Children infected with the coronavirus and the hospitals flooded in the fall. Doctors worry about what winter will bring.
Winter seems to have come five months before I arrive at the University of Iowa's Stead Family Hospital for Children, and staff fear dark times will soon come.
The 190-bed facility is about two-thirds full during a typical fall. This year, it has been crowded with young patients since July.
Dozens have developed coughing, wheezing, and fever due to COVID-19, making more children sick than in the early months of the pandemic. Many young patients arrived with severe infections from other respiratory viruses, which usually do not strike in full force until late fall or early winter.
Flu season is coming, and no one is counting on a repeat last winter from postponing that annual blight.
Jennifer Erdal, director of nurses for the pediatric intensive care unit, said her staff is preparing for the current rush of young patients into winter. "It feels a little scary and confusing that it's been two months since that, and we're still swamped - and we think we have another month."
Jodi Whipple, a nurse at the University of Iowa Children's Hospital, talks with 10-year-old Covid Bo Harvey, admitted to the pediatric intensive care unit.
Early in the pandemic, she said, many children hospitalized with COVID came to be treated for something else and tested positive for coronavirus upon admission.
"It's not like that anymore," she said. "We have perfectly healthy children who haven't yet been vaccinated, who have had the COVID virus and are very sick here in the ICU. A lot of the people don't realize these things are happening."
The 28-bed unit looks after many of the sickest children in Iowa. During the regular fall, nine beds are empty per day, but they are often full recently. "It was very stressful and emotionally exhausting for all of us," said Dr. Aditya Padaka, the unit's medical director.
This overcrowded ward is familiar to many hospitals dealing with many young patients as the coronavirus and other bugs spread in late summer and early fall.
Iowa's largest children's hospital has allowed few strangers to visit during the pandemic. USA TODAY team leaders called him to the pediatric intensive care unit in early October to document how the staff was coping with the great wave of young patients.
The Children's Hospital, which was moved to a new building in 2017, was designed to keep the clamor behind the scenes. Intensive care rooms and nursing stations remain quiet, except for frequent beeps and beeps that alert staff to potential problems.
Tubes and wires connect sick children to machines that monitor their condition and provide them with oxygen, medicine, and food.
Patient rooms are surrounded by glass walls and doors and are kept closed when rooms contain infectious disease states. Doctors and nurses wear gowns, goggles, gloves, and face masks before entering these rooms. When they have finished visiting the patient, they take off, dispose of the protective clothing, and then put it back on outside the next door.
Every morning, doctors, nurses, medical residents, and other staff gather in the hall outside each room to see what the child is doing and what treatment is needed. Dozens or more can participate in each consultation, and patients' parents are invited to listen and ask questions.
Once the baby is out of the ICU, the housekeepers go to clean up. They can change some rooms in half an hour or less, but it can take an hour and a half to disinfect a room where a COVID-19 patient is staying. There's no time to waste because another sick kid will probably need the room as soon as it's available.
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