Sick kids are filling hospitals, but there aren’t enough beds
Kristi Maeng didn’t panic when oxygen levels for Jordan, her 5-year-old son with Down syndrome, plummeted, sending him to the hospital. She could accept one week in a tiny windowless emergency department room. She even learned to cope with the broken TV and nonfunctioning nurse call button.
What truly alarmed this
Silver Spring, Md., mother of three was seeing doctors scramble to find beds for their sickest pediatric patients.
As the nation grapples with a surge in respiratory illnesses making very young children and babies ill, the high demand for inpatient and pediatric intensive-care-unit beds means children are spending days and weeks in emergency rooms designed for short-term evaluation and treatment.
The surge has hit states in the East and Southeast particularly hard, with Washington, D.C., Maryland and Virginia reporting the highest incidence of influenza-like illness, which includes RSV, or respiratory syncytial virus, according to Centers for Disease Control and Prevention data.
Pediatricians last week asked President Biden and Xavier Becerra, the secretary of the Department of Health and Human Services, to declare an emergency to give providers and hospitals more flexibility to care for sick children.
The letter from the heads of Children’s Hospital Association and the American Academy of Pediatrics said that in some states, more than 90 percent of pediatric beds are full, meaning more children like Jordan will languish in emergency departments and makeshift spaces.
A CHA spokeswoman said conversations with the administration and Congress continue but that further action has not yet been taken.
Experts say the high demand for pediatric ICU beds is due to the early onset of RSV, which is making children sicker than usual, along with the start of flu season and the continued circulation of the novel coronavirus on top of an overall decrease in pediatric beds and chronic staff shortages.
“It’s not fair for an ER doctor to have to decide which kid am I going to send to the bed,” Maeng, 42, said. “The system is not working.”
Theodore R. Delbridge, the governor-appointed head of a Maryland state agency responsible for coordinating statewide emergency management systems, saw this coming. One year ago, clinicians reported an out-of-season increase in RSV and worried that flu and COVID surges could overwhelm the system.
He expanded C4, the federally funded Critical Care Coordination Center, created in December 2020 to find intensive care beds for adults with COVID, to a pediatrics call center called C4 Pediatrics. At all times, two doctors with pediatric expertise and two clinical coordinators with a bird’seye view of pediatric inpatient and intensive-carebed capacity across the region field calls from doctors seeking transfers for their critically ill patients.
The pediatric division staffed up in October 2021, but, to his surprise, Delbridge said, it was not very busy, taking only about 20 calls a month, with a peak of 64 calls in June.
“That all changed in September,” he said.
The center fielded 194 pediatric requests that month and more than three times as many — 639 — in October, including nearly 600 for respiratory illnesses, Delbridge said. The center is on pace for a busy November as well, with 359 calls as of midday Tuesday.