Dell Children’s Medical Center in Central Texas treated 11 children with COVID-19 on Wednesday, four of whom were in the intensive care unit. The young COVID-19 patients treated there have ranged in age from newborn to 17.
“The Delta variant is different,” said Dr. Z. Leah Harris, Chief Physician at Dell Children’s. Children are more susceptible to the delta variant than previous versions of coronavirus. They get sick, she said, coming in sicker than in previous surges.
Eleven may sound like a low number, but Harris said that at any given time last year, only five children were treated for COVID-19. It was rare that they were at the ICU.
“A child on a fan at the ICU is one too many,” she said.
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Austin’s third increase in the case of COVID-19 has burdened adult hospitals in central Texas. In the last two weeks, the region has had between one and 10 available ICU beds for adults. It has also seen the most people ever hospitalized with COVID-19 locally with 653 on Wednesday; most people on fans, with 163 on Wednesday; and most people on ICUs, with 237 on Sunday.
On Thursday, the number had improved slightly, with 630 people hospitalized with COVID-19 in central Texas, 157 people on fans and 229 people on the ICU.
Sometimes some local adult hospitals have diverted patients to other hospitals because they were drunk, Harris said.
This week, Travis County hit its 100,000. case of COVID-19.
However, what happens at Dell Children’s is different from what happens at adult hospitals, Harris said: Dell Children’s still has bed availability for every patient to be admitted.
“We have not hit bed capacity,” said Harris, who is 230 beds. “We do not reject people.”
While many adult hospitals have had to stop performing non-emergency surgery, Dell Children’s has continued with planned procedures.
But Dell Children’s is not immune to the rise in adult hospitals. Employees have been sent to work at adult hospitals during previous surges. Versions of the area surge plan include Dell Children’s care for adult patients if there are no local hospital beds for adults. That part of the surge plan has not yet been implemented.
Not just COVID-19
Right now, however, Dell Children is feeling the strain of increasing infection rates in society. Its emergency department is busier than it has ever been, Harris said. Waiting times are measured in hours, not minutes.
It’s not just COVID-19. Right now, coronavirus accounts for the fourth most virus cases at Dell Children’s. Respiratory syncytial virus, or RSV, typically a winter virus, hit the area hard, causing the most virus-related hospitalizations for children in the hospital. Nr. 2 and 3 are parainfluenza and rhinovirus.
The number of children admitted to Dell Children’s has almost doubled compared to August last year. A year ago, they had about 100 children hospitalized. On Wednesday, the number was 190.
What changed? A year ago, Harris said, people followed the Centers for Disease Control and Prevention’s guidelines for infection. They wore masks, restricted their activities and washed their hands often. They did not enter the emergency rooms with RSV, parainfluenza, rhinovirus or COVID-19 because these preventative measures kept all viruses at bay.
“Four months ago, we thought we had won,” Harris said, not expecting a Delta tribe to hit.
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Will there be a larger increase?
COVID-19 in children is a cause for concern, Harris said.
In some states, the cases overwhelmed pediatric hospitals, she said. Texas pediatric hospitals still have capacity, but that may change. Her concern: When children go back to school, cases will increase and the number of children in need of hospitalization will too.
The time between exposure to COVID-19 and the onset of hospitalization symptoms may take some time.
“I do not know what we’re going to look like in terms of COVID outbreaks and disease three weeks from now,” Harris said.
Dell Children could begin to feel the strain of bed availability. “As a society, we could quickly need 20 or 30 beds,” she said.
Clearly, wearing masks and vaccinations works to reduce cases of the disease, Harris said.
“It protects us and the people around our children,” Harris said.
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Children 12 and older can receive the Pfizer vaccine, approved for acute use in children aged 12-15 years and fully approved for people 16 and older.
Children admitted to Dell Children’s COVID-19 are largely unvaccinated, Harris said. Only one has been a breakthrough, but that child had underlying health problems.
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As with adults, immunocompromised ones account for most breakthrough cases in vaccinated teens. The FDA and CDC now recommended a third dose of Pfizer or Moderna for this population.
Returning to these precautions can help reduce the number of children receiving COVID-19; the number of inpatients; and the number who spread it to other people at risk of serious illness and then have to be hospitalized.
“We are very much a country in crisis right now,” Harris said. “COVID is genuine, and we know individuals can face life-threatening events from exposure to COVID.”