Disaster Perspective on Pediatric EM and COVID-19

Elizabeth Greer, DO

I had the privilege of virtual interviewing for Pediatric Emergency Medicine fellowships from the comfort of my home – my sleeping dog next to me and my favorite coffee in hand. I did not have to spend days travelling in airports or attempting to figure out how to get from a hotel to the hospital. All of this was in efforts to prevent worsening of a pandemic we still had much to learn about.

I suspect my interest in Disaster Medicine and Preparedness is an attempt to subside my anxiety of the unknown. I have to say that “prepping” might be a lifelong affliction. As an undergraduate, I filled my gas tank and packed a “go-bag” when two presidential candidates were in my hometown at the same time. While I have always had a tendency for the “prepared,” nothing could have spurred the desire to have plans and actions set in place than my experience with RSV in the Ohio River Valley region during the Fall of 2019. At one point, we had one functioning bed in our ED to see new patients as the rest of the 30 rooms were filled with patients waiting for floor or PICU beds. That was when our research unit was converted to patient rooms – doubling up infants in cribs. We had to rent cribs from other hospitals and use rooms in 3 different units at the adult hospital. We were short staffed on respiratory therapists and many quit due to the constant pressure.

A lot of that might sound awfully similar to what the adult world has and continues to experience with COVID-19. It’s definitely what I'm afraid will reoccur this Fall with the delta variant and schools starting in person again. In fact, this is what is already happening in many institutions nationwide, especially in the Southeast. This is an impending disaster. We need to be prepared for the worse – our children with severe acute illness from COVID and waves of MIS-C as the aftermath.

In residency, I used to think I had PTSD from what I call “RSV 2019.” Now, I can feel a new infectious surge has just begun. I worry about what happens when there is a capsized tour boat full of children or an impending hurricane and we are boarding admitted patients in our pediatric ED and overflowing into the hallways with COVID patients. I’m frustrated with the controversy and confusion over the vaccine. Until we depoliticize this pandemic, we can only be prepared for and plan for the worse. What a time to start a Pediatric Emergency Medicine fellowship... a disaster I hadn’t planned on while sitting at my desk in quarantine.