COEUR D'ALENE, Idaho — A top doctor at North Idaho's largest hospital expressed concerns this week about a potential surge in pediatric COVID-19 hospitalizations as students head back to school.
Dr. Vanessa Carroll, Kootenai Health's Medical Director of Pediatrics, said in a presentation on Tuesday that the hospital does not have a pediatric intensive care unit (PICU). Sacred Heart Medical Center in Spokane has 19 PICU beds, she said.
Six children were in critical care at Sacred Heart as of Tuesday due to COVID-19, a spokesperson for Providence said. Caiti Bobbitt, a spokesperson for Kootenai Health, said the hospital is not caring for any pediatric COVID-19 patients as of Thursday but has it has seen "an uptick" in the last few months. The vaccination rate for those between the ages of 12 and 17 in North Idaho is also "extremely low," Bobbitt added.
Children younger than 12 years of age are ineligible to receive any of the three coronavirus vaccines. Panhandle Health District reports that 12% of children ages 12 to 15 in Idaho’s five northern counties are vaccinated, Carroll said. Nineteen percent of children ages 16 to 17 years of age in North Idaho are vaccinated and the total vaccination rate for people ages 12 and older in North Idaho is 39%, she added.
“For children less than 12 years of age, they are vaccine ineligible at this time. But they're having increased exposure as more of the social safeguards are being unwound, and they're starting to resume school or have resumed school in parts of the nation," Carroll said. "So it's becoming a more dangerous time for them than previously.”
“For children less than 12 years of age, they are vaccine ineligible at this time. But they're having increased exposure as more of the social safeguards are being unwound, and they're starting to resume school or have resumed school in parts of the nation," Carroll said. "So it's becoming a more dangerous time for them than previously.”
Last week, almost 2,100 children in the United States were hospitalized with COVID-19, Carroll said. This is more than a 500% increase since July 2021. A study out of Canada also showed that children testing positive for COVID-19 with the Delta variant are twice as likely to be hospitalized compared to previous variants. One person infected with the Delta variant is now spreading the virus to five to nine people on average, Carroll said, compared to about two-and-a-half people on average with the Alpha variant.
“We can anticipate from the Coeur d’Alene School District alone approximately 200 children will require hospitalization for COVID. About a third of those hospitalized actually need an intensive care, so about 60 are going to need to be admitted to a pediatric intensive care unit or PICU," Carroll said. "...Please be aware that at the very least, you can probably double this number to estimate the number of school-aged children in our county who are unvaccinated and at risk.”
“If we add up the available beds based on the current projections, we don’t have enough beds to even care for the Coeur d’Alene School District with COVID that require hospitalization, much less Kootenai County or even those states that these hospitals directly serve. So we have a problem," she added.
Kootenai Health has seen pediatric COVID-19 patients who have had pneumonia with oxygen requirements, some who have had risk factors and others who have not, Dr. Carroll said. A newborn baby also presented with bronchitis.
"We've actually had a few of the MIS-C...we just talked about one required transfer to a pediatric intensive care unit for heart failure," Carroll said. "We've actually had another child present with mucositis or inflammation of their mucosal surfaces in a rash. So COVID is here, and we have seen it and have cared for it."
Multisystem inflammatory syndrome (MIS) can affect children (MIS-C) and adults (MIS-A), according to the Centers for Disease Control and Prevention. It is a rare but serious condition associated with COVID-19 in which different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs.
Pediatricians in North Idaho are also seeing increased numbers of Respiratory Syncytial Virus (RSV), which is a common respiratory virus that usually causes mild, cold-like symptoms, but can be serious for infants and older adults, the CDC says.
“In talking to many of our outpatient colleagues, they're reporting winter clinic volumes in the summer, so COVID and RSV are leading to high numbers of hospitalizations," Carroll said.
Kootenai Health is also seeing an increased number of admissions for mental health issues, she said, including children with anxiety, depression, overdoses and eating disorders.
Carroll said the hospital is anticipating a potential surge in patients when schools reopen, especially if there is inconsistent masking. There are no mask mandates in place for Coeur d'Alene, Post Falls and Lakeland Schools. School begins for these three districts on Tuesday, Sept. 7.
“We're certainly concerned, we're worried about the increased number of admissions, again, based on the national trend that we just discussed," she said.
But hospital staff are already recognizing the upcoming need for pediatric beds and preparing for it. Nursing leadership has helped to reallocate space so that the hospital can "care for as many children as possible," Carroll said. The hospital has also done a regional assessment of PICU bed capacity to understand where children who become severely ill can go for intensive care.
