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ATLANTA — As a trio of respiratory viruses spreads across the country and pediatric hospitalizations remain high, some hospitals are running into a new problem: a shortage of medical-grade cribs.
Pediatric hospital beds have been more full than usual for months. Last month, children's health leaders called for a formal emergency declaration from the U.S. government to support hospitals and communities amid an "alarming surge of pediatric respiratory illnesses, including respiratory syncytial virus and influenza, along with the continuing children's mental health emergency."
Michigan's largest health system, Corewell Health, ordered more than 50 additional cribs "to accommodate the surge in pediatric upper respiratory infections," Tim Essenmacher of Corewell Health William Beaumont University Hospital and Corewell Health East's Melanie Fisher told CNN in an email.
Corewell Health Helen DeVos Children's Hospital has brought out both specialized and non-specialized cribs from storage to meet the demand of pediatric patients.
"We also received a shipment of 10 cribs from the Stryker Corporation. Additional cribs have been ordered so that we are well positioned to handle additional pediatric patients," said Jeremy Kelly, business assurance specialist with that hospital.
A spokesperson for Stryker declined to comment.
Demand at Hard Manufacturing, which makes cribs, bassinets and youth beds for hospitals, has shot up, President Marjorie Bryen said.
"It's been a crazy time over the past 4-6 weeks and it doesn't appear to be calming down anytime soon," she wrote in an email.
"Since we make our products to order for each hospital customer, this spike in demand (especially after the very limited demand during the two years of COVID-19) has been a challenge for us to maintain our typical turnaround times. We are working overtime to meet the demand as best we can. Maintaining a high-quality product is critical and cutting corners is not an option," Bryen said.
Ventilators are also in demand, according to the American Hospital Association, which received its first non-COVID-related request to the dynamic ventilator reserve since the program's launch in April 2020 due to the surge in RSV cases.
More shortages affecting hospitals
Cynthia Zheng, director of pharmacy operations and support services at Nemours Children's Health, Delaware Valley, says some shortages have been ongoing since the COVID-19 pandemic.
"These shortages vary from items being on backorder with no estimated shipping date to product discontinuation without notice. The reasons include transportation issues and labor shortages," Zheng said. "At Nemours Children's Health, these supply challenges are magnified due to pediatric populations needing more specialized equipment to accommodate different stages of growth. In addition, the high volumes as a result of an early spike in RSV, have only put more strain on an already stressed system."
And as more people turn to medications to ease symptoms or treat infections, hospitals are reporting a shortage of things like Tamiflu, amoxicillin, Augmentin and albuterol.
The shortage of these key medications used to treat common childhood illnesses like flu, ear infections and sore throats doesn't seem to be a manufacturing problem but a result of increased demand.
Demand for over-the-counter children's painkillers has also increased, fueled by the surge in respiratory illnesses.
At Seattle Children's, Emily Benefield, manager of pharmacy clinical programs, encourages families to wait to buy over-the-counter liquid fever reducers if their child doesn't have a fever and to "consider other ways to keep your child comfortable such as ensuring they are well hydrated and avoiding overheating with clothing and blankets."
Such alternative treatments "could be a key factor in addressing the shortages," Zheng said.
Chief Pharmacy Officer Champ Burgess of University Hospitals Cleveland says officials there are asking doctors to prescribe alternative medications, such as cephalexin and trimethoprim, to reduce the demand on some of the affected drugs.
"We try to save the medication for patients who really need it and there's no other alternatives available, but if there is an alternative, we provide guidelines for physicians to switch to," Burgess said.
We try to save the medication for patients who really need it and there's no other alternatives available, but if there is an alternative, we provide guidelines for physicians to switch to.
–Champ Burgess, University Hospitals Cleveland
Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, said that preserving medications for patients who critically need them is especially important with the pediatric population.
"We want to be very good stewards of the drugs that are at our fingertips because they are in limited supply and because we know that if we give them when they're not needed, it can actually increase the strength of the viral infection," she said.
While hospital systems may seem to be at a tipping point — overburdened with sick people and running out of medicine and equipment — Mike Schiller, senior director of the supply chain with the Association for Health Care Resource & Materials Management, said not to worry.
"We're coming up on three years that we've been in this type of an environment, and the back of the U.S. health care system — hospitals — has not broken," he said. "We're very resilient, very resourceful. And I think that you've seen that across both the clinical and supply chain operational workflows and processes to support patient care, and we'll continue to do so with both RSV, flu and any COVID cases that come up."
Last month, children's health leaders requested a formal emergency declaration from the federal government to support hospitals and communities amid an "alarming surge of pediatric respiratory illnesses, including respiratory syncytial virus and influenza, along with the continuing children's mental health emergency."
The Biden administration has not declared a public emergency for RSV or flu, but in a letter to the nation's governors Friday, U.S. Health and Human Services Secretary Xavier Becerra wrote that the public health emergency declaration for COVID-19 can be applied to more broadly address challenges brought on by a confluence of COVID-19 and other respiratory and seasonal illnesses.
"The administration has exercised regulatory flexibilities to help health care providers and suppliers continue to respond to COVID-19. These flexibilities — while critical in addressing the COVID-19 pandemic — can also help address many of the challenges you face during the spread of non-COVID-19 illnesses, including RSV and flu," the letter says. "They remain available to you and health care providers as you all make care available in response to flu, RSV, COVID-19, and other illnesses."
For example, if a hospital has staffing shortages that have been exacerbated by the COVID-19 pandemic, it may use a waiver that would allow increased surge capacity or easier patient transfers — even if the patients need treatment for something other than COVID-19, such as flu or RSV.
Becerra acknowledged that flu and other respiratory viruses are "increasing strain" on the country's health care systems, and said the Biden administration "stands ready to continue assisting you with resources, supplies, and personnel."