POST 195. September 6, 2021. CORONAVIRUS. “…there are “zero ICU beds left for children in Dallas County, Texas,”.,..”That means if your child’s in a car wreck, if your child has a congenital heart defect or something and needs an ICU bed, or more likely if they have Covid and need an ICU bed, we don’t have one. Your child will wait for another child to die… (county judge Clay Jenkins)

…Your child will just not get on the ventilator, your child will be CareFlighted to Temple or Oklahoma City or wherever we can find them a bed, but they won’t be getting one here unless one clears.”

The judge added no ICU beds have been available for children for at least 24 hours. The Texas Department of State Health Services told CNN the shortage of pediatric ICU beds is related to a shortage in medical staff.

“Hospitals are licensed for a specific number of beds and most hospitals regularly staff fewer beds than they are licensed for. They can’t use beds that aren’t staffed. With the increase in COVID cases, hospitals are experiencing a shortage of people to staff the beds that they are licensed for,” department spokesperson Lara Anton said in an email, adding that staffing agencies in the state are working on recruiting medical surge staff from across the US.”” (A)

for links to POSTS 1-195 in chronological order highlight and click on

http://doctordidyouwashyourhands.com/2021/09/coronavirus-tracking-links-to-posts-1-195/

Nearly 2,200 children are hospitalized with Covid-19 nationwide, data from the Department of Health and Human Services shows, a number that includes both confirmed and suspected coronavirus-linked hospitalizations.

That’s a more than 50% increase from the beginning of August when National Institutes of Health Director Dr. Francis Collins said a record 1,450 kids were hospitalized with Covid-19 and a 15% increase from last week when Reuters reported another record of 1,900 kids hospitalized.

The number of children admitted to hospitals with Covid-19 each day has also reached a new peak of 309 per day, or 2,163 children hospitalized per week, according to the Centers for Disease Control and Prevention (CDC), though this statistic includes kids who may have been hospitalized for another reason and tested positive for the virus.

The CDC data shows 14 states—many of which have vaccination rates below the national average—set new records for child Covid-19 hospital admissions since the start of August: Alabama, Alaska, Florida, Georgia, Hawaii, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, South Carolina, Texas, West Virginia and Wyoming.

The states with the highest rates of children being admitted according to the CDC include Georgia, with 1.43 children hospitalized per 100,000 residents, Florida (1.38), Alabama (1.16) and Louisiana (0.83). “ (B)

“Child hospitalizations have been surging in states—primarily based in the Southern U.S.—seeing broader increases in cases and hospitalizations driven by the more infectious delta variant. The uptick has been tied to a massive increase in coronavirus cases among children as there is not yet evidence that delta causes children to become sicker than other variants. More than 180,000 children tested positive for Covid-19 during the week ending August 19, according to the American Academy of Pediatrics, a nearly four-fold increase from mid-June when just 39,000 cases were reported. The surge is also being exacerbated by a rise in cases of respiratory syncytial virus, or RSV, a contagious seasonal flu. While RSV infections typically surge during the winter flu season, experts say the respiratory infections are likely increasing now because masking and social distancing to prevent Covid-19 infections delayed the normal RSV season. The corresponding surges are pushing many pediatric hospitals to capacity. For example, the pediatric ICU at Children’s Hospital New Orleans has been full for several weeks, reported The Wall Street Journal. Children under 12 are also not yet eligible for the protection of the vaccine, and inoculation rates among kids who are eligible remain low…Experts are bracing for the situation to get worse as the return to classrooms nationwide appears to already be driving an increase in Covid-19 cases. As Forbes reported, tens of thousands of students were under quarantine just days into the fall semester, including many in states with governments battling mask mandates in schools. “In the first nine days of school, there were 503 cases of coronavirus in Duval County Public Schools,” Dr. Mobeen Rathore, an epidemiologist at the Wolfson Children’s Hospital in Jacksonville, told CNBC. “We are not only preparing for acutely ill children but also MIS-C. We are updating our protocols and planning for people, facilities and supplies for any surge.” MIS-C, a rare inflammatory syndrome caused by Covid-19, has already sickened 4,404 children and killed 37 since the start of the pandemic, according to the CDC.”  (C)

“The number of children hospitalized with COVID-19 in the North Texas region surpassed 100 for the first time during the pandemic…

There was a frank and desperate plea from medical professionals for everyone to get vaccinated and wear masks.

Those at Cook Children’s are seeing an alarming number of children, whether they have pre-existing conditions or not, hospitalized with COVID-19.

And that’s impacting the ability to care for not just COVID patients, but any child who is sick or injured…

Cook Children’s also shared the news it opened a third COVID unit for the first time, and it filled up within 24 hours.

“We need some compassion from the community, we need people to understand that this is an illness that is absolutely affecting our children and we’re hitting a crisis mode when our children’s hospital is having trouble seeing all of the patients presenting to us and we can’t do it without your help,” Medical Director of Urgent Care Services for Cook Children’s Dr. Kara Starnes said.

Cook Children’s reported seeing a record 600 patients in its ER Monday.

In a regular year, they would see about 300 this time of the year.

“We run one of the biggest, busiest, baddest ERs in the country at 300. And we go up to 400, even 500 in the past, but at 600, we are physically unable to care for kids in a timely fashion,” Medical Director Of Emergency Services for Cook Children’s Dr. Corwin Warmink said.

Cook Children’s was also forced to shut down its urgent care center in Hurst over the weekend to consolidate staff due to shortages.

The hospital system said it’s running thin on staff due to illness and burnout.

It’s vaccine requirement for employees doesn’t kick in until September 27, and officials say that requirement is not a factor when it comes to these staffing shortages.

“We haven’t lost staff due to vaccine requirements,” Dr. Starnes said. “The staffing shortages we’re experiencing currently are due to illness or burnout.”

The steep incline in COVID cases among children was already underway when schools started across the area…

Dr. Susi Whitworth said every hospitalization she’s seen at Cook Children’s is someone not vaccinated.

“If we had higher uptake of the COVID vaccines, we would be infinitely better off than we are now. There has never been this much information about a vaccine in the past,” Dr. Whitworth added.

And doctors said it’s not just children with pre-existing conditions who end up hospitalized.

They are seeing plenty of healthy children showing up too.” (D)

“At least 452 children in the United States have died of COVID-19 since the pandemic began, a tiny fraction of the nearly 650,000 deaths nationwide. That lopsided tally has led many to downplay the pandemic’s toll on kids.

But two new studies issued Friday by the Centers for Disease Control and Prevention make clear that children have hardly received a free pass. And especially since the arrival of COVID-19 vaccines and the Delta variant, kids’ prospects rest largely on the decisions made by the adults who surround them.

When adults and eligible adolescents get vaccinated in large numbers, younger children are at greatly reduced risk of becoming seriously ill with COVID-19, the new reports show. Conversely, when few are willing to get the jab, the pediatric wings of hospitals will fill — as they did in COVID-19 hot spots across the country in mid-August.

A study that examined hospitalization rates in 99 counties across 14 U.S. states found that the rate at which children were being hospitalized for COVID-19 had jumped fivefold in the span of about seven weeks this summer. For the youngest patients — those under 4 — hospitalization rates jumped by a factor of 10.

A second report found that in a two-week period last month, pediatric hospital admissions and trips to the emergency department were highest in states where vaccine coverage was lowest. Meanwhile, hospital visits and admissions were lowest in states where vaccination rates were highest among eligible residents.” (E)

“More children went to the hospital and emergency room in states with lower vaccination rates, according to a new study from the US Centers for Disease Control and Prevention.

Children have largely been spared the worst of Covid-19 — hospitalizations and deaths are rarer for children than for adults — although recently children’s hospitals have been filling up in Covid-19 hotspots around the country.

It’s the same pandemic, but now it’s drastically different for kids

The research published Friday in the CDC’s Morbidity and Mortality Report found that hospitalizations and emergency room visits for kids with Covid-19 increased from June to August of this year.

In the two week period in mid to late August, ER visits were 3.4 times higher in the states with the lowest vaccination rates and hospitalizations were 3.7 times higher than in states with the highest vaccination rates. The states with the lowest vaccination coverage were in the South.

“Broad, community-wide vaccination of all eligible persons is a critical component of mitigation strategies to protect pediatric populations from SARS-CoV-2 infection and severe COVID-19 illness,” the CDC-led team wrote.

And while the more highly contagious Delta variant sent more kids to the hospital with Covid-19, it was a similar proportion to the numbers who were hospitalized earlier in the pandemic, a second report found.

The team found hospitalization rates increased five-fold among children and teens and increased rapidly from late June to mid-August, coinciding with the spread of the more contagious Delta variant in the United States.

The rate of hospitalization for unvaccinated teens was 10 times higher than for those that were vaccinated. Hospitalizations were highest among kids aged up to 4, and teens 12-17.

One in four of the children who were hospitalized needed intensive care…

CDC Director Dr. Rochelle Walensky highlighted the studies Thursday in the White House Covid-19 briefing, saying they showed children were not getting more severe disease from the Delta variant. “And although we are seeing more cases in children, and more overall cases, these studies demonstrated that there was not increased disease severity in children. Instead, more children have Covid-19 because there is more disease in the community,” she said.

“What is clear from these data is community level vaccination coverage protects our children. As the number of Covid-19 cases increase in the community, the number of children getting sick, presenting to the emergency room and being admitted to the hospital will also increase.”

That makes it important to protect children. “Preventive measures to reduce transmission and severe outcomes in children and adolescents are critical, including vaccination, universal masking in schools, and masking by persons aged 2 years and older in other indoor public spaces and child care centers,” the CDC-led researchers wrote.” (F)

“…The COVID-19 vaccines have done an extraordinary job of stamping out disease and death. But as the hypertransmissible Delta variant hammers the United States, the greatest hardships are being taken on by the unvaccinated, a population that includes some 50 million children younger than age 12. Across the country, pediatric cases of COVID-19 are skyrocketing alongside cases among unimmunized adults; child hospitalizations have now reached an all-time pandemic high. In the last week of July, nearly 72,000 new coronavirus cases were reported in kids—almost a fifth of all total known infections in the U.S., and a rough doubling of the previous week’s stats. “It’s the biggest jump in the pandemic so far” among children, Lee Beers, the president of the American Academy of Pediatrics, told me. Last week, that same statistic climbed to nearly 94,000.

The most serious pediatric cases are among the pandemic’s worst to date. In the South, where communities have struggled to get shots into arms and enthusiasm for masks has been spotty, intensive-care units in children’s hospitals are filling to capacity. In several states, health workers say that kids—many of them previously completely healthy—are coming in sicker and deteriorating faster than ever before, with no obvious end in sight.

Kids remain, as they have been throughout the pandemic, at much lower risk of getting seriously sick with the coronavirus, especially compared with unvaccinated adults. But the recent rash of illnesses among the nation’s youngest is a sobering reminder of the COVID-19 adage that lower risk is not no risk. With so many children unable to access vaccines and their health contingent on those around them, parents and guardians must now navigate the reality that Delta represents a more serious danger to everyone—which means it’s a more serious danger to kids as well.” (G)

“The Food and Drug Administration’s decision to grant full approval to Pfizer-BioNTech’s two-dose Covid-19 vaccine Monday for people ages 16 and up is a pandemic milestone, but parents may wonder what it means for their young children who still aren’t authorized to get vaccinated.

While Monday’s approval doesn’t cover young people ages 12 to 15, they can still get the Pfizer vaccine through emergency use authorization.

No Covid vaccines have been authorized or approved for use in children under 12. Emergency use authorization for younger children is expected in the fall or winter. But several steps need to be taken first, including the completion of clinical trials.

Dr. Peter Marks, the director of the FDA’s Center for Biologics Evaluation and Research, said in a video news conference Monday that trials for vaccines for children continue and that the agency “has to wait for the company to submit the data from those trials so that we have a good safety dataset, because we certainly want to make sure that we get it right in the children ages 5 through 11 and then even in younger children after that.”..

The American Academy of Pediatrics, or AAP, said in a statement Monday it “has called on the FDA to work aggressively to authorize a vaccine for ages 11 and younger” as the delta variant spreads throughout the country among unvaccinated people, including children. The organization also discouraged parents from seeking the vaccine “off-label” — a practice in which doctors prescribe approved drugs for unapproved uses — citing a lack of safety and efficacy data.

The AAP said there were 180,000 new cases of Covid-19 among children and adolescents in the week that ended Thursday.

“The clinical trials for the Covid-19 vaccine in children ages 11 years old and younger are underway, and we need to see the data from those studies before we give this vaccine to younger children,” AAP President Lee Savio Beers said in the statement. “The dose may be different for younger ages. The AAP recommends against giving the vaccine to children under 12 until authorized by the FDA.”

NBC News reported last month that emergency authorization for Covid-19 vaccines in children under 12 could come in early to midwinter, according to an FDA official. The agency hopes to then move quickly to full approval for that age group. (H)

“A kids’ vaccine cannot come soon enough, but the process is taking longer than some initially expected.

“We had really hoped that maybe we would have something in place before we tried to bring kids back into the school classroom, but, unfortunately, we haven’t been able to do that,” said Dr. Emily Chapman, senior vice president and chief medical officer at Children’s Minnesota.

Trial data are still being gathered for Covid-19 vaccines for younger children. Once the vaccine companies have trial results, they’ll need to submit the information to the US Food and Drug Administration, which will assess the vaccines for authorization.

Dr. Scott Gottlieb, a former FDA commissioner who now sits on the board of Covid-19 vaccine maker Pfizer, said Sunday on CBS’ Face the Nation that the company will likely be able to file the data for 5-11-year-olds for authorization “at some point in September” and then file the application for an emergency use of the vaccine “potentially as early as October.”

“That’ll put us on a time frame where the vaccines could be available at some point late fall, more likely early winter depending on how long FDA takes to review the application,” Gottlieb said.

There’s no official timetable once a company submits to the FDA. Emergency use considerations can take several weeks.

“There’s always something that makes things not the way we think,” said Dr. Stanley Perlman, who is on the FDA’s Vaccines and Related Biological Products Advisory Committee and is also a pediatrician and professor of microbiology and immunology at the University of Iowa Health Care. “Obviously, we want it done as soon as possible, but we want it done right.”

When asked Wednesday whether a Covid-19 vaccine will be authorized for young children before Thanksgiving, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN’s Wolf Blitzer that he hopes so, but he does not want to get ahead of the FDA.

“They should be getting the data, at least in one of the companies, by the end of September,” noted Fauci.

“Then the data will be presented to the FDA, and the FDA will make a determination whether they will grant that under an emergency use authorization or some other mechanism.”… (I)

“The nurses and doctors who care for the sickest patients at Children’s Hospital New Orleans (CHNO) have to take the good where they can these days. On Aug. 6, Louisiana Governor John Bel Edwards announced that more than 3,000 children statewide had been diagnosed with COVID-19 over the course of just four days. That same week, about a quarter of Louisiana children tested for COVID-19 by the state’s largest health system turned out to have the virus.

Seventy young patients ended up in treatment at CHNO during the 30 days ending Aug. 23. Prior to this summer, the hospital had never had to care for more than seven COVID-19 patients at a time, and usually fewer than that; on any given day in August, that number has been at least in the mid-teens, enough that the facility had to call in a medical strike team from Rhode Island to help manage the surge…

This grim scenario may seem shocking, given one of the pandemic’s long-standing silver linings: that children, for the most part, are spared from the worst of COVID-19. About 400 children nationwide have died from COVID-19 since the pandemic began, and most pediatric hospitals have seen no more than a handful of patients at a time—which makes the current surge in the South and parts of the Midwest especially unnerving…

Children have also drawn a short straw. Viruses are wily, seeking out and infecting vulnerable hosts at all costs. Without authorized vaccines for people younger than 12, any child who has not previously been infected has no immunity against SARS-CoV-2, meaning the virus effectively has free rein among America’s 50 million youngest residents. Even among older children who can get vaccinated, rates are low: just 35% of 12- to 15-year-olds and 45% of 16- and 17-year-olds are fully vaccinated, according to U.S. Centers for Disease Control and Prevention data…

CHNO’s resident staffers weren’t quite prepared for the uptick in pediatric cases, either. “It was a shock,” Blancaneaux says. After a year of few-and-far-between cases in the pediatric hospital, “All of a sudden, eight out of the 20 patients I saw [in a day] were COVID positive.” It’s gotten to the point, he says, where doctors assume any patient who comes in with flu-like symptoms has COVID-19.

The hospital’s quiet atmosphere hides the work happening behind the scenes to keep pace with that increase. CHNO has implemented an incentive program to encourage current staff nurses to pick up extra shifts, and has hired about 150 new nurses to help manage the patient load.

Perhaps more concerning, the current spike began in July, before most schools in Louisiana had started back up. As the school year continues, Delta will almost undoubtedly find new footholds. ­No one wants to consider what happens if this is the ascent of a bell curve, rather than the peak—particularly since vaccines for the youngest Americans may not be available until late 2021 or early 2022. “(J)

“To make matters worse, schools are now reopening and the Texas health care system is stretched to its limits. In the face of this crisis of pediatric infections, Texas is also battling another crisis — a crisis of failed leadership. Gov. Greg Abbott continues to fight against the public health measures that would protect children in his state, doubling down on contentious legal battles to enforce his executive order banning protective mask mandates. A Dallas County court ruled against Abbott’s mandate ban last week, and he responded by digging in his heels and reissuing his executive order banning government entities from requiring vaccines that could slow the spread of the virus.

Florida is also facing a crisis of failed leadership that has contributed to the state being the #1 spot for Covid-19 infections in the country. Despite the fact that Florida has had more cases and hospitalizations than any other state last week, Gov. Ron DeSantis has been actively fighting public health measures that could provide relief. Data from two weeks ago showed a record high number of daily Covid deaths in the state. Like Abbott, he has banned vaccine passports. And like Abbott, he has been fighting to maintain his executive order against mask mandates, going so far as to threaten the salaries of the superintendent and school board members. Further, when a circuit court judge ruled against the governor’s ban on mask mandates in schools last week, DeSantis pledged to appeal the case and continue to fight against one of the most critical protective measures available to schools…

Both of these viruses are bringing children into the hospital, putting them on ventilators, and causing mortalities. At this point, it doesn’t make sense to compare them or debate which is worse — political leaders should be using all of the tools available to them for prevention.

Politicians like Abbott and DeSantis don’t know what they are talking about — not when it comes to public health or treatment of infectious disease in children. And when a child is sick with RSV or Covid, or both, no one is going to call them for help.

As a pediatric airway surgeon, I have seen many young children with RSV struggle to breathe. When medications, oxygen and respirator masks aren’t enough to relieve the heaving and gasping for air, I have to insert a breathing tube or perform surgery to open the airway…

In the meantime, where elected officials fail to protect the health of our children, doctors, nurses and health care providers will stand, and we will care for you and your family. We just need misguided politicians like DeSantis and Abbott to get out of our way.” (K)

“A summer that began with plunging caseloads and real hope that the worst of Covid-19 had passed is ending with soaring death counts, full hospitals and a bitter realization that the coronavirus is going to remain a fact of American life for the foreseeable future…

More than 1,500 Americans are dying most days, worse than when cases surged last summer but far lower than the winter peak. Though the rate of case growth nationally has slowed in recent days and incremental progress has been made in Southern states, other regions are in the midst of growing outbreaks. And with millions of schoolchildren now returning to classrooms — some for the first time since March 2020 — public health experts say that more coronavirus clusters in schools are inevitable…

The summer surge has played out in a fatigued, politically divided country with no unified vision for how to navigate the pandemic. During previous upticks, the promise of vaccines led many to think that a return to ordinary life was perhaps just months away and that masking up or staying home was a short-term investment toward that goal. But the virus’s mutations and the refusal of millions of Americans to take the shots have dimmed that hope…

In much of the United States, schools are just beginning to open up, though children under 12 remain ineligible for vaccines, and mask usage is uneven. Vaccination rates are inching upward as more employers require shots, but 36 percent of adults are still not fully vaccinated. And breakthrough infections in vaccinated people are becoming more frequent, suggesting that vaccines are losing some efficacy, though they remain highly protective against severe outcomes…

“What worries me the most is not where we’re at, although that’s bad enough, but where we’re headed,” said Andrew Noymer, an associate professor of public health at the University of California, Irvine. “I think the U.S. is still in for a doozy of a next six months. We haven’t seen the effects yet of school reopening.”…

There will be no immediate fix for the pandemic, experts said, and no promise that the current surge will be the final one.

“I think we’re definitely at risk for being in a very unsatisfying, muddling-though kind of state for a while,” said Dr. Joshua Sharfstein, a vice dean at the Johns Hopkins Bloomberg School of Public Health.

Still, there remains the prospect, as more city councils vote to require face coverings and more people decide to get shots, that the pandemic’s course will eventually feel more upbeat, more like it did when summer started.

“I’m hoping March of next year that we’re having a very different conversation, that we’ve gotten through it,” said Cory Mason, the mayor of Racine, Wis., where masks are once again mandatory. “I think that’s the one thing that everybody agrees on: Can we just get back to a place where Covid isn’t dominating so much of our time and our lives?”” (L)

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