Child COVID-19 Cases Increasing In Northeast Ohio Children's Hospitals

Northeast Ohio hospitals are seeing a concerning uptick in children hospitalized with COVID-19, and officials warn those numbers could continue to rise if proper precautions are not taken in schools.

Currently, two children are hospitalized with the virus, and one of them is in the intensive care unit at Akron Children's Hospital, said Dr. Rob McGregor, chief medical officer.

After weeks of zero COVID-19 hospitalizations, the hospital is now admitting one to four new patients per day, he said.

McGregor anticipates these numbers will continue to increase in the coming weeks now that many schools are back in session.

“It definitely is an uptick,” he said. “I am anxious about school starting and what will travel with that.”

UH Rainbow Babies & Children's Hospital in Cleveland currently has one child hospitalized in the ICU, said Dr. Claudia Hoyen, director of infection control. The hospital system has seen a recent increase in children needing hospitalization after weeks of very low or even zero admissions, she said.

In Cuyahoga County, 13 percent of new cases are in children, said Jana Rush, chief epidemiologist at the Cuyahoga County Board of Health.

The increase in pediatric cases and hospitalizations is likely due to the delta variant, which spreads much more easily than previous strains of the virus and subsequently leads to more severe cases, McGregor said.

“Even if most kids have mild cases of COVID, if enough kids have it … sheer numbers will suggest that we are going to have more of those kids that are much sicker with it,” McGregor said.

The variant is driving a surge in cases across the state and nationwide. While Ohio's hospitals are not overwhelmed like some hospitals in other states, children’s hospitals in some Ohio cities, including Cincinnati and Columbus, are starting to fill up, Hoyen said. The Cleveland area seems to be a few weeks behind them, she said, and it is only a matter of time before things get worse.

“Once we get kids back in school, especially since so many of the school districts in our area have made masking optional … we will follow suit with our colleagues,” Hoyen said.

One possible reason the Northeast Ohio region is faring better than others, Hoyen added, could be because Cuyahoga County’s vaccination rate is one of the highest in the state. More than half of the county’s population is vaccinated, according to the Ohio Department of Health.

Masks, Vaccines The Key To Protecting Kids

Young patients hospitalized with COVID-19 are typically otherwise healthy, McGregor said, although obesity seems to be a common comorbidity.

Akron Children's is seeing more and more patients in the age 5 to 12 range, he said, whereas, in previous months, the majority of the sickest patients were either infants or older teens.

Children under the age of 12 are not yet authorized to receive the COVID-19 vaccine, which is why this is so concerning – especially if schools do not require students to wear masks indoors, McGregor said.

The good news, McGregor added, is that there are many ways to protect unvaccinated children. Schools should require masks indoors during the school day and continue to enforce social distancing in the classroom, he said.

“The things that we did before there was a vaccine were pretty effective – if we mask, socially distance and have hand sanitizing,” he said.

In addition to that, McGregor said it is especially important for unvaccinated adults to get the vaccine to further protect the little ones in their family who cannot yet get the shot.

That’s also a big reason Akron Children’s recently mandated vaccines for its employees, said president and CEO Grace Wakulchik.

“Our job is to protect kids and families, and our staff first,” she said. “The best way to do that is to get a vaccine.”

Employees who cannot, or do not wish to receive the vaccine must be regularly tested for COVID-19 in order to keep their jobs.

The policy has not yet taken effect, but McGregor said there has already been an uptick in employees receiving the vaccine since the announcement Monday.

Vaccines are not mandated for University Hospitals employees at this time, Hoyen said, but officials are having conversations about whether to make that decision, given the increasing spread of the delta variant.

The Pfizer and Moderna vaccines will likely become authorized for the younger age groups in the late fall, McGregor said. Researchers are looking to recruit more pediatric patients for the trials, he added.

Hospitals Have Room, But Prepped For Surge

Akron Children’s still has plenty of inpatient and intensive care unit beds available, and officials can open up an extra unit if a serious surge were to occur, McGregor said.

The biggest complication, McGregor said, is that the hospital is currently experiencing a staffing shortage.

“From medical assistants to nurses, that’s a challenge across the state in all the children’s hospitals,” he said.

The hospital instated a hiring freeze earlier on in the pandemic when elective procedures were postponed and volumes were down, Wakulchik added. Now, it’s a challenge to get workers.

“As volumes have continued to grow, we’ve had to go out and recruit just the same as other hospitals … so we’re all recruiting from the same labor pool, if you will,” Wakulchik said. “It is just a tight labor market right now.”

The hospital is ramping up recruitment efforts and even speeding up orientation to get new employees onboarded more quickly, she said.

UH Rainbow also still has capacity, and officials are reviewing the hospital’s surge plans from earlier in the pandemic to see if any updates are needed, Hoyen said. That plan would be put in place if beds began filling up, she said.

“We had talked about, you know, really doing anything we can to prepare and ensure that we are ready to do whatever we need to do for our community,” Hoyen said.

Another challenge is that other respiratory illnesses are also on the increase, such as respiratory syncytial virus, commonly known as RSV, McGregor said. Though this illness typically spreads in the winter months, it was nearly nonexistent last year because children were wearing masks during the school day, McGregor said.

Now, the hospital is seeing a startling increase in pediatric RSV cases as well – which could also complicate the hospital’s total bed space in the event of a potential surge, McGregor added.

Hospital officials are also gearing up to roll out booster shots for immunocompromised patients.

Last week, the U.S. Centers for Disease Control and Prevention gave the green light for immunocompromised individuals to receive a booster shot of the Pfizer and Moderna vaccines.

McGregor said officials have started reaching out to patients who may qualify for this – such as children over the age of 12 who have weakened immune systems due to conditions like inflammatory bowel disease and cancer. Patients can receive the dose at any of the hospital system’s primary or urgent care locations, he said.