Are Emergency Rooms More Dangerous For Kids During A Covid Surge?

“Be careful. I don’t want to have to take you to the emergency room.”

It’s an admonishment that nearly every caregiver has delivered at some point to their children. For good reason — no one wants an injury or a trip to the hospital. But during the Covid-19 pandemic, the warning has been delivered with a darker edge.

Many parents have heard nearly two years of pleas to flatten the curve of infections to help preserve hospital capacity. They’ve read harrowing stories of how first Delta and then Omicron have broken healthcare workers.

Is it any wonder then, that the monkey bars have taken on a threatening air?

Fortunately, interviews with medical professionals indicate that worry over whether it is safe to visit an emergency room during the coronavirus pandemic is overblown. Emergency care is still not a pleasant Saturday afternoon activity, but it’s also not a reason to avoid normal childhood activities these experts say, especially if the activities in question happen outside.

The worse the injury, the shorter the wait.

The bottom line is this: If you need emergency care, don’t hesitate to go to the emergency room, says Dr. Kelly Fradin, a New York City pediatrician who runs the Instagram account AdviceIGiveMyFriends. But be prepared to wait.

Traumatic injuries will always be treated faster than more minor ones, says Dr. Alexis Halpern, an attending physician in the emergency department at NewYork Presbyterian/Weill Cornell Medical Center. “That's just because we have to make sure nobody dies,” Dr. Halpern says.

Hospitals have national benchmarks for how long it takes patients to be admitted after arriving at the ER for things like car crashes (or heart attacks for adults). During the pandemic those benchmarks were still being met, Dr. Halpern says — even during Omicron. Wait times have increased, however, for less-serious injuries like nursemaid’s elbow or a sprained ankle.

Is it any wonder that the monkey bars have taken on a threatening air?

Most childrens’ trauma cases are caused by falls (34%) and motor vehicle incidents (40%), according to data from the National Trauma Data Bank’s 2016 Pediatric Annual Report (the most recent year for which data is publicly available). The median wait time before being treated for a fall was 84 minutes that year. That time has likely increased in the pandemic, says Dr. Halpern.

Romper spoke with parents whose children needed emergency care in the last several months, and their stories bear out this dynamic of longer waits while still being able to access quality care.

There’s Covid in the hospital, sure, but it’s also in the grocery store.

The prospect of waiting in an emergency room or urgent care may spark concerns about Covid exposure, but both doctors expressed faith in hospitals’ strict mitigation measures. The best thing families can do is get all eligible people vaccinated.

“The emergency room is not necessarily a higher risk place than your grocery store or your movie theater,” says Dr. Fradin.

Mask-wearing is ubiquitous; staff usually have high-quality N95 masks and other protective equipment. There’s good ventilation, backed by HEPA air filters, and in many places nearly all the staff are vaccinated.

“I want people to feel comfortable that doctors and nurses are very careful. And you should never forgo care that’s needed because you’re scared to go.”

For medical needs that are clearly non-life-threatening, some caregivers may try to utilize an outpatient facility like an urgent care instead of a hospital. When Katie Gutierrez’s 16-month-old son fell and sliced open his chin in January, she knew immediately it would need more than a bandaid. Gutierrez took her son to a pediatric urgent care in San Antonio, where she lives. The nurse there told Gutierrez that they’d been regularly seeing large numbers of kids with Covid. After about a two-hour wait where mask-wearing was strictly enforced, Guitierrez’s son was seen and his chin glued back together. Neither of them contracted Covid-19 from their visit.

Dr. Fradin also suggests taking advantage of a nurse hotline, which are often provided by insurance companies and pediatricians’ offices. Caregivers can call and get advice about what kind of medical care is needed. These options may be useful outside of normal business hours and when trying to determine what level of care is needed — perhaps this injury can be safely handled by an urgent care center or can wait until a pediatrician’s normal business hours.

Of course, not every family has a primary care doctor, says Dr. Halpern. If that’s the case and you’re not sure how serious an injury or other physical reaction is, it’s always better to err on the side of getting the care you need. In other words, go to the ER.

“Obviously, there is Covid in the emergency department,” says Dr. Halpern, adding that it’s understandable that people might be afraid of needing to go there. But, she says, “I want people to feel comfortable that we are very careful. And you should never forgo care that's needed because you're scared to go.”

Wear seatbelts and helmets and let the rest go.

In a pandemic when kids have endured a lot of restrictions and upheaval, both Dr. Fradin and Dr. Halpern were emphatic that that parents should not curtail outdoor activities like skiing, playgrounds, or ice skating solely for fear of needing emergency care.

Outdoor physical activities are valuable for a number of reasons, not least of which because they can take the place of indoor activities that carry a higher risk of contracting Covid-19. While some activities carry an inherent risk of injury, wearing proper protective gear will lower that risk considerably.

Only 5.7% of pediatric traumas in 2016 occurred in kids who were wearing a helmet, according to the NTDB report. About 79% of the children with traumatic injuries had no protective equipment involved, either because it wasn’t relevant or they weren’t wearing it. Neither car accidents or falls are easy to prevent, but wearing seatbelts and helmets will go a long way toward avoiding serious injury, both doctors said.

“Don't not go skiing because you're worried about going to the ER,” Dr. Halpern says. “Please do not limit these children's activities any more than they've already been limited during this pandemic.”

Experts:

Dr. Kelly Fradin, a New York City-based pediatrician

Dr. Alexis Halpern, an Attending Physician and an Assistant Professor in the Department of Emergency Medicine at NewYork-Presbyterian/Weill Cornell Medical Center

Alex Hazlett writes about tech and parenting for Romper. She is a freelance journalist based in New York who covers technology and family life. Previously, she was the Director of Special Projects at Mashable.