Dr. Matthew Harris saw 30 patients at his New York metropolitan area pediatric emergency room the night after Christmas.
Twelve of them—12 kids—tested positive for COVID-19.
“Every single child I saw with fever had COVID,” Harris told The Daily Beast. “Every single one including, I can tell you, several infants.”
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He would have expected no positive cases at all two months ago.
“Maybe one if they were immunocompromised,” the pediatric emergency physician told The Daily Beast of the lull earlier this fall. “It’s a huge difference.”
The New York State Department of Health reported that 157 out of 7,536 children 4 and under who were tested for the coronavirus came back positive on Nov. 3. But the same stats showed 546 out of 7,056 tested positive on Dec. 20—nearly quadruple the rate. The state further reports that hospitalizations of kids (18 or under) with COVID in New York are up fourfold in two weeks.
“This is the first major surge in pediatrics that we’ve had throughout the pandemic,” Harris said. “The number of kids with positive tests is just skyrocketing. It’s like a tidal wave.”
As Harris breaks the news to parent after parent, he is grateful to be able to tell them that children with COVID-19 “overwhelmingly do well.” He reports that most of the hospitalized kids have underlying conditions such as leukemia that are complicated by COVID. Only a handful of otherwise healthy kids he’s treated have become seriously ill solely due to the coronavirus.
But Harris says it is too early to tell if the new Omicron variant will lead to Multisystem Inflammatory Syndrome in Children (MIS-C), as sometimes happened with the Alpha variant and, to a lesser extent, with Delta.
“What makes me nervous is what’s gonna to happen three weeks from now,” Harris told The Daily Beast. “Will we be seeing high rates of MIS-C?... I think we just have to kinda hold our breath and see what happens.”
Whatever the rate, the sheer number of infections may translate into more MIS-C cases.
“These are some of the sickest kids I’ve ever seen in my career,” he said of pediatric COVID patients who subsequently fall victim to the syndrome that can attack the heart, lungs, kidneys, brain, eyes, and gastrointestinal system.
Whatever happens long-term, even if the great majority of pediatric COVID infections continue to be relatively mild, each patient requires proper care.
“The short-term problem is that if my emergency department is over capacity with COVID patients, how do I take care of everyone else?” he asked. “I mean, we’re the largest level-one trauma center for children in the state. And we get extraordinarily injured children, and I have to have beds to put them in.”
As a Northwell medical director for emergency management, Harris has worked with his colleagues there and in other health-care systems to expand and reinforce their capacity to handle whatever comes as best they can in this new wave.
“I think we’re as prepared as we can be for a large pediatric surge in patients,” he said. “But it keeps me up at night.”
The challenge his facility faces may soon be shared by his counterparts across the country.
“I think every children’s hospital is trying to think about: How do we get kids home to make room for the next one or the next one, or the next 10?” he said.
Meanwhile, the pandemic will continue on into another year.
“The inpatient burden has grown substantially, but really where this is still the biggest threat is the public health,” Harris said. “These kids are going to continue to spread it. And they got it from someone. It’s still the most common place that young children get COVID is at home.”
At the end of a shift during which as many as a dozen patients have tested positive, he does all he can to ensure he does not bring the virus home to his own three children.
Two of them are of school age. The third is just 10 weeks old.
“I come home and I want to burn my clothes,” he said.
He performs a ritual that many frontline medical workers followed when the first wave hit New York in the spring of 2020.
“I don’t touch anything. I go upstairs, I sit in the shower for 20 minutes, and I just hope that I’m not bringing this home to my kids,” he reported.
He spoke as a father more than as a doctor.
“They’re just so, so susceptible, and while again, the overwhelming majority of kids will do just fine, I don’t want my kids to be in that denominator,” he said.
Harris himself contracted COVID-19 back near the start of the pandemic, and became seriously ill.
“Wondering if I was ever gonna see my kids again,” he recalled. “You only have to have that sentiment once in your life.”
He has gone on to also become director of Northwell’s vaccine rollout. He was socially distanced in the next room when that system’s Registered Nurse Sandra Lindsey became the first person in the country to receive the COVID-19 vaccine many of us hoped would end the pandemic. His two older children were vaccinated the first day they were eligible. And he advises the parents of his patients to ensure that everyone in the household who has not gotten the jab do so.
He certainly does not subscribe to the notion—gaining in popularity as Omicron spreads—that we might as well accept that we are all going to get COVID anyway.
“Complacency can be dangerous,” he said. “Because there is a risk, no matter what you get, you know, it’s always a risk… COVID has broken all the rules.”
The early evidence suggests that this new variant may prove to be less likely than some predecessors to produce severe illness. But Harris knows that another mutation could change what is already bad into something far worse in just a few weeks.
“The other thing that keeps me up is that we’re a variant away from having a very highly infectious, highly virulent [virus],” he said.
“It would make 2020 look like a walk in the park,” he added.
