The White House is resisting demands from pediatric health groups to declare a national emergency due to the early rise in respiratory illnesses among children.
Given that seasonal flu, respiratory syncytial virus (RSV), coronavirus, and other respiratory viruses are swarming in the country, the American Academy of Pediatrics and Children’s Hospital Association argue that an emergency declaration that would give providers additional funding and more flexibility over regulations is the best and quickest way to help the congested healthcare system.
In a letter to President Biden and Health and Human Resources Secretary Xavier Becerra, the two organizations said the “unprecedented extent” of RSV and rising flu infections warrant a double declaration of a national emergency and a public health emergency.
“We need emergency funding assistance and flexibility in the same way we were provided to respond to the COVID surges,” the organizations wrote.
However, the Department of Health and Human Services (HHS) said that a national emergency is not currently required.
“We’ve offered assistance to countries to combat the effects of RSV and influenza and are ready to provide assistance on a case-by-case basis to communities that need help,” said an HHS spokeswoman.
“We encourage people to take everyday prevention measures. This includes avoiding close contact with sick people, staying home when sick, covering coughing and sneezing, and keeping up to date with their flu and COVID-19 vaccines to prevent the spread of infectious diseases. National public health emergencies are identified based on nationwide data, scientific trends, and the insights of public health experts,” she added.
In a conversation with reporters earlier this month, government health officials told the government that the federal government is working with state and local partners to resolve capacity issues in hospitals amid the rise in respiratory illnesses.
If demand for a jurisdiction exceeds its capacity and available resources, the federal government could step in and help with staffing and supplies, said Dawn O’Connell, assistant secretary for preparedness and response.
Supplies such as ventilators and personal protective equipment are available through the Strategic National Stockpile, O’Connell said, but no state has yet applied for such a level of assistance.
The support offerings — and the demand for more — come from the fact that hospitals are busy, beds are scarce and staff shortages are pushing the workforce to the limit. In some cases, there aren’t enough doctors, nurses, or respiratory therapists, even when hospitals have beds available to staff them.
According to data from the Centers for Disease Control and Prevention, the hospitalization rate among all children peaked at 17.5 out of 100,000 in the week of November 12, a rate that was double that of any other season since records began.
Capacity shortages in pediatric hospitals and pediatrician practices mean that more children are being cared for in community and adult hospitals, which may have limited or no capacity to care for children.
Amy Knight, president of the Children’s Hospital Association, said an emergency statement makes it easier for hospitals to add cribs in places not normally used for inpatients, such as a treatment room or game room.
“From a regulatory perspective, that’s not okay. If you have a public health emergency, you’re allowed to… make decisions like this,” Knight said. “Ultimately, it opens up many opportunities for children’s hospitals to do the right thing for patients regardless of the typical regulatory bureaucratic restrictions.”
Oregon became the first state last week to declare an emergency in response to the surge in RSV.
Since there are only two hospitals in the state with a pediatric intensive care unit, Governor Kate Brown (D) said the ordinance will give hospitals additional flexibility in beds for children and allow them to draw on a pool of volunteer medical nurses and doctors and take further measures to care for pediatric patients.
The US has had a public health emergency due to COVID-19 since 2020, which has been renewed every 90 days. Other emergencies in recent years have included the opioid epidemic, monkey pox, Zika, and H1N1 swine flu.
Public health experts said the US was careful about declaring emergencies outside of specific cases, such as natural disasters, but the ongoing COVID-19 emergency has paid more attention to the process.
“COVID has led to greater awareness of this opportunity and possibly more desire to use it among stakeholders and others,” said Jen Kates, vice president of the Kaiser Family Foundation.
“And I think that speaks to the fact that it is very difficult to draw attention to public health crises and that resources are limited. The letter from pediatric groups is really a call to concern that there’s a public health emergency they’re feeling faced with and that there simply aren’t enough resources,” said Kates.
Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, said the exemptions and flexibilities that apply during a public health emergency should become the status quo.
“I think that’s the problem. Not so much that they ask about it, but why do they have to ask again and again? ” Adalja said.
“In my opinion, this threshold for declaring an emergency really suggests that our healthcare system, our public health system, is unable to respond to an infectious disease emergency adequately on its own.”