HJBR Nov/Dec 2021

Q&A 26 NOV / DEC 2021 I  HEALTHCARE JOURNAL OF BATON ROUGE proud of how everyone rose to this occa- sion and worked together to make sure children continued to receive the highest quality care. Did hospital staff anticipate this surge in pediatric cases? We did prepare early on for a surge of patients, but it wasn’t until the Delta variant emerged that our capacity was challenged. We had general pediatricians prepared to help in the emergency room. Less busy clin- ics were absorbing patients (in person and by video visit) from more overwhelmed clinics. We had to be somewhat creative in making sure patients’ needs could be addressed so that they would not unneces- sarily end up in the busy hospital and ED. What impact did Hurricane Ida have on your facility and patients? As with all storm events, there are many operational challenges before and after. One example is that expensive vaccines must be secured. Patients often need to be resched- uled due to clinic closures. When one office is out of power, we try to accommodate patients in an office that is functioning bet- ter. Patients who were displaced from Ida found their way to our clinics and hospital, and some out-of-town physicians needed space to accommodate their patients. For- tunately, none of our clinics flooded or were heavily damaged with this storm. Every event like this prompts us to think about how we can strive to be better. What were the biggest challenges during this Delta wave? Supplies, oxygen and space were not the biggest problem. Staffing shortages have been the biggest challenge of this pandemic for our hospital system. Nurses in particular are in critically short supply from the ICU to the outpatient clinics, a situation expe- rienced nationwide. While coping with increased volumes in our offices, another challenge for pediatricians has been the sheer number of conversations we need to have every day to educate patients about isolation, quarantine, when to do a test, what to do if it’s positive, why it’s important to mask, the truth about vaccines, why it’s important to get kids back in school, etc. The toll the pandemic has taken on the mental health of our kids and parents has been sig- nificant and sobering. What experiences, details were unexpected? Early on, the explosion in demand and need for video visits was remarkable. We had a good platform in place to do video visits, but they hadn’t caught on yet. Luck- ily, this has turned out to be a great way to address patients’needs without themhaving to expose others to get a test and advice. We had to quickly put in place measures to bet- ter distance patients and keep them out of waiting rooms. Testing sites popped up and mass vaccination sites followed. All of these things will be beneficial in the future even if COVID-19 is no longer a problem. Has the hospital seen an unexpected surge of respiratory syncytial virus (RSV) cases recently? If so, why do you think that happened? Do you think it may be due to the previous year’s social isolation preventing kids building up immunity? This summer’s surge in RSV infections was both surprising in its timing and prob- lematic in that there are many overlapping symptoms with COVID-19. It’s hard to say for sure without scientists’ further analy- sis, but I do feel like the social distancing, handwashing and masking we did for COVID-19 almost eliminated both RSV and influenza this past winter. These measures relaxed some as COVID cases improved, and then people emerged into social life and summer activities. What was different about treating children with COVID-19 as opposed to adults? Many times, the entire family was infected with COVID-19 at the same time. More difficult to handle in some ways, there were situations where only one or two fam- ily members were affected, but the others tested negative. Families had to sometimes pull in vulnerable grandparents to keep negative but quarantined children while a parent cared for themselves alone. Fami- lies who couldn’t separate had to try and prevent the virus from spreading within the household, which wasn’t always successful. While COVID-positive patients in the adult hospital were restricted to zero visitors, that isn’t possible with children. Thus, the chil- dren’s hospital had to find ways to allow a parent to be with each child but could not allow siblings or other family members to visit. Did the Delta variant manifest differently in children? There were many more cases of COVID among children during the Delta surge; plus, it may have affected children more severely. There were more deaths in chil- dren and young adults, and it became clear that nobody is spared from this unpredict- able virus. Still, most young patients recov- ered well as they usually do. Some patients had mild cough or congestion as their only symptom, which makes it very hard to dis- tinguish from allergies or a common cold. We planned accordingly to ensure plenty of