LOS ANGELES - More than 220 children’s hospitals are asking the Biden administration for help as they experience a devastating delta variant-driven surge of child patients with COVID-19.
In a letter distributed by the Children’s Hospital Association (CHA), pediatric hospitals cited "high demand and staffing challenges."
"With pediatric volumes at or near capacity and the upcoming school season expected to increase demand, there may not be sufficient bed capacity or expert staff to care for children and families in need," the letter reads.
The letter cites three key complications for children that are causing pediatric hospitals to be overwhelmed by the ongoing crisis.
Financial pressure for families
The first issue the CHA said is putting a strain on hospitals’ ability to treat children is the financial burden caused by the COVID-19 pandemic as the delta variant sent cases, deaths and hospitalizations soaring in recent weeks in the U.S.
The surge has erased months of progress. Deaths are soaring at about 1,000 a day on average for the first time since mid-March, and new cases are averaging 147,000 a day, a level last seen at the end of January. Many of those cases are among children.
A new study published in "The Journal of American Medicine Association" earlier this month suggested that younger children are more likely to spread COVID-19 within households compared to older children.
According to the study, the highest odds of transmission were in children between 0 and 3 years old compared to children between 14 and 17 years old. Children between 4 and 13 years old also had increased odds of transmitting the virus but not as high compared to the younger demographic.
"As the number of pediatric cases increases worldwide, the role of children in household transmission will continue to grow," the researchers wrote. "We found that younger children may be more likely to transmit SARS-CoV-2 infection compared with older children, and the highest odds of transmission were observed for children aged 0 to 3 years."
The CHA letter explained that many marginalized communities have been disproportionately impacted by the current health crisis and are still in need of serious financial support in order to overcome the losses they have endured.
The letter urges the Biden administration to provide additional financial support for the struggling communities.
"As the highest Medicaid hospitals in the nation, children’s hospitals serve the most economically challenged and diverse communities and are still awaiting additional provider relief funding (PRF) to remediate their losses and stabilize their finances," the CHA wrote.
A mental health crisis among children
The CHA said the COVID-19 pandemic is currently exacerbating issues caused by the disruption of normal life, which is leading to a "national children’s mental health crisis."
"Layer on the financial stress on families and COVID-19 illness and death, and the existing pediatric mental health capacity in inpatient and outpatient settings across the nation is being overwhelmed by children presenting with serious and severe mental and behavioral health needs," the CHA explained in the letter.
RSV (respiratory syncytial virus)
An additional problem that is flummoxing medical experts is the unexpected and severe wave of RSV (respiratory syncytial virus) which has hospitalized dozens of children.
RSV, or respiratory syncytial virus, is a common cause of cold-like symptoms but can be serious for infants and the elderly. Cases dropped dramatically last year, with people staying home and social distancing, but began cropping up as pandemic restrictions eased.
Typically, infants are exposed to RSV during the first year of life, often when older siblings become infected in school and bring the virus home, Kociolek said. But, he added, ’’there were a lot of kids and babies who were not exposed to RSV in winter of 2020 and winter of 2021. That just leaves a much larger proportion of susceptible infants."
The U.S. Centers for Disease Control and Prevention issued a health advisory on June 10 about an increase in RSV cases across parts of the South. Cases have appeared in many other states, too.
Among U.S. kids under age 5, RSV typically leads to 2 million doctor’s office visits each year, 58,000 hospitalizations and up to 500 deaths — higher than the estimated toll on kids from COVID-19.
"While experts are divided on how long the trend will continue, the immediate impact is clearly producing substantial pressure on pediatric hospital capacity," the CHA wrote in the letter.
CHA CEO Mark Wietecha said the issues have compounded the already growing toll the pandemic has taken on staff working in pediatric hospitals.
Wietecha pleaded for additional funding for specialized training to care for infants and young children.
Because care for children differs drastically for adults, Wietecha says pediatric-trained staff are costlier.
"The combined COVID19 and behavioral health pandemic has increased work stress and ‘burn out,‘ which was already a major challenge to recruitment and retention. With staff rethinking their careers and greater competition for the remaining talent, children’s hospitals are reporting shortages which are exacerbating capacity constraints," Wietecha writes.
"All of these factors are converging and unfortunately setting up the perfect storm threatening national pediatric hospital capacity. We ask for immediate support for pandemic-driven staffing cost increases through federal pediatric emergency assistance, specifically the release of provider relief funding and any other federal workforce support that can be quickly distributed and targeted to pediatric crisis response," he added.
Still no COVID-19 vaccine for younger children
The letter came as many parents anxiously await the day when a COVID-19 vaccine will be made available for younger children as schools across the country resume classes amid the delta variant surge.
A need for a vaccine for younger children has taken on a new urgency due to the new wave of COVID-19 infections. As of Aug. 16, 1,900 children in the United States were hospitalized with COVID-19, according to the U.S. Department of Health and Human Services — setting a new pandemic record for kids.
While many experts say vaccines for children are desperately needed, some say it may be a while before parents with younger kids can get their shots.
Speaking on NPR’s "Morning Edition" On Aug. 24, National Institutes of Health Director Dr. Francis Collins said it’s "unlikely" that there will be federal approval of COVID-19 vaccines for young children before the end of this year.
"I've got to be honest, I don't see the approval for kids — 5 to 11 — coming much before the end of 2021," Collins said.
Until a vaccine for children becomes widely available, Collins pressed the importance of face masks to curb the spread of the virus.
"If you want to avoid having that outbreak that's going to send all the kids home again, you should be doing everything to avoid that. And that means wearing masks," Collins told NPR. "And by the way, if somebody tries to tell you we don't really have scientific evidence to say that masks reduce infection in schools, that's just not true. There are dozens of publications, both from the U.S. and other countries, to show that's the case. So, boy, I wish we could get over that fight."
The Associated Press contributed to this story.