LULU GARCIA-NAVARRO, HOST:
The fourth wave of this pandemic is crashing over us in the United States. We are now over 100,000 infections a day. And unlike previous waves, it is hitting a new demographic much harder than before - children. At least 135 of them are currently hospitalized with COVID in Florida alone. We should note that the state is not changing course to prevent the spread of the virus. Governor Ron DeSantis has refused to support another round of mask mandates and instead has said schools that put them in could be defunded. Dr. Marcos Mestre is chief medical officer of Nicklaus Children's Hospital in Miami, and he joins us now. Welcome to the program.
MARCOS MESTRE: Thank you for having me here.
GARCIA-NAVARRO: Can you describe to us what you're seeing in children at your hospital?
MESTRE: Yes, we have definitely seen an increase in visits to our emergency departments and our urgent care centers, which we have around the city of Miami. Secondary to that, we've seen increased hospitalizations due to COVID-19 infections.
GARCIA-NAVARRO: How is this different to how the initial coronavirus strain was impacting children?
MESTRE: So initially, there was not as significant a percentage of the patients that were affected secondary to the infection, and it was because none of the older population had the vaccine. Now we see that the older population in a good majority is vaccinated, but the younger population, those under 12, are not able to be vaccinated. And we still haven't seen the uptick in terms of vaccinations of those 12 to 18 that we would like, and hence, they are still vulnerable.
GARCIA-NAVARRO: Why are kids getting more sick this time around? Is it something specific to the delta variant? Do we know?
MESTRE: Yeah, we're not exactly sure. And in terms of the severity, we're still trying to determine. It does seem that the children are a little bit sicker, requiring more oxygen and perhaps needing more respiratory support than we were initially.
GARCIA-NAVARRO: And what about the ages? I mean, when you say obviously these are children, what ages are we seeing coming in?
MESTRE: So we've seen the gamut. We see folks from 2 weeks old. Typically, they present with just fevers. Now, those that seem to have the greatest complications are those that are adolescents and especially those adolescents who are overweight or increased BMIs.
GARCIA-NAVARRO: Dr. Mestre, can you take me into the wards? I mean, this must be enormously distressing to see young kids now coming down with this in this fourth wave.
MESTRE: Most definitely, and not only for the families, but also for our staff. Imagine having gone through this. We were getting ready to come out of this in early June. We were even having discussions about peeling back some of the restrictions that we had, and then we were hit with this delta wave. It's well known that there's a nursing staff shortage across the country, and we're no exception to that. And in addition, you're 100% right in regards to the families that are being affected by this. But again, 99% of them are not going to require hospitalization, but that 1% will.
GARCIA-NAVARRO: Dr. Mestre, do we know how these kids got infected? I mean, are they in families with vaccinated parents or caregivers, or are they in families with unvaccinated parents and caregivers?
MESTRE: So it's a mix. Definitely those children that have come in that are older - 12 and older - that would have qualified for the vaccine - none of our patients had received the vaccine. So even though they could have had the vaccine, they didn't. And for those that are younger than 12 years of age, yes, we do see plenty of times that the parents may have not been vaccinated. So that's going to be the most common place where you're going to get infected, is in the home. So what we recommend for those 12 and under is that those parents and those siblings that are 12 and over to also be vaccinated in the home.
GARCIA-NAVARRO: And what have they said to you? Can you just tell me a story of what maybe a family may have said once they realize that their child is sick?
MESTRE: Sure. I mean, they always come back with wishing that they had been vaccinated and trying to prevent this. There is obviously the fear, and as a father of three, I understand that fear that parents have and the concerns in regards to the vaccines. My wife's a pediatrician, and we even had those concerns as we talked it through. When you do the risk-benefit analysis, the benefits that the vaccine has offered through the minimal risk - it's a no-brainer for us to recommend that to all families.
GARCIA-NAVARRO: Do you expect this to get worse in the fall? I mean, it's sort of taken everyone by surprise that this wave would be hitting in the summer when people are outdoors, not crowded inside.
MESTRE: Sure. In Florida, sometimes, there's a theory that it may be the reverse for us in the summer. We did hit our peak last summer. Obviously, it gets pretty hot down here in Florida. So more folks kind of crowd inside during the summertime. But, yes, definitely concerned not only for COVID in the fall, but we are seeing more of the respiratory - typical respiratory infections that we weren't seeing last summer - the RSV, the influenza. And that's what makes this surge a little worse is that in addition to COVID, we're taking care of everything else as well.
GARCIA-NAVARRO: That's Dr. Marcos Mestre, chief medical officer at Nicklaus Children's Hospital in Miami. Thank you very much.
MESTRE: Thank you. Transcript provided by NPR, Copyright NPR.