The White House is resisting calls from pediatric health groups to declare a national emergency over the early rise in childhood respiratory disease.
As seasonal flu, respiratory syncytial virus (RSV), coronavirus and other respiratory viruses sweep the nation, the American Academy of Pediatrics and the Children’s Hospital Association are calling for a declaration of emergency, which would provide providers with additional funding and greater regulatory flexibility, is the best and quickest way to help the overburdened health system.
In a letter sent last week to President Biden and Secretary of Health and Human Services Xavier Becerra, the two organizations said the “unprecedented levels” of RSV and rising flu infections are a double declaration of a national emergency and an emergency for the public. justify public health.
“We need emergency funding and flexibility along the lines of what was provided to respond to COVID spikes,” the organizations wrote.
But the Department of Health and Human Services (HHS) indicated that a national emergency is not necessary at this time.
“We have provided support to jurisdictions in addressing the impact of RSV and flu and stand ready to provide case-by-case assistance to communities in need of assistance,” said an HHS spokeswoman.
“We encourage people to take daily preventive measures, including avoiding close contact with people who are sick, staying home if they are sick, covering coughs and sneezes, and staying up to date on their flu and COVID-19 vaccines to prevent the spread of infectious diseases. National public health emergencies are determined based on national data, scientific trends and the insight of public health experts,” she added.
Speaking to reporters earlier this month, administration health officials said the federal government is working with state and local partners to alleviate capacity problems at hospitals as respiratory illnesses rise.
When demand for a jurisdiction exceeds its capabilities and available resources, the federal government can step in and help with personnel and supplies, said Dawn O’Connell, the 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 requested that level of support.
The offer of support – and the call for more – comes as hospitals run out of capacity, beds are scarce and staff shortages push the workforce to its limits. In some cases, even when hospitals have beds available, there aren’t enough doctors, nurses, or respiratory therapists to staff them.
According to data from the Centers for Disease Control and Prevention, hospitalizations among all children peaked at 17.5 in every 100,000 during the week of Nov. 12, a rate twice that of any other season on record.
Capacity constraints in children’s hospitals and pediatric wards result in more children being cared for in public and adult hospitals, which may have limited or no capacity to care for children.
Amy Knight, president of the Children’s Hospital Association, said a declaration of emergency would make it easier for hospitals to add children’s beds in places not normally used for inpatients, such as a treatment room or playroom.
“From a regulatory point of view, that’s not okay. When you have a public health emergency, you get to … make those kinds of decisions,” Knight said. “It ultimately creates a lot of opportunities for children’s hospitals to do the right thing for patients, regardless of typical regulatory bureaucratic constraints.”
Oregon last week became the first state to declare a state of emergency in response to the RSV spike.
With only two hospitals in the state with a pediatric ICU, Gov. Kate Brown (D) said the order will give hospitals additional flexibility to staff beds for children and allow them to use a pool of medical volunteer nurses and physicians and other steps to provide care to pediatric patients.
The US has been facing a public health emergency for COVID-19 since 2020, and it’s been extended every 90 days. Other emergencies in recent years include the opioid epidemic, monkeypox, Zika and the H1N1 swine flu.
Public health experts said the US has been prudent in declaring emergencies outside of specific cases such as natural disasters, but the ongoing COVID-19 emergency has drawn more attention to the process.
“COVID has led to increased awareness of this opportunity, and possibly more desire to try and leverage it with advocacy groups and others,” said Jen Kates, vice president of the Kaiser Family Foundation.
“And I think that says it’s very hard to get attention for public health crises and resources are limited. The letter from pediatric groups is really an alarm call that there’s a public health emergency they’re dealing with, and there just aren’t enough resources,” Kates said.
Amesh Adalja, a senior scientist at the Johns Hopkins Center for Health Security, said the waivers and flexibility that occur during a public health emergency should become the status quo.
“I think that’s the problem. Not so much that they ask for this, but why do they have to ask for this all the time?” said Adalja.
“This threshold to declare an emergency, I think it really speaks to the fact that our healthcare system, our public health system, is not able to respond quickly enough to an infectious disease emergency on its own.”