Riley infectious disease physician says December saw the highest number of children hospitalized for Covid since the pandemic began; National Guard is deploying to Riley this week.
By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org
For Dr. Samina Bhumbra, the Covid pandemic often feels like the movie “Groundhog Day.” It’s as if she is living the same day over and over again.
“There have been very few moments since March of 2020 that we’ve been able to catch a breath or catch a break,” she said last week after a full day of treating patients with a variety of infectious diseases. “There’s always been a new obstacle that’s been presented to us.”
The “us” she is speaking of is the healthcare community, but it extends to society at large, of course.
As associate medical director for infection prevention at Riley Hospital for Children, Dr. Bhumbra was thrust into the front lines of the fight against Covid straight out of her fellowship in the summer of 2020.
But December marked the toughest month at Riley since the pandemic began nearly two years ago.
“We’ve admitted at least 70 patients with Covid this month,” she said on Dec. 29. “And of those, 40 percent needed ICU care.”
As of this afternoon (Jan. 4), Riley was caring for 32 Covid-positive patients in the hospital, according to Dr. Elaine Cox, chief medical officer for Riley. Of those, nine are new moms in the maternity center and 11 are children in the pediatric intensive care unit – seven of whom are on ventilators.
“We have about four times as many children admitted as we’ve had in any other wave (of the pandemic),” Dr. Cox said. “And acuity is worse. More than half are spending time in the ICU and 40 percent of those are on ventilators.”
What’s tragic, Dr. Bhumbra said, is that the vast majority of the children admitted were eligible for the vaccine but had not received it.
“It’s easier to count the kids who are vaccinated vs. the ones who aren’t,” she said. “And these kids in the ICU aren’t there for just a day or two. They’re sick and they need a lot of help.”
HOPING FOR HEALING
Shawn O’Connor is praying that her 10-year-old son Maddox does not need to be admitted to Riley, but he tested positive for Covid over the weekend, just days before he was set to be vaccinated, and for now is being treated at home.
Maddox, who is known around Indianapolis for his outreach work with the homeless community, suffers from mitochondrial disease, which saps his strength and weakens his immune system.
O’Connor has a message for other parents out there: “The debate over vaccines is a hot topic, I know, but vaccines aren’t political. They are public safety,” she said. “It’s not about taking away our freedoms, it’s about protecting our neighbors.”
Those who choose not to get vaccinated or who go out in public knowing they are sick are playing Russian roulette with the life of her son and others like him, she said.
O’Connor, who is caring for her son at home while he is being closely monitored by Riley physicians via phone and other electronic means, said she gets up every three hours to give medication to control his fever, he is on continuous fluids, and he is using a BiPap machine to keep his lungs open.
“His doctors have been amazing,” she said Sunday night. “Dr. (Theodore) Wilson is on call for metabolism and he called us every four hours through the night and into the morning. Cardiology called … checking on him.”
STRAIN ON HEALTHCARE
“I wish people could see how much of a strain this is putting on our healthcare system,” O’Connor added. “These doctors are being forced to treat kids at home and still take care of all the kids in the hospital. Riley has literally been a godsend.”
As the patient census hits capacity at Riley and more team members are hit with the virus, a six-person team from the Indiana National Guard is deploying to the hospital this week.
Two clinicians and four nonclinical workers will assist wherever and however they can, according to Dr. Cox. This will be the 13th IU Health hospital to receive support from the National Guard. In addition, a 20-person team from the U.S. Navy is working alongside staff at IU Health Methodist Hospital.
“It’s an all-hands-on-deck approach right now,” said Liz Linden, chief nursing officer for the IU Health Academic Health Center.
Riley leaders have asked that parents not take their children to the Riley emergency department to be tested for Covid. A trip to an urgent care center or their pediatrician should be faster and will free up Riley staff to care for emergencies in the ED.
O’Connor planned to have her son vaccinated in November, when a lower dose of the Pfizer vaccine was approved for use in kids 5-11. But he had major emergency surgery that month, which threw off her timetable. He was later cleared to receive the vaccine and was scheduled to get his first dose this week, before he got sick.
This afternoon, O’Connor said Maddox is still at home, holding his own. His fever comes and goes, and his blood-oxygen level is improving, now holding steady in the mid-90s during the day. She is hopeful that he can receive a monoclonal antibody infusion Wednesday.
“So he’s thankfully getting medical attention, just not the conventional way,” she said.
Dr. Michele Saysana, chief quality and safety officer for IU Health and a hospitalist at Riley, cautions that while there have been advances in treatments for Covid over the past 22 months, some are losing their effectiveness and supply is limited for others.
“There is by far more vaccine available than there will be treatment for Covid,” she said.
BY THE NUMBERS
As of mid-December, only about 20 percent of children in the U.S. ages 5-11 had received their first Covid shot; 14.7% were fully vaccinated. Among those 12-17, 53.4% were fully vaccinated. In Indiana, just over half of the eligible population from age 5 through adult has been vaccinated.
Dr. Bhumbra continues to preach the value of vaccines to the families she encounters in clinic and on inpatient rounds.
“The hardest thing of all this is just knowing we have the means – with the vaccine, with masking, with handwashing combined – to help prevent a lot of the things we’re experiencing now,” she said.
“I just wish folks out there would understand that even though they may be healthy, or their family member fortunately didn’t get really sick from Covid, it may infect others around them and be far worse.”
It takes a physical and mental toll on the healthcare workers who are faced with surge after surge of Covid patients, the same healthcare heroes the public saluted in the early days of the pandemic.
For Dr. Bhumbra, it’s disheartening, but she continues to approach each vaccine-hesitant caregiver with compassion and patience.
“The common reason we hear from families who haven’t been vaccinated is that they want to see more research. We are in our world of medicine and we see one thing, but it’s not necessarily congruent with what people see who aren’t in medicine,” she said. “Trying to bridge that gap is really difficult.”
So she listens to their concerns and addresses them as best she can, reassuring parents that the vaccine is safe and effective.
“I try to share the knowledge so they can spread the knowledge. But it’s tough,” she said. “We are entering our third year of this, and it’s wearing us down.”
VACCINE CLINIC AT MUSEUM
Riley is partnering with The Children’s Museum of Indianapolis this Thursday on another free vaccine clinic for children ages 5 and older, as well as adults. Booster shots and flu shots also will be offered.
The first clinic at the museum attracted hundreds of families, and Dr. Bhumbra hopes for a similar turnout this Thursday. The vaccine clinic, which runs from 4 to 8 p.m., is open to the public, and pre-registration is not required. The museum is located at 3000 N. Meridian St.
File photos by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org