The White House resists declaring an emergency as flu and viruses surge in children

The White House is resisting calls from children’s health groups to declare a national emergency over the early rise in respiratory illnesses in children.

As the seasonal flu, respiratory syncytial virus (RSV), coronavirus, and other respiratory viruses sweep across the country, the American Academy of Pediatrics and the Children’s Hospital Association argue an emergency declaration, which would give providers additional funding and more flexibility from regulations, is the best and quickest way to help. Overburdened health system.

In a letter sent to President Biden and Health and Human Services Secretary Xavier Becerra last week, the two organizations said that “unprecedented levels” of respiratory syncytial virus and rising influenza infections required a dual declaration of a national emergency alongside a public health emergency.

“We need emergency funding support and flexibility similar to what was provided in response to the COVID surges,” the organizations wrote.

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But the Department of Health and Human Services (HHS) has indicated that a national emergency is not necessary at this time.

An HHS spokeswoman said: “We have offered the support of jurisdictions to counter the impact of RSV and influenza, and we stand ready to provide assistance to communities that need assistance on a case-by-case basis.”

“We encourage people to follow everyday preventative measures, including avoiding close contact with sick people, staying home when sick, covering coughs and sneezes, and keeping up with flu and COVID-19 vaccinations to prevent the spread of infectious diseases,” she added, adding that national public health emergencies are being identified. Based on national data, scientific trends, and the insight of public health experts.

In a call with reporters earlier this month, administration health officials said the federal government is working with state and local partners to ease capacity issues at hospitals as respiratory illnesses increase.

When demand for a jurisdiction exceeds its available capabilities and resources, said Dawn O’Connell, Assistant Secretary for Preparedness and Response, the federal government can step in and help with staffing and supplies.

O’Connell said supplies such as ventilators and personal protective equipment are available through the Strategic National Stockpile, but no country has requested this level of support yet.

Offers of support — and demands for more — come as hospitals are full, and a dearth of beds and staff shortages are pushing the workforce to breaking point. In some cases, even if hospitals have beds available, there are not enough doctors, nurses, or respiratory therapists to staff them.

According to data from the Centers for Disease Control and Prevention, the hospitalization rate in all children for the week of November 12 peaked at 17.5 per 100,000, a rate that was more than twice as high as any other season on record.

Capacity constraints in children’s hospitals and children’s offices result in more children being cared for in community hospitals and adult hospitals, which may have limited or no capacity to care for children.

Amy Knight, president of the Children’s Hospital Association, said the emergency declaration makes it easier for hospitals to add cots for children in spaces not normally used for inpatients, such as a treatment room or playroom.

From an organizational point of view, this is not acceptable. When you have a public health emergency, you’re allowed to … make these kinds of decisions, Knight said. “It ultimately creates a lot of avenues for children’s hospitals to do the right thing for patients regardless of the typical regulatory bureaucratic constraints.”

Last week, Oregon became the first state to declare a state of emergency in response to the RSV spike.

With only two hospitals in the state having a pediatric intensive care unit, Gov. Kate Brown (D-) said the order would give hospitals additional flexibility to staff beds for children and allow them to rely on a pool of volunteer nurses and doctors and take other steps to provide care for pediatric patients.

The United States has been under a COVID-19 public health emergency since 2020, renewed every 90 days. Other emergencies in recent years include the opioid epidemic, monkeypox, Zika, and H1N1 swine flu.

Public health experts said the United States has been judicious about declaring emergencies outside of specific situations such as natural disasters, but the ongoing COVID-19 emergency has brought more attention to the process.

“COVID has led to more awareness of this possibility and perhaps more willingness to try and use it on the part of advocacy groups and others,” said Gene Cates, vice president of the Kaiser Family Foundation.

“And I think that speaks to the fact that it is very difficult to bring attention to public health crises, and resources are limited. The message from pediatric groups is really a call for concern that there is a public health emergency that they feel they are facing, and there are not enough resources,” Keats said.

The waivers and flexibilities that occur during a public health emergency should become the status quo, said Amesh Adalja, a senior fellow at the Johns Hopkins Center for Health Security.

“I think that’s the problem. Not so much that they’re asking for it, but why do they have to keep asking for it?” said Adalja.

“This threshold for calling an emergency declaration, I think, really speaks to the fact that our health care system, our public health system, is not able to respond adequately quickly enough to an infectious disease emergency on its own.”

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