Every one of Rhode Island’s pediatric hospital beds was full on Sunday and Monday, according to an NBC News analysis of data from the Department of Health and Human Services.
Rhode Island is among the states most severely affected by the aggressive, nationwide surge of pediatric respiratory infections. As of Monday, 76% of pediatric hospital beds were full nationwide. Beds in Washington, D.C., were at 98% capacity, and beds in Arizona were at 96% capacity.
Dr. Frank Overly, the medical director for pediatric emergency medicine at Hasbro Children’s Hospital — a division of Rhode Island Hospital in Providence — said his hospital is beyond capacity now. On Monday, the hospital’s 29 pediatric beds in the emergency room were occupied and there were 29 additional patients in the waiting room, he said.
Like most states, Rhode Island is seeing cases of flu, respiratory syncytial virus (RSV), Covid and other respiratory viruses all at the same time. Overly said RSV accounts for a large share of pediatric cases at his hospital, but flu cases there are rising.
“At times, it’s getting up to over 40 families in the waiting room,” he said, adding that wait times have reached “numbers we’ve never seen before,” such as eight or nine hours for patients who don't have life-threatening conditions.
Hasbro is the only children’s hospital in Rhode Island.
Overly said he took on work over the weekend that would ordinarily be split among several hospital staffers: He cleaned beds, discharged patients, and fetched new kids from the waiting room to oversee and treat. Normally, nurses, technicians, medical assistants and secretaries would help with these processes, but everyone was busy caring for other patients, Overly said.
While some of Rhode Island's adult hospitals are treating pediatric patients with milder cases, children that require more intensive care are being directed to pediatric hospitals in states like Connecticut, Massachusetts and New Hampshire.
Hasbro doesn't turn away patients once they arrive, so the hospital is using beds in the adult emergency department at Rhode Island Hospital and other flex spaces to care for as many kids as possible.
Teresa Paiva Weed, president of the Hospital Association of Rhode Island, said strained hospital capacity "is a New England-wide and national issue."
Dr. Sarah Combs, an attending physician at Children’s National Hospital in Washington, D.C., said doctors there are seeing patients in hallways and flex rooms formerly occupied by clinics. The hospital is operating at or near capacity and the waiting room is fairly full, she said.
"If you come in with trouble to breathe or you actually can't breathe, you're going to be taken right back, so you might have literally a three-minute wait time," Combs said. "If you are there with a nonemergent complaint, you are going to have a long wait time."
Combs said Children’s National is the only pediatric center in Washington that provides both intensive and specialty care under one roof, but added that it has support from other pediatric units in the district, Virginia and Maryland.
Weed said Rhode Island is unique in that "many states have more than one pediatric hospital, and we only have one." Nevertheless, Hasbro is still fielding calls from out-of-state hospitals looking to transfer patients.
Overly said several pediatric units in New England have closed in recent years, which has put further strain on hospital capacity. Tufts Children's Hospital in Boston, located about an hour away from Hasbro, closed in July.
Hospitals have also shut down pediatric units in the mid-Atlantic region. Henrico Doctors’ Hospital in Richmond, Virginia, shuttered its pediatric wards in April, and Doylestown Hospital in Doylestown, Pennsylvania, closed its six-bed pediatric unit at the end of September.
Weed said staffing shortages pose yet another challenge, given the "higher-than-usual number of early retirements and resignations" among health care providers during the pandemic. Even if Hasbro were to find more beds, Overly said, it might not have enough nurses to oversee them.
Weed said Rhode Island Gov. Dan McKee's office is expediting nurses’ licenses so out-of-state nurses can treat kids in Rhode Island, but other New England hospitals are short-staffed as well.
Overly said his hospital might benefit from Rhode Island declaring a state of emergency related to the surge of pediatric respiratory viruses. Such a declaration could help allocate more funding to pediatric care, address nursing shortages and reduce the burden of paperwork for overwhelmed hospital staffers.
"With the resources that we have, we’re struggling to provide the normal care that we would provide," Overly said. "When you have limited resources, you sort of stretch things, which means the care is probably different than what it would be in a normal time."