"We don't entirely know how COVID-19 will affect our community's children. The very limited research we have seen so far shows that there are some severe cases in children, but not at the same rates as adults." -Tim Robinson, CEO, Nationwide Children's Hospital

Columbus hospitals are primary receiving and treatment zones for patients infected with the coronavirus. As the pandemic has required the city’s three adult health care systems to adapt to changing times, Nationwide Children’s Hospital has as well. It is the country’s second largest children’s hospital, logging more than 1.5 million patient visits in 2018. Patients came from all 50 U.S. states and 45 foreign countries.

In early April, Children’s CEO Tim Robinson reflected on his organization’s response thus far via in written answers to questions from Columbus CEO.

How do you feel about the response at Children’s overall?
What I feel the most is an overwhelming sense of pride. We plan for emergencies and for situations that will stretch our resources, but every emergency is different. This one affects our patients, but it also affects our employees and their families. It’s an anxious time for everyone. 

Our team members are doing extraordinary things constantly, often going far beyond their regular jobs. They stood up rapid internal lab testing for COVID-19 in just a few days, and they are staffing a number of new hotlines for our referring physicians and the families we all serve. They’ve worked tirelessly to ramp up telehealth capabilities to offer appointments by phone and video. These are the kinds of projects that can take months or years, and they’ve taken days. 

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What worries you most? Running out of beds, or personal-protective and other equipment? What about overstretched staff?
We have several priorities: We need to protect our current patients, who may have underlying conditions that put them at higher risk; to continue treating patients who are in immediate need; to prepare ourselves for children who become sick with COVID-19; to protect our staff (and) to minimize the overall impact on our staff members, many of whom have ongoing or new responsibilities to care for their family members; and to support and serve our community.

We are working to maintain a good supply of personal protective equipment and to ensure that our employees are supported and that children who may have COVID-19 are properly screened, so that precautions can be taken to prevent the spread of infection. 

Is the need most critical in the intensive care unit or other areas? What about capacity for COVID testing?
Nationwide Children’s Hospital takes care of many, many young people with complex conditions, which may put them at higher risk if they are infected. We don’t know if the greatest need will be in our pediatric intensive care unit, in our emergency departments, or if needs will show up in other places—if, for example, our greatest need will be in specialties that commonly treat children with compromised immune systems. We’re preparing for every possibility.

We don’t entirely know how COVID-19 will affect our community’s children. The very limited research we have seen so far shows that there are some severe cases in children, but not at the same rates as adults. Thus far, we’ve only had four inpatients test positive for COVID-19, and we’re cautiously encouraged by that.

The CDC designated our lab as qualified for testing COVID-19 in mid-March, and we began our drive-through testing site on March 16 … we have not had testing capacity problems, but we do expect to be seeing more demand in the future.   

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How have your staff gone above and beyond to solve the new issues arising from the pandemic?
We’ve seen people go above and beyond all over the hospital. Some examples: 

Our COVID-19 testing team needed a specific kind of small tube to run each test. They asked their colleagues in our Abigail Wexner Research Institute if any of (those) labs could spare some, and the AWRI almost immediately came up with 12,000 of the tubes for donation. Our Child Life team, made up of professionals who support patients and their families during hospital stays, used sidewalk chalk to create an interactive art project outside of our main hospital tower so patients could see it from their rooms. A video of it is on our Instagram page. A sergeant from our Protective Services team tasked with providing security throughout the hospital recognized that families were going to be particularly stressed when they walked in over the next several weeks. He took on the responsibility of giving his officers extra training in empathetic language, so that those families could feel comforted the second they walked in our doors.     

How has the current crisis affected Children’s budget needs?
With the reduction of elective surgeries and procedures and our efforts to reduce non-emergent clinics, we have seen nearly a 35 percent reduction in activity and related revenue. At the same time, we are seeing increased expenses associated with testing and other COVID-19 related activities. As a result of these factors, early estimates say that we could see a $20 to $30 million monthly impact on financial performance.

In the midst of crisis, have you been able to glean any lessons on preparedness?
I believe the main lesson is how important it is for everyone to pull together proactively for the same goals, and Ohio has been a national model for that. Our health systems have always been collaborative, but we are now in constant communication to coordinate our response.

Laurie Allen is a freelance writer.