Wednesday afternoon doctors and administrators expressed how staffing shortages due to sickness and burnout along with the demand of services for COVID-19 are putting a massive strain on the Cook Children's Health Care System and its employees.
The hospital has added a third COVID-19 unit for the first time since the pandemic started. It has nine beds and the pediatric hospital system said within the first 24 hours it was completely full.
Their COVID-19 ICU is also full and on Wednesday, Cook Children's said it also set a record with 35 patients hospitalized for COVID-19. That's the highest number of coronavirus patients hospitalized at the medical center at any point in the pandemic.
“We need compassion from the community and this is an illness affecting our children,” said Dr. Kara Starnes, D.O., medical director of Urgent Care Services at Cook Children's. “We are hitting crisis mode and we can’t do it without your help.”
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Cook Children's also had to close their Hurst urgent care facility over the weekend due to lack of staffing and demand of patients.
"We don't typically close our facilities and this move should sound an alarm or it should be like a canary in the coal mine so to speak for what may be to come if we don't take measures as a community to slow down the spread of COVID-19," said Cook Children's Chief Diversity Officer Winifred King.
On Monday, their remaining six locations saw about 1,400 children, which is about double the normal patient load.
There are a combination of reasons for the influx. Doctors are seeing extremely sick kids, but at the same they're being inundated with parents bringing in children for mild symptoms or rapid COVID-19 tests.
"We understand that schools are having requirements and people need to get their kids back to school and to work, but we also want you to understand that you don't need to panic. If your child has been exposed, or has some symptoms, your child is going to need to stay home anyways if they're running a fever, they need to be home at least 24 hours fever free without medicine and so, rushing in to be seen immediately is causing an increased volume in the clinics," explained Starnes during the Zoom news conference.
She suggested if people need a test, to go to a local site or buy an at home testing kit.
Listed below are links to where people can find COVID-19 testing sites:
"Another thing to think about, and I know this can be a bit challenging with schools, but if you have a known positive case of COVID in your family, and you have other sick family members, the assumption can very easily be made that most likely everyone else has COVID as well, and that we need to isolate for 10 days from the onset of symptoms," said Starnes.
She said the common symptoms of COVID-19 in kids they're currently seeing are cough, fever, runny nose, sore throat, body aches, headache, vomiting and diarrhea.
Starnes said it's 'pretty safe' for parents and caregivers to manage these symptoms at home, but if a child starts to have difficulty breathing, they're not eating or drinking properly, not acting right, or if someone has a sick baby under three months, to come in person.
"We're begging for the public's help so that we can take care of the kids who are really sick so we can get to those kids more quickly, because right now if you come to the urgent cares, you can expect at least a two-to-three hour wait. Sometimes it's even longer than that, and we really want to be able to see the patients who really, really need us," said Starnes.
Starnes said they're dealing with loss of staff members due to people being out sick or exposed to COVID-19 despite being vaccinated. She said other illneses are also playing a factor.
Another big component is burnout. Doctors, nurses and other medical professionals who have been going for the last 18 months continue to to work overtime and extra shifts to keep up with the demand.
"They're just really, really tired, and we are struggling with how to manage the patients with the staff that we have," said Starnes.
Some have questioned if staffing shortages seen across the state have to do with vaccine mandates issued by health care employers. Starnes said Cook Children's policy doesn't go into effect until the end of the month and doesn't believe that's related to what they're currently seeing.
Cook Children's said they've asked for 18 nurses from the state, which is bringing health care workers from outside of Texas, to help fill positions. They've only been able to get four because the majority are not trained in pediatrics.
Cook Children's Emergency Department is Feeling the Pressure
On Monday alone, Cook Children's Emergency Department saw 601 patients come through, an all-time high and double the normal number of patients according Dr. Corwin Warmink, M.D. medical director of Emergency Services.
“We are breaking records we don’t like to break. I have been at Cook Children’s for 18 years and this is the worst it’s ever been," said Warmink.
The hospital system said it hasn't seen numbers like this since the H1N1 outbreak in 2009.
Warmink said since school has started, half of the patients coming in are for COVID-19 related concerns or illnesses.
He said just like the urgent care facilities, they too are having people fill up the emergency department with minor symptoms or people asking for a coronavirus test for their child.
"I think we're kind of the last resort for a lot of people that can't get to their primary care physician or to their urgent care center and then they come to us, but we really are imploring people to use us (the emergency department) as the resort for when your child is severely ill, not to get a COVID test or not to (say), 'Hey, I was exposed," said Warmink.
They're advising people to ask themselves if it can wait before bringing a child with minor symptoms to the emergency department.
He said while most children will experience mild symptoms and recover from COVID-19, they are seeing more severe cases now than they did back in January.
- Cook Children's Stats:
- 1,129 children with COVID-19 have been hospitalized during the pandemic
- 241 admitted to the Intensive Care Unit
- Seven kids have died due to COVID-19.
- A 4-year-old and 15-year-old have died due to COVID-19 in the past week
"The Delta variant changed everything, Delta loves kids," said Warmink. "Delta is a game changer, and so that storyline of, 'Oh it doesn't really make children sick or doesn't affect children,' is just not true anymore," explained Warmink.
He continued to urge people to have their children wear masks and get kids who are 12 and older vaccinated.
"I have two kids in school, they wear a mask. It's a no brainer for me, it's the simplest thing in the world, and it doesn't bother them. So the adults in the room, need to step up and do what's right, mask mandates or not, put your kid in a mask. And vaccines, it seems ridiculous that we're having this conversation but, you know, for so long, people were desperate to get that vaccine, and I think people got a little complacent of , 'Well everyone else is getting the vaccine so I don't need to,' well Delta changed that game too," he said.
He said this is on top of of other illnesses that are usually seen at school. The demand is taking a toll on the healthcare workers who continue to echo that all of this is preventable.
"Everything in my training and career was to not freak out, but I'm freaking out," said Dr. Warmink, as he chocked up about the demand he's seeing.
Labor Day Concerns
Since the pandemic started, after every holiday weekend there tends to be a spike in COVID-19 cases. Experts at Cook Children's don't expect anything different this time around for Labor Day weekend, unless people change their behaviors.
“We cannot magically create hospital beds at the drop of a hat,” said Dr. Mary Suzanne Whitworth, M.C., medical director of Infectious Diseases at Cook Children's. “Wear a mask no matter if you’re vaccinated or not, wearing a mask is not an option.”
With school in session and Labor Day weekend coming, they're asking everyone to mask up and get vaccinated.
Staying Alert of Symptoms
Health care professionals continue to reiterate that most symptoms can be taken care of at home, but it is important to keep an eye out and monitor a child's symptoms.
"We've had a lot more kids this time than probably what we've seen in the last six months or so," said Dr. Marcial Oquendo, M.D., with Oak Cliff Pediatrics about the amount of COVID-19 positive pediatric patients he's seen.
He said they're not only testing positive, but sick with full-blown symptoms such as cough, congestion, runny nose and fever,
While the majority are expected to recover and overcome the disease, there is the rare chance that four-to-six weeks later another complication may arise. It's called Multisystem Inflammatory Syndrome in Children or MISC-C.
"A lot of organs can inflame and one of them is the heart and that's usually the one we worry about the most," said Oquendo.
While a fever is one of the main symptoms, there are other specific clues that a child might have MISC-C.
"Redness of the eyes, it looks like pink eye, a lot of kids will have their lips will turn a little bit bright red, and cracked, their tongue will be bright red, they can complain of chest pain or rashes, or sometimes hives, sometimes their fingers and their toes can look purple," he said.
Oquendo says blood tests help diagnose the condition, but it's important parents and doctors remain alert.
"Thankfully it's still very rare," Oquendo said. "It's a matter of people knowing this exists and pediatricians and family doctors and nurse practitioners being aware this is still a possibility."
*Map locations are approximate, central locations for the city and are not meant to indicate where actual infected people live.
How to Avoid COVID-19 Infection:
The best way to prevent infection is to take precautions to avoid exposure to this virus, which are similar to the precautions you take to avoid the flu. CDC always recommends these everyday actions to help prevent the spread of respiratory viruses, including:
- Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- Avoid close contact with people who are sick.
- Stay home when you are sick.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces.
*Information shared from the Office of Texas Gov. Greg Abbott