HJAR Nov/Dec 2021

Q&A 14 NOV / DEC 2021 I  HEALTHCARE JOURNAL OF ARKANSAS We clearly saw the cumulative weight of stress and exhaustion among our teams. Did hospital staff anticipate this surge in pediatric cases? While we didn’t anticipate it, we managed the crisis well. Our teams worked diligently even though they were stretched, often taking on extra shifts. The clinical teams, especially nurses and respiratory thera- pists, were true superheroes, advocating for patients’needs and bringing compassion to every bedside, all while providing some of the most physically and emotionally chal- lenging care of their careers. What were the biggest challenges during this Delta wave? One of the biggest challenges was see- ing so many children so sick and under- standing that it could have been pre- vented. Nearly all of our ICU and ventilated patients were unvaccinated, and that never changed despite daily fluctuations in num- bers. I heard many staff talk about how hard it was to watch a teen struggle to breathe and know the available vaccine could have prevented the severe illness. Of course, this was on top of staffing challenges that reflect national shortages, especially in nursing. Has the hospital seen an unexpected surge of respiratory syncytial virus (RSV) cases recently? If so, why do you think that happened? Some think it may be due to the previous year’s social isolation preventing kids building up immunity. Do you think that is accurate? Children’s hospitals nationwide experi- enced a tremendous increase in respiratory syncytial virus this summer, and that is typi- cally an illness we associate with winter. This past fall and winter, we saw very little RSV because people were masking and social distancing well. When summer arrived, and people became more lax in those efforts, RSV began to spread rapidly among chil- dren. We experienced a historic high in RSV cases, which further exacerbated the challenges with staffing and resources we were noting during the simultaneous rise in COVID-19 Delta variant cases. Did the Delta variant manifest differently in children? It does look somewhat different in chil- dren. Not all children have the same respira- tory symptoms that adults show, especially in the less severe cases. Children experi- ence fever, sore throat, nausea and diar- rhea. They can also experience the symp- toms we’ve become familiar with in adult cases over the last 18 months: cough, short- ness of breath, fatigue, headache, changes in smell and taste. Did you see many cases of MIS-C (multisystem inflammatory syndrome in children)? We have seen a handful, but it’s still rel- atively rare. We have seen about 30 cases at Arkansas Children’s since the pan- demic began, and there have been about 4,000 total cases in children’s hospitals nationwide.