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ICU Beds In Alabama Have Been Filled With Adults And Children

NOEL KING, HOST:

Alabama is one Southern state where there is a real shortage of ICU beds for people of all ages. We're going to check in now with Dr. David Kimberlin. He's a pediatric infectious disease doctor at the University of Alabama at Birmingham and at Children's of Alabama.

Good morning, Dr. Kimberlin.

DAVID KIMBERLIN: Good morning, Noel. How are you?

KING: Good. Thank you. Thanks for being with us. What are you seeing in your pediatric hospital right now?

KIMBERLIN: Well, we're seeing a whole lot of patients with COVID. And, you know, some of them are being admitted to the regular floor, but, you know, about a third are admitted to the intensive care unit. And as of yesterday, more than half of the patients in the intensive care unit had COVID and were there for COVID-related reasons. So I do agree with the prior report that numbers are maybe not increasing as much as they were a week or two ago, but they are still increasing. We are not on the downhill side of this yet.

KING: And, Dr. Kimberlin, just to be clear, these are only children that you're working with?

KIMBERLIN: In the hospital I was referring to, yes, that's correct. Children's of Alabama is the primary pediatric facility in the state. Now, across the state, things are equally dire. And, of course, the numbers - just raw numbers - are much worse for adults 'cause there are a lot more adults than there are children. In Alabama, for these last several weeks, we have had a net negative ICU bed capacity. In other words, you know, anywhere from 10 to 60 or 70 or 80 adults and children in the state are looking and waiting for an ICU bed that is not there, either because the bed doesn't exist or the bed's there but there's no one to staff it because the medical personnel are stretched so thin or are out with COVID themselves.

So this is a - it's hard to stress just how bad this is. I do think we are beginning to see some improvement, and I hope that improvement continues. But keep in mind, we're not that far out from Labor Day. So what happens over these next days, week or so is going to really be telling.

KING: When you can't get a child into a hospital bed at your hospital, what do you do? Do you contact another hospital and try to get them in there? Does that work?

KIMBERLIN: There's, you know, standard approaches that are exactly like that. You get on the phone, and you start calling around and seeing who does have capacity. They're saying the same thing up in Idaho, for instance, and extending over into eastern Washington state, where they're desperately trying to find beds for patients with COVID, and there are no beds in the state. And now, the problem in the Southeast is that everybody's been hit - you know, Arkansas, Missouri, Louisiana, Florida, Alabama, now Kentucky, now Tennessee. So when we're looking for the - and Mississippi, of course - and when we're looking for these beds, therefore, we have to really not only call our neighboring states, but oftentimes call much farther away. And we've had, you know, patients air-flighted out of Houston, for instance, three and four states over, trying to find places for them to go.

KING: That is absolutely extraordinary. And I guess it's worth noting that children don't just get sick with COVID. They break their arms. They, you know, fall out of trees. There are lots of things that send kids to the hospital other than this virus. But for the parents that you're talking to, as they watch their children being admitted, whether it's for COVID or something else, how are they holding up? What are they telling you?

KIMBERLIN: It's tough. You know, if they're there for - with their child having COVID, of course they're scared because it's a lethal disease. And if they're a teenager and perhaps not vaccinated, which is the case for the overwhelming - virtually all - majority of children or adolescents being admitted, at least over these last few weeks, then they have guilt associated with it also. Now, if they're in the hospital for another reason, sometimes they have to sit in the emergency room for one or two days before a bed upstairs opens up where they can get out of the ER to get to a regular room, even if it's not for COVID. That's how stretched the system is right now.

KING: What is the - what are the numbers like? Are you seeing mostly older children who don't have the vaccine, like 12 and up who don't have the vaccine, or are you seeing mostly young kids who can't get the vaccine yet?

KIMBERLIN: Right now at our facility - and I think this is reflected pretty well across the Southeast - it's mostly adolescents that would qualify for the vaccine. And the overwhelming majority - I mean, like, literally virtually all have not been vaccinated.

KING: What are those discussions with parents like? I mean, I know you don't want to blame a parent whose child is in the hospital. But do you sit down and have a conversation about why the child is not vaccinated and how the parents should act going forward?

KIMBERLIN: We do, and those can be hard conversations. You're right about that. The - they really start with, you know, just the basic question, have you received the vaccine? Has your adolescent received the vaccine? How about others in the household? And what we try to do is to turn that in a way that encourages everyone in the household to be vaccinated. And that includes the adolescent who's sick with it once they're over the COVID disease. They, as well, need to be vaccinated. So we try to use it in a positive way, a building kind of way to connect with the family and ultimately get them where we need for them to be as a society so that the cavalry really does come here and we have enough people vaccinated that this does not happen again, but also where they need to be for their own health.

You know, there have been millions of children and adolescents who have been orphaned because their parents have died from COVID. So this is not only about protecting the adolescent or the younger child from the disease itself, it's also from the effects of the disease on the adults in their lives.

KING: Just very quickly, do you get the impression that these conversations are working? Are you changing people's minds about the vaccine?

KIMBERLIN: Noel, I think they are working one-on-one. Not every single time - but overall, I think they are. The challenge is that one-on-one isn't going to get us where we need to be fast enough. This needs to be an all-hands-on-deck moment. And too often - and this is true in my state; I think it's true in other Southern states, but I fear that it's true across the United States - too often, people don't realize this is an all-hands-on-deck moment. This delta variant is totally different from the virus that tore through the United States this past winter. And I have seen the ravages that it can do on a community. This is the real deal. People need to get vaccinated if they're 12 and over if they've not been, and they need to wear masks indoors, whether they've been vaccinated or not.

KING: Dr. David Kimberlin, a pediatric infectious disease physician at the University of Alabama at Birmingham and at Children's of Alabama. Thank you, Dr. Kimberlin, for your time today.

KIMBERLIN: Thank you. Transcript provided by NPR, Copyright NPR.