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Pediatric hospitalist cites concern about capacity to care for all children if COVID cases continue to climb

Dr. Kate Dutkiewicz, Beacon Children’s Hospital.

In her own words: Dr. Kate Dutkiewicz, Medical Director at Beacon Children’s Hospital, explains how children with every illness and injury could be impacted by rising pediatric COVID cases. And what we can do to stop this from happening.

Children need specialized nurses and doctors because they are not small adults. They have different and unique needs.

Beacon Children’s Hospital is one of only three children’s hospitals in northern Indiana. Among us, our hospitals have about 100 total beds for pediatric patients, and a small fraction of those are intensive care beds for children who are critically ill. A few other hospitals in this region have a handful of beds to care for pediatric patients, but the majority of hospitals in our region are not equipped to admit children. Together, we serve a population of about 700,000 children under the age of 18.

Normally this ratio — 100 beds for 700,000 children — works out OK. We can predict familiar disease and accident patterns to a certain extent, and except on rare occasions, we are able to accommodate seasonal increases in hospitalization rates.

But this year is different.

Pediatric COVID-19 infection rates are rising steadily in our region. Let me explain why this is so concerning for ALL our children.

The American Academy of Pediatrics says the national hospitalization rate for pediatric patients with COVID is currently at 1 percent. But the average amount of time children with COVID spend in the hospital, depending on their age and whether or not they need intensive care, is between seven to 10 days, according to the Indiana Department of Health.

If 20 percent of children in our area would get COVID and require hospitalization, that would mean 1,400 children when we only have about 100 available pediatric beds. Depending on the severity of their illness, and the amount of time they’re in the hospital, three-quarters of our beds could be filled with COVID patients.

Why is this so scary when pediatrics patients are very unlikely to die of COVID based on what we’ve see for the last 18 months? Because kids who have OTHER problems that can be very serious — like RSV, flu, cancer, sickle cell disease, appendicitis, sepsis, diabetes, seizures, or sustain injuries from car accidents and near drownings, or have any other illnesses that routinely rely on the specialized care provided by our hospitals — literally may not be able to get in here, or anywhere.

Children’s hospitals in Indianapolis are seeing record numbers of kids with COVID, and the Delta variant is impacting the number of pediatric patients requiring hospitalization in Chicago. Some are taking patients from Louisiana and Texas because there are no pediatric beds available in those states. Adding to this concern, there is also currently a nationwide shortage of nurses and medical personnel that is affecting hospitals everywhere, which makes it particularly difficult to find specialized people to staff pediatric beds.

Even if a bed is physically available, it is useless unless there are skilled providers to care for the child in it.

The possibility that there will be no access to care for children sounds preposterous in this country. But it is a very real scenario, especially as our children head back to school, many of them with little or no protection against COVID.

The very good news is that this can be avoided. Vaccination has proven to be very effective against this virus. Wearing masks helps decrease transmission of COVID and other respiratory illnesses. The best thing you can do to prevent serious harm to children you love from every illness and injury OTHER THAN COVID, as well as from this virus, is to get yourself and your children who are 12 and older vaccinated against it. Please encourage kids to wear masks to school, to decrease the rate of spread.

This will help keep our pediatric hospital beds open for ALL children when they need care.