The soaring number of children contracting COVID-19 is straining Georgia’s pediatric health care system.
More kids than ever before are suffering from coronavirus cases so severe that they need to be hospitalized, filling pediatric wards at a time when physicians are also contending with an unseasonable surge of other respiratory viruses.
Many area children’s hospitals are reporting that more than three-quarters of their ICU beds are occupied — in some places, it’s closer to 90%.
While ER doctors and pediatric specialists interviewed this week say they’re able to keep up with cases for now, many fear what could come in the weeks ahead as the delta variant tears across the region and schools continue with in-person, often mask-optional learning.
“We haven’t reached that critical moment yet where we’re unable to provide that care,” said Dr. James Black, medical director of emergency services at Albany’s Phoebe Putney Memorial Hospital. “We’re doing everything we can to stay just ahead of that, but it’s a race and a race that most of us are losing.”
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Credit: undefined
Many are alarmed at the sheer increase of cases in such a short amount of time. In Georgia, the number of hospitalized children ages 0 to 4 has nearly quadrupled over the last two weeks, from 8 to 31, according to the state Department of Public Health. Among school-aged children 5 to 17, the number has almost doubled, from 28 to 50.
The situation is even more dire in other parts of the Southeast. In Dallas, earlier this week there were no more pediatric ICU beds available for children, and Louisiana’s children’s hospitals reached capacity earlier this month. In Florida, which is currently logging about one-fifth of the country’s COVID hospitalizations, about 54 children were being admitted per day in early August.
“What we’re seeing is that a low-frequency event, which is needing to be hospitalized, is happening a lot more frequently because so many kids are being infected in our communities right now,” said Dr. Stephen Thacker, associate chief medical officer at Memorial Health University Medical Center in Savannah.
One-two punch
Previous COVID variants didn’t hit young people as hard. With many patients delaying routine medical care and elective procedures, some children’s hospitals were able to act as a relief valve for the health care system at large, lending staff, equipment and sometimes even space to adult hospitals overflowing with COVID-19 patients.
In May, when the government authorized emergency use of the Pfizer-BioNTech vaccine for adolescents ages 12 to 15, health authorities hoped the shots would protect young people before they returned to school.
Credit: Alyssa Pointer
Credit: Alyssa Pointer
But vaccination rates lagged. And last month, things began to shift.
The highly contagious delta variant, first identified in India in late 2020, began to sweep across the country as many Americans, vaccinated and not, traveled and mingled more freely without masks or other COVID precautions. That included children, who, after being cooped up for the better part of a year, were particularly vulnerable to highly contagious illnesses like respiratory syncytial virus. RSV typically spreads in colder months and can cause pneumonia and bronchiolitis in small kids.
That one-two punch of COVID and respiratory viruses like RSV is stretching many pediatric health systems to the brink.
Hospitals around the country are reporting 1,963 pediatric patients hospitalized with confirmed and suspected COVID-19 cases, according to the federal Department of Health and Human Services, a record number for the pandemic.
Severe illness from COVID-19 is still uncommon in children — about 1.3% of COVID cases among Georgia kids have resulted in hospitalizations, according to the Children’s Hospital Association.
But doctors are still trying to understand the long-term impact of the virus on children, including Multisystem Inflammatory Syndrome in Children, a rare ailment that’s dogged some kids who had COVID-19.
And even though only a small percentage of children suffer severe cases, enough kids have become infected that pediatric hospitals have been filling up.
On Tuesday there were 22 patients hospitalized with COVID in the hospitals run by Children’s Healthcare of Atlanta, a spokeswoman said. As recently as June, there were none.
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Credit: undefined
At Savannah Memorial Health’s children’s hospital, doctors and nurses were treating eight pediatric and neonatal coronavirus patients on Tuesday, including a pair of newborns.
Statewide, 135 kids under 18 were hospitalized with confirmed or suspected cases of COVID-19, according to the most recent information hospitals reported to HHS. Georgia had the nation’s fourth-highest number of children currently hospitalized with COVID-19, after Texas, Florida and California.
Many of the children hospitalized, and particularly those who need intensive care, have chronic underlying conditions like diabetes or are immunocompromised. But a sad, growing trend in hospitals is that the children’s siblings and parents are also infected with COVID 19, doctors say.
“That’s one of our biggest concerns that we’re seeing right now,” said Dr. Brian Griner, who owns a pediatrics and internal medicine practice in Valdosta. “Whenever you have small ones (who catch COVID), that easily takes care of the whole family in one fell swoop, including the parents.”
Many, but not all, are families in which the parents and older children are not vaccinated.
‘Rolling the dice’
The rise in hospitalizations comes as the number of positive COVID-19 tests has surged.
DPH said it saw a 117% increase in the number of cases among Georgia children aged 5 to 17 this week versus last, and an 111% increase for kids under age 4.
Experts attribute that in part to low vaccination rates among young people.
Only one in five Georgians between the ages of 12 and 17 is fully inoculated, according to federal data.
Meanwhile, many of those unvaccinated children are now attending in-person schools, which in many places don’t require masks.
Schools in metro Atlanta reported nearly 4,000 infections since the start of fall semester as of Friday, and at least 19 Georgia school districts have temporarily shut down, shifted to online learning or moved to a hybrid of in-person and digital instruction within days of starting the school year.
Credit: Alyssa Pointer
Credit: Alyssa Pointer
Sarah McCool, a clinical associate professor at the Georgia State University School of Public Health, said her biggest concern among schools is the threat of continued transmission.
“We already have high community transmission in the Atlanta area, and it is just going to exacerbate transmission,” she said. “You are still rolling the dice.”
Dr. Hugo Scornik, a Conyers pediatrician who leads the Georgia chapter of the American Academy of Pediatrics, said schools need to encourage vaccination of teachers, staff and all eligible children and have proper procedures in place for quarantining students who may have been exposed to COVID-19.
“All kids need to wear a mask in school, and schools need to have procedures to enforce mask use and social distancing amongst the kids,” he said.
Thacker, the Savannah physician, sees the next two weeks as particularly crucial for the state’s pediatric health system. Modeling suggests rising case numbers are likely, but Thacker said he’s encouraged by a recent uptick in vaccination rates.
“I hope that our communities are hearing that message around vaccination,” he said. “I think there’s a chance for us not to be in the boat that we see other states in.”
Staff writers J. Scott Trubey, Helena Oliviero and Ariel Hart contributed to this article.
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