Editor’s Note: Ben Tinker is the executive producer of CNN Health. The views expressed in this commentary are his own.
When my husband and I were counting down the days to the birth of our son last year, one of my best friends shared this quote with me: “Making the decision to have a child – it’s momentous. It is to decide forever to have your heart go walking around outside your body.”
Two weeks ago, I watched as my heart lay helpless in a pediatric ICU bed, hooked up to a tangled array of wires and tubes and lifesaving machinery – cared for around the clock by a team of dozens of doctors, nurses and respiratory therapists.
As the executive producer of CNN Health, I have been responsible for covering – along with my incredible team – every development, big and small, in the coronavirus pandemic over the last year and a half. That includes, of course, all the latest news regarding infections, vaccines and masks, but also the secondary ramifications of Covid-19, such as kids falling behind on routine vaccinations, the mental health impact of remote school and work, as well as a vicious resurgence of respiratory viruses as children and adults emerge from their Covid bubbles.
Back in June, we reported on a spike in cases of respiratory syncytial virus (RSV) across the South. “RSV is a common respiratory virus that usually causes mild, cold-like symptoms … but RSV can be serious, especially for infants and older adults,” according to the US Centers for Disease Control and Prevention. That same week, we also reported why the upcoming flu season might be more severe.
Even as these other common respiratory illnesses skyrocket, we are again averaging more than 150,000 new Covid-19 cases every day in the United States. More than 95,000 Americans are currently hospitalized with Covid-19 – nearly all of whom are unvaccinated.
Covid-19 hospitalization rates among children and adults under age 50 are now the highest they’ve ever been. And we still don’t have a Covid-19 vaccine for children younger than 12.
What that means: It’s up to responsible adults and adolescents to get vaccinated against Covid-19 to protect this country’s children – to slow the spread of coronavirus, keep in-person learning possible and reserve hospital beds for those who unexpectedly need them by no fault of their own.
This is why I’m sharing my family’s story – as a call to action for everyone to make the important decisions that allow us to maintain a safety net that any of us might need at any time.
You probably remember last winter, preeminent health experts worried about a “double whammy” of Covid-19 and flu resulting in the country’s hospitals being overwhelmed. But while many hospitals certainly exceeded capacity (and health care workers were run ragged – physically, mentally and emotionally), the double whammy never bore out. Why? Stay-at-home orders and mask wearing rendered flu virtually non-existent last winter. But this winter, with everyone back out and about, I’m worried we aren’t ready.
The warning signs
Like many children, my son spent most of the last year at home. But once Covid-19 vaccines became widely available and it seemed like the country was getting a grip on the pandemic a few months ago, we decided to enroll him in daycare. He’s 16 months old now, and we worried about him missing out on learning in a structured setting, and not having the chance to socialize with other kids. We did our research, toured a few options, and ultimately enrolled him at a daycare with substantive Covid-19 mitigation measures in place – not to mention a great curriculum.
Since he started in June, little man has been beset by constant “daycare crud” – as one of my colleagues calls it – that many children experience when they first start school. A runny nose, a little cough, an ear infection; some steamy showers, infant ibuprofen, antibiotic prescriptions; we all move on.
Indeed, our son did contract RSV his first month at school and recovered just fine. Then three Saturdays ago, he started acting a little funny – nothing too concerning, he just wasn’t himself. We were scheduled to leave town on a family vacation the next day, so I took him to the doctor to get checked out before we left. Diagnosis: Probably another ear infection. The pediatrician told us to keep an eye on his symptoms over the next day or two and wrote a prescription for us to fill while we were out of town if we needed it.
But Sunday morning, little man barely touched his breakfast – odd for a kid who usually eats such an unbelievable amount of food that we wonder where in his body it goes. He was fussy, tired, wanted to cuddle during the daytime – all out of the ordinary. We kept packing the car to leave, hoping he’d sleep it off on the road, but as we pulled out of the driveway – literally, before we got to the end of our street – he threw up, so we turned around and came home.
We decided to put him down for a nap, see how he was acting when he got up, and then reevaluate whether or not to hit the road again. When I woke him up, his breathing really concerned me – he was taking short, shallow breaths. When I went to change his diaper, rather than seeing his belly expand and contract with each breath, it looked like he was sucking in beneath his ribs. I knew from talking to his pediatrician when he was sick with RSV that this was a telltale sign of respiratory distress in children.
So, we got back in the car and drove straight to the emergency room at Children’s Healthcare of Atlanta.
Cause for concern
Luckily, we didn’t have to wait too long to be seen. And as soon as he was evaluated, the sense of urgency escalated even more. Thank God it did. By the time we got back to a room in the ER, little man’s heart was beating more than 180 beats per minutes (normal for his age is 80-130 BPMs) and he was taking close to 60 breaths per minute (normal for his age is 20-30 breaths per minute). Most concerning: His blood oxygen level was dipping into the low 80s (good is 95% and above; anything below 90% is concerning).
The ER staff got him hooked up to oxygen and tried a few albuterol treatments, which had little to no effect (we learned this was actually good news, because it indicated he didn’t have undiagnosed asthma). At that point, the doctor told us our chances of not spending the night in the hospital were 10-15%. What they needed to determine was how much oxygen support he needed, and that would be the deciding factor between admitting him to a “floor” (regular) room or the pediatric ICU.
While we worked to figure that out, a test for 15 respiratory viruses (including Covid-19) came back positive for two: rhinovirus and parainfluenza. While usually not a big deal, this double whammy resulted in our son developing bronchiolitis – “a common lung infection in young children and infants,” according to the Mayo Clinic. “Most children get better with care at home. A small percentage of children require hospitalization.”
Thankfully, a chest X-ray came back negative for pneumonia.
The low-flow oxygen didn’t help at all, and we were quickly reaching the upper limits of high-flow oxygen support. Shortly after midnight, the ER staff wheeled us up to the pediatric ICU on a gurney, my son half asleep on my chest.
Not all heroes wear capes
We arrived in the ICU to find a team of doctors, nurses and a respiratory therapist waiting for us. I handed my son to them, and they laid him down in a crib to hook him up to a device called a RAM – basically the most significant form of non-invasive oxygen support before needing to be sedated.
Since he was not sedated, he needed to be pinned down and held still while they positioned the cannula in his nose and taped the tubing to his face. A feeding tube also needed to be inserted because you’re unable to eat while receiving this level of oxygen support.
Somewhere amid all screaming and crying, I felt myself about to throw up or pass out, so I stepped to the back of the room to sit down. I knew they were helping him; I just couldn’t bring myself to watch.
Thank God he’s so young, I thought, that when this is all over, he won’t remember any of it.
Once he had finally settled down and fallen asleep, my husband went to run home and grab our toothbrushes, my contact lens case and – most importantly – some toys and books that would help little man feel more comfortable during his hospital stay. We were told to expect to be there a week, based on the typical trajectory of these illnesses. We were also warned that they usually peak between days 3-5, so things could still get worse.
I stood over my son’s bed, machines whirring and beeping next to me, unable to believe where our day had ended up. I was anxious and terrified, but also grateful and at peace, knowing he was receiving care from an extraordinary team of caregivers.
Now in the room just the two of us, I started to quietly sing “Raining Tacos,” one of my son’s favorite silly songs: “It’s raining tacos / from out of the sky / tacos, no need to ask why / just open your mouth and close your eyes / it’s raining tacos.” That’s as far as I made it before I started sobbing.
Would we ever sing and dance to this song again? Would he ever make it out of the ICU? And if he did, would there be any long-term effects of his illness?
What transpired were five excruciating days and nights for all of us: constant poking and prodding, watching and waiting, and – worst of all – deep suction every few hours to remove the mucus stuck in his airways, so he could begin to breathe on his own again. And this was for a case that ultimately did not get worse, as doctors suggested it might.
Every single person who entered our little one-room universe that week wore a mask and disposable yellow gowns, to protect themselves from contracting a respiratory illness. But while one of the nurses tried to make my son laugh by telling him the gown made her look like Big Bird, I swear it looked more like a superhero cape to me.
During my darkest, sleep-deprived moments, I wondered what would’ve happened had we left for vacation and been driving through rural Georgia when things took a turn for the worse. I wondered if we’d made a mistake by not bringing him to the hospital a day earlier. And, of course, I questioned whether we made the right decision to send him to daycare, which is almost certainly where he contracted the two viruses that knocked him out.
But during my most present, salient moments, I was just grateful – grateful for the incredible team caring for our son (and us!); grateful for our health insurance and not needing to factor in our ability to pay in deciding to go to the hospital in the first place; and grateful there was an open bed for inpatient treatment.
Time for action
During one of my conversations with the hospital staff, they told me they’re usually super slow this time of year, but instead their ICU was almost at capacity – in large part because of the unforeseen number of respiratory viruses circulating this season. On the day we were transferred out of the ICU to a regular room to monitor little man one more night while he slept (if oxygen desaturation occurs, it’s likely going to be during REM sleep), the nurse told us they only had one bed left.
I refused to let my mind go to the place if my son had been this sick and couldn’t receive the care he needed because hospitals were overrun with Covid patients. But around the country, some families are already living this nightmare scenario. The week my son was hospitalized, Dallas County, Texas had zero remaining ICU beds for children.
Dallas County Judge Clay Jenkins laid out the consequences in no uncertain terms: “That means if your child’s in a car wreck, if your child has a congenital heart defect or something and needs an ICU bed, or more likely if they have Covid and need an ICU bed, we don’t have one. Your child will wait for another child to die.”
At the beginning of this week, five states were at more than 90% ICU capacity. Georgia, where we live, is third worst: 94% full statewide. Children’s Healthcare of Atlanta says they’re seeing more Covid-positive children now than at any other point during the pandemic.
The national data bears this out. The American Academy of Pediatrics said last week that more than 120,000 Covid-19 cases were reported the previous week, and that child cases have “steadily increased” since the beginning of July.
And on Thursday, at a news conference with leaders from metro Atlanta hospitals, Dr. Jim Fortenberry, chief medical officer of Children’s Healthcare of Atlanta, said he supports in-person learning but also supports universal mask wearing, regardless of vaccination status.
“We owe it to our kids to do everything to protect them,” he said.
This is why I am so bewildered but also furious when I read about governors banning mask mandates – something science tells us would serve as another important layer of protection against coronavirus, and also against other surging respiratory viruses.
Here in Georgia, Gov. Brian Kemp last week signed an executive order allowing businesses to disregard local Covid-19 ordinances, including masking.
This is simply inexcusable. In the early weeks – and even months – of the pandemic, it would’ve been understandable if we and our leaders didn’t make all the right decisions for our health. We didn’t have the science then, but now we do.
Research has shown that the Covid-19 vaccines are safe and effective, and masks are another important strategy to snuff out a virus that is still transmitting at “high” and “substantial” levels in more than 95% of US counties.
Children across the country are getting infected with the coronavirus in greater numbers not because the Delta variant specifically targets them. It’s because young children are not eligible to be vaccinated, and the virus is looking for a new host.
But still, less than two-thirds of eligible Americans (people age 12 and older) have gotten vaccinated, so we never got our community immunity levels where they needed to be. Put simply: We’ve failed our children.
The virus doesn’t care if someone is unvaccinated because they’ve made that choice or because they’re not yet eligible. That this wave is beginning to rival previous waves, when there were no vaccines, is unforgivable.
There are only so many hospital beds available, and adults and children alike need care for things other than Covid-19 – which can be prevented with a free, widely available vaccine.
Heart disease and cancer are still the leading causes of death in this country. Those patients deserve treatment. People who get in an accident, by no fault of their own, deserve treatment. The infinitesimally small number of people who did everything right yet experience serious breakthrough Covid-19 infections deserve treatment.
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And my son, who got sick because his immune system hasn’t fully developed yet, deserved treatment. Thankfully, he got it and has fully recovered, but I’m sharing our family’s story because it is my sincerest hope that no parent or child ever finds themselves in the circumstance of needing care and not being able to get it because of the poor decisions of others.
We’ve made the same mistakes too many times throughout this pandemic, but tomorrow can be different. Tomorrow needs to be different – not only for ourselves, but for our kids.
Thankfully, we know the ways out of this nightmare: Wear a mask and get vaccinated.