'A terrifying experience’: Montreal mother shares ordeal as ICU sees increase of children admitted with COVID-19 in fifth wave
If the first four waves of COVID-19 infections were more like ripples when it came to their serious effects on children’s health, then the fifth wave is more like a serious swell.
“We are seeing more children get sick with COVID and be sick enough to come to the ICU,” said Dr. Saleem Razack, medical director of the pediatric intensive care unit (PICU) at the Montreal Children’s Hospital.
Most of the young patients at the Children’s have underlying conditions, Razack said, or are babies with underdeveloped immune systems and too young to be vaccinated – but not all children admitted have obvious risk factors.
“A surprise in this wave which caught us off guard,” said Maryse Dagenais, nurse manager of the PICU, is that this time around they’ve seen “healthy children, teenagers come in with COVID symptoms and requiring hospitalization in the PICU.
She agrees most of the children they’ve seen weren’t vaccinated because of their age, “or have had one dose,” Dagenais said, adding she thinks fully vaccinating eligible kids is the best way to help protect everyone.
Only 10 per cent of all children in the province aged 5-11 have had two doses of vaccine.
If a child does wind up in the PICU, they often come in with “full-blown respiratory symptoms,” said Dagenais, and need to be sedated and placed on ventilators.
Hospital stays in the ICU and then in COVID-19 units can generally last from a couple of days to a couple of weeks.
The increase in the number of kids needing that supportive care is not a blip, but rather admissions have been higher and pretty steady over the last few weeks.
The current seven-day average at the Children’s stands at 9.4 admissions and at Ste-Justine Hospital, at 29.6, according to health ministry data.
A snapshot of Jan. 24 shows there were nine children hospitalized at the Montreal Children’s that day, and 28 kids sick enough to require beds at Ste-Justine, compared to just two and nine admissions respectively at the peak of the first wave.
Two children in Quebec have died of COVID-19 during this latest wave. One, a baby younger than two months old in mid-December and a second child, aged 4, succumbed to the disease about a month later.
Overall, such deaths are very rare, and the number of pediatric hospitalizations is also nowhere near those in the adult population.
But having a sick child is a frightening experience for any family, especially when that child is vulnerable to begin with.
A ‘TERRIFYING EXPERIENCE’
Finding out her nine-year-old daughter Arville was positive for COVID and needed to be admitted to the PICU was “the most terrifying experience,” for her mother, Lindy Sevillo and her husband.
“She's the one that we are very, very careful at protecting…but the COVID still got her,” Sevillo, a Montreal resident, told CTV News in a phone interview from the hospital.
Arville was born very premature, and has permanent health problems as a result, along with developmental delays.
“She is very fragile,” Sevillo explained. The girl lives with a tracheostomy so she can breathe and has a feeding tube.
When COVID-19 first hit the province, her parents decided to homeschool their daughter to protect her. They also kept their distance from family and friends. The plan worked for almost two years.
Sevillo and her husband are both double vaccinated, she said, and Arville was scheduled to get her first shot imminently.
“If she has the vaccine I don’t know if it’s a different situation,” she said adding she is “really pro-vaccine, but COVID caught [Arville] at the wrong time.”
She's still not sure how Arville contracted the virus, but there had been outbreaks at her husband's workplace and various neighbours in their apartment building had also tested positive like so many others, as the highly contagious Omicron variant spread rapidly during the last month or so.
One day when Sevillo noticed Arville wasn’t tolerating her food and had a mild fever, they went straight to the emergency room and got the diagnosis they’d been dreading.
But whereas adult COVID patients who are hospitalized are usually separated from family, Sevillo quickly learned that when Arville was admitted, not only would she be able to remain at the hospital with her daughter, she would in fact be confined to the room.
CO-CONFINED IN A HOSPITAL BUBBLE
“We do have the parents with us, which is a bit different than how the adult hospitals deal with it there,” said Dagenais.
“We never at the Children's called parents ‘visitors.’ They’re caregivers. So they need to be there and are integral parts of the care of the children,” Razack explained.
Because of that intimate relationship, even if the parent hasn’t yet tested positive, they are considered to have COVID-19 for the sake of infection control.
“The chances are really high,” they’ll soon catch it if they haven’t already, Razack said, and most do.
“They're very courageous, I must say because we confine them to the room with their child and they cannot come out,” said Dagenais.
It’s a difficult stay. The parents need to be healthy enough to remain at the Children’s around the clock, but many have mild symptoms and don’t usually feel great. At the same time, their child is very sick in the bed next to them.
Sevillo found herself in that very situation, speaking to us by phone in a whisper from their hospital room in a COVID-19 unit after Arville was released from the PICU.
And yes, Mom also caught the virus, and had chills, a scratchy throat, some congestion and feels tired.
She described their protective living environment inside the room as a genuine plastic bubble.
“There’s cellophane and just the little zipper which you can enter (through) the centre and another cellophane bag that you can go inside,” she said, adding how “impressed” she is by the nurses who have to put on and remove their PPE properly each time they need to be in the room.
“When we go in the room, we're exposed to the child and we're exposed to parents,” said Dagenais, and all the aerosols both people produce.
“It is very bizarre,” Sevillo said about this experience at the hospital, a place she has been countless times before with Arville as she underwent dozens of surgeries since her birth nine short years ago.
It all signalled to her that the future will look very different, with physical distancing and precautions around others likely becoming “a new normal," she said. "We will not be going back to normal."
FIFTH WAVE FATIGUE: EVERYONE’S ‘AT A QUARTER TANK’
Still, one of the biggest challenges, even at the Montreal Children’s Hospital is the staffing issue, due to the highly contagious Omicron variant circulating in the community.
“Somebody gets exposed and needs to be quarantined or often it's through children, and so on. That makes staffing the unit very challenging at this sort of highly busy time,” Razack said.
Some colleagues decided to change or cancel holiday plans, as Razack did, so they could be available to fill in at the last moment.
“So those are the things that are coming together to make this be – what do they say – living in interesting times?”
And even if children's hospitals have had a different clinical reality vis-a-vis COVID-19 in the past, it's not their first time being exposed to active duty.
“As far as my staff, in the past waves they have been very generous and they went to help in the adult sectors,” said Dagenais.
So by now, the level of exhaustion among the staff is extraordinarily high. In addition, non-COVID respiratory viruses created an unusual influx of hospitalizations this fall, so staff have been working virus-to-virus non-stop.
There’s also accumulated mental fatigue from trying to keep up with all the scientific knowledge around COVID-19 as much as possible as it emerges and changes sometimes daily.
“Nearly two years into the pandemic everyone is at a quarter tank,” Razack said. “Everyone’s depleted.”
“But the other side of it is the gratitude for the people you work with. Because here they are – and I'm even a little tearing up as I tell you this – h ere they are rising to the occasion, you know? And it's a little bit biased, but it makes me understand why the Montreal Children's Hospital is the best hospital in the world.”
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