With a rising tide of Covid-19 patients threatening to overwhelm hospitals, public health officials across the United States are reaching for a safety valve that the Northeast used in the spring: borrowing beds in children’s hospitals to care for adults.
U.S. hospitalizations are at a record-high of 104,600, according to the Covid Tracking Project, and the nation set a record this past week for the most deaths in a seven-day period.
“As the fall came into play and the second surge hit, I think we’re seeing a lot more of that happening now,” said Amy Knight, president of the Children’s Hospital Association, a national group representing more than 200 U.S. facilities.
It’s rare for American children’s hospitals to admit adult patients or loosen their admittance criteria, so the fact that it is being done now speaks to the severity of the crisis, according to Dr. Peter Jay Hotez, a professor of pediatrics and molecular virology and microbiology at Baylor College of Medicine and the co-director of Texas Children’s Hospital Center for Vaccine Development.
“I don’t even know if this was done during H1N1 in 2009, so I can’t think of too many modern precedents,” he said.
Because coronavirus infections seem to largely spare younger children, compared with teenagers and adults, children’s hospitals and the pediatric wards of general hospitals tended not to become swamped early in the pandemic.
“It was more like a trickle of kids that needed to be hospitalized,” Ms. Knight said.
Since then, however, the number of children becoming infected and needing hospital care has risen sharply, and children’s hospitals may have less room and resources to spare at a time of year when the need for pediatric beds tends to rise anyway because of influenza.
“We’re much more limited in capacity for pediatric critical illness throughout the country,” said Dr. Brian Cummings, who works in the intensive care unit at MassGeneral Hospital for Children in Boston. “Clearly we’re overwhelming the adult I.C.U. capacity, and then to use an even scarcer resource really does concern all of us that advocate for children.”
Even so, children’s hospitals are pitching in to help with the coronavirus surge in various ways. The Children’s Hospital Association released guidelines in April for several possible approaches, including taking in pediatric patients from general hospitals to free up space in those facilities, and raising their maximum admission ages.
The St. Louis Children’s Hospital, a part of BJC HealthCare, started opening its doors to adult patients in November, and another pediatric hospital in St. Louis, Cardinal Glennon Children’s Hospital, has been accepting adult transfers who do not have Covid-19. Oishei Children’s Hospital in Buffalo said it would temporarily raise its admission ceiling to admit patients up to 25 years old.
During the first big surge in the Northeast, from April to June, MassGeneral Hospital for Children took adult patients in its 14-bed intensive care unit. “As we watched hospitals become overwhelmed, everyone wanted to step up and do their part,” Dr. Cummings said.
The unit went back to normal over the summer, but with cases trending upward again in Massachusetts, he said, “we are definitely worried that we’re going to have patients again in the next week or two.”