemic,” according to Pavia.
“That’s the result of a real change in the way we’re behaving,” he said, “not masking in schools. We’re not wearing masks out in public.”
Children can go to school safely, according to Pavia, “but they really need to have everyone in a classroom masked for it to work.”
Pavia said he and other health care providers take it “very personally when people tell us that [masking] doesn’t work, or that masks are a personal choice, as if running a stoplight ... or smoking in an indoor space is a personal choice.”
“By not protecting children with methods that we know work, you’re hurting children,” he said.
In Utah, during “the worst of last winter, about 12% of all infections were happening in children. Now it’s about 25%,” Pavia said. “One in four cases is in school-aged children. And that’s in spite of the fact it’s fairly hard to get your child tested.”
“These mild illnesses” of COVID-19 in children “are not trivial, as people like to portray them,” Pavia said.
Every time a child gets sick, “that means a parent stays home from work” and “other siblings are quarantined,” he said,” he said. “It means that that child misses out on a week in school” or “their classroom has to shut down.”
The rising cases also take a toll on caregivers, who have been stretched thin for 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 TV news segment about the coronavirus pandemic where “they played a code blue alarm.”
“We are all essentially programed to jump up and respond to that,” Ferrin said. So, “I jumped off the couch and I was ready to respond.”
His wife was confused, and Ferrin assured her he would be OK. “We are dealing with so many of these intense situations,” he said.
In the pediatric ICU, “we help patients and families deal with situations that come to them on the worst days of their life,” Ferrin said. “And since the pandemic has started, we’ve seen a dramatic increase in the amount of people having the worst day of their life.”
Primary Children’s serves families in a very large area in the Intermountain West, he said.
“If somebody lives between Denver and L.A. and between Phoenix and Canada, we are their last line of defense for kids that stands between a bad event and a funeral,” Ferrin said.
Surges at Primary Children’s
The number of children who are becoming very sick with COVID-19 is “becoming a really big deal,” according to Pavia. In the U.S., “a record number of children” — 30,000 — were hospitalized in the past week, he said.
“At Primary Children’s, the number of children that are being hospitalized keeps creeping up,” Pavia said. “In May, we went weeks at a time with almost no children who were hospitalized. We’re now averaging eight to 12, with several in the ICU.”
Some people may think that “isn’t that high,” Pavia said, but if that is “your child who’s struggling to breathe, who’s on a ventilator to help them breathe, you worry every moment about whether they’re going to survive.”
“Everything hurts” for a child who has inflammation in his or her body from COVID-19, according to Ferrin.
“Their eyes can get really red. It hurts when you touch their arm,” he said. “... I was helping a kid turn that was COVID positive, and just the act of rolling over caused a lot of pain and discomfort.”
Whenever people “make a lot out of the fact” that fewer children are dying of 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 on the staff here,” Pavia said.
Doctors and nurses at Primary Children’s have cared for about 100 children, roughly 95 of whom were Utah residents, who have had Multisystem Inflammatory System, an extreme, rare condition from COVID-19, that, among other issues, “can cause heart damage,” according to Pavia. One child needed emergency heart survey, he said.
“We are putting two children in a room right now” at Primary Children’s and are struggling to find beds in the ICU, according to Pavia. “We’ve had to cancel important surgeries in order to have space in the ICU.”
That’s not all due to COVID-19, he said, but “COVID is quite literally the straw, or the bale of straw, that’s breaking the camel’s back in your health care system.”
Utah also is seeing a surge in respiratory syncytial virus, or RSV, which affects children under five, primarily less than 2 years old, Pavia said. Usually, cases rise in the winter, and kids are hospitalized, many in the ICU.
“Last winter ... there was almost no RSV circulation as children stayed home and masks were pretty much universal,” he said.
Then “something we’ve never seen before” happened, he said, and RSV “came back in the late summer” and continued to increase.
“It’s already at a level beyond an average year,” Pavia said, and is “headed towards reaching a level of one of our worst years ... with, so far, no real drop in numbers.”
Pavia and Ferrin said they are pleading with Utahns to help alleviate the COVID-19 situation.
“If everybody takes a little bit of ownership of what they can control, it makes a huge difference in the big picture,” Ferrin said.