With Covid-19 patients on the rise threatening to overwhelm hospitals, U.S. public health officials are reaching for a safety valve the Northeast used in the spring: borrowing beds in children’s hospitals to care for adults.
U.S. hospital stays hit a record high of 104,600, according to the Covid Tracking Project, and the nation set a record for the most deaths in a seven-day period last week.
“When the fall came in and the second spike hit, we’re seeing a lot more of it now,” said Amy Knight, president of the Children’s Hospital Association, a national group that represents more than 200 US facilities.
According to Dr. Peter Jay Hotez, Professor of Pediatrics and Molecular Virology and Microbiology, it is rare in American children’s hospitals to admit adult patients or to relax their admission criteria. The fact that this is happening now speaks to the severity of the crisis at Baylor College of Medicine and co-director of Texas Children’s Hospital Center for Vaccine Development.
“I don’t even know if this happened during the first half of 2009, so I can’t think of too many modern precedents,” he said.
Since coronavirus infections appear to largely spare younger children compared to teenagers and adults, children’s hospitals and the children’s wards of general hospitals tended not to be flooded at the beginning of the pandemic.
“It was more like a trickle of children being hospitalized,” Ms. Knight said.
Since then, however, the number of children who become infected and need hospital care has risen sharply, and children’s hospitals may have less space and resources available if the need for pediatric beds due to influenza increases anyway.
“We are much less able to treat pediatric critical diseases across the country,” said Dr. Brian Cummings, who works in the intensive care unit at MassGeneral Hospital for Children in Boston. “Obviously we are overwhelming the capacity of the adult intensive care unit, and using an even scarcer resource affects all of us who care about children.”
Even so, children’s hospitals are helping with the rise in the coronavirus in a number of ways. The Association of Children’s Hospitals published guidelines in April for several possible approaches, including admitting pediatric patients from general hospitals to free up space in these facilities and increasing their maximum admission age.
St. Louis Children’s Hospital, part of BJC HealthCare, opened its doors to adult patients in November, and another St. Louis children’s hospital, Cardinal Glennon Children’s Hospital, has accepted transfers for adults without Covid-19. Oishei Children’s Hospital in Buffalo said it will temporarily raise the admission limit to admit patients up to 25 years of age.
During the first major surge in the northeast from April to June, the MassGeneral Hospital for Children admitted adult patients to its 14-bed intensive care unit. “When we saw how hospitals were overwhelmed, everyone wanted to do their part,” said Dr. Cummings.
The unit returned to normal in the summer, but with Massachusetts cases picking up again, he said, “We’re definitely worried we’ll have patients again in the next week or two.”
