They shared how Cook Children’s is currently being impacted by a surge in COVID-19 cases and hospitalizations.

Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases, Corwin Warmink, M.D., medical director of Emergency Services, Kara Starnes, D.O., medical director of Urgent Care Services, and Bianka Soria-Olmos, D.O., pediatrician at Cook Children’s Pediatrics Haslet have all worked tirelessly to ensure our patients and families are receiving the best care throughout the pandemic.

During the news conference, the experts addressed what they are seeing in our urgent care locations, emergency department, and Cook Children’s system as a whole.

“We need compassion from the community and this is an illness affecting our children,” Dr. Starnes said. “We are hitting crisis mode and we can’t do it without your help.”

Cook Children's Urgent Care facilities are being stretched thin. Over the weekend, Cook Children’s was forced to close its Hurst location due to a lack of staff members and high demand for services.

"This is the first time we’ve had to take such measures. We closed in an effort to consolidate staff and safely take care of our patients,” Dr. Starnes explained.

On Monday, the six remaining urgent care locations saw 1,400 children. This is twice the number of patients the urgent care centers typically see.

Dr. Starnes stressed that if you believe your child has been exposed to COVID-19, it is best to find a local testing site in the community or use an at-home testing kit. You can find a list of local COVID-19 testing locations here. 

Cook Children’s Emergency Department (ED) is experiencing patient volumes not seen since the H1N1 pandemic in 2009. On Monday, the ED saw 601 patients with patients arriving every 2.5 minutes.

“We are breaking records we don’t like to break,” Dr. Warmink said. “I have been at Cook Children’s for 18 years and this is the worst it’s ever been.”

We encourage all families to come to the emergency room for emergencies but ask that they do not come for a simple COVID-19 test. This pulls resources away from critically ill and injured patients and takes up already limited bed space. Along with COVID-19, we are still seeing RSV cases but thankfully, they appear to be on a downswing.

“The adults in the room need to step up and do the right thing,” Dr. Warmink said. “If you send your kid to school without a mask, it’s not if they are going to get sick, it’s when.”

Dr. Warmink advises all parents, “Ask yourself if this can wait” before bringing their child into the emergency department.

Most children have mild illness with COVID-19, but that is not the case for everyone. Throughout the course of the pandemic, Cook Children's has hospitalized 1,129 children with COVID-19, with 241 of those admitted to the Intensive Care Unit (ICU). Throughout the pandemic, seven children with COVID-19 have died. Two died this past week. They were a 4 year old and a 15 year old. 

"We are seeing more severe illness than we have seen at any point during the pandemic. The January surge was nothing compared to what we’re seeing now,” Dr. Whitworth said.

As a result, on Monday, Cook Children’s opened up a third COVID-19 unit for the first time since the start of the pandemic. This unit has nine beds – and within the first 24 hours of being open, was completely full.

With Labor Day weekend ahead of us, Dr. Whitworth encourages everyone to be safe, mask up, and socially distance, as we cannot handle another influx at this time.

“Every child that has the virus inside of them has the potential to spread it to someone else, and they don’t mean to,” Dr. Whitworth said. “Much of what we are seeing is 100% preventable, children have to wear a mask.”

Cook Children's also set a record for COVID-19 hospitalizations on Wednesday with 35 patients. This is the highest number of COVID-19 patients hospitalized at the medical center at any point in the pandemic. The COVID-19 ICU was also filled. 

What can the community do to help?

All four experts we heard from on Wednesday have a few simple pleas:

1. Get vaccinated and get your child vaccinated as soon as possible.
2. Please have your children wear a mask to school.
3. Wash your hands frequently.
4. Re-think gatherings – if you gather, wear masks, stay socially distant and gather outdoors if possible.

Across the board, Cook Children's is seeing record numbers of families each day who are wanting rapid COVID-19 tests for their children.

"We understand this is a scary time, but want to remind families not to panic if your child was exposed to COVID-19," Dr. Starnes said. "We understand schools have requirements, but we need you to understand we do not want you to panic or rush in to be seen immediately after an exposure. Rushing to our urgent care locations puts a strain on our resources.”

The best thing you can do if your child was exposed is find a local testing-only site in the community or use an at an at-home testing kit.

Cough, fever, runny nose, sore throat, body aches, headache, vomiting and diarrhea are all common symptoms of COVID.

For children over the age of 3 months, these symptoms can typically be managed at home with symptomatic care. Medications such as acetaminophen or ibuprofen can help with fever and pain. You should encourage your child to drink plenty of fluids and it is ok if they do not have much of an appetite.

Parents should seek care for their child over 3 months of age if they have had 5 days or more of fever, difficulty breathing, inability to keep fluids down or stay hydrated (no tears or no urination for 8 hours or longer) or if their child is having pain or fever that is not helped by an appropriate dose of fever reducer/pain reliever.

Patients under 3 months of age who are sick should be seen in person and evaluated.

Also, if there is at least one known positive case at home and others are sick, it can be assumed that all have COVID and everyone needs to isolate at home for 10 days from the start of symptoms.

“We cannot magically create hospital beds at the drop of a hat,” Dr. Whitworth said. “Wear a mask no matter if you’re vaccinated or not, wearing a mask is not an option.”

Angie, Cason's mom, told Good Morning America that she worries her son might get reinfected with the novel coronavirus at school. She’s urging students to wear masks for the sake of her immunocompromised son, and all kids under age 12 who can’t yet get vaccinated for COVID-19.

Read the full GMA story here.

"By the night of the 27th she came down with a really bad rash and by this time her lips were swollen, her eyes were bloodshot and her face was starting to swell," she said of Peyton. "She still had a horrible headache and stomachache and kept waking up in pain."

Tara, who lives in Weatherford, Texas, says she and her husband both tested positive for COVID-19 about a month prior and their five children, including Peyton, had symptoms. Knowing something wasn’t right with Peyton, she took her daughter to Cook Children’s Emergency Department in Fort Worth the next morning.

"They tested her for COVID-19 and said she was negative for COVID but she was positive for antibodies, and they started doing more lab work and figured out she probably had MIS-C," said Tara. "By that night she was in the ICU and about 4 p.m. the next day she was put on a ventilator."

Nicholas Rister, M.D., a pediatric infectious diseases specialist at Cook Children’s says MIS-C is directly related to COVID-19 and usually occurs a few weeks after a child has had the virus.

"It's frustrating because we don't know the exact link to why is COVID doing this in particular," Rister told "GMA." "What we've seen previously with other infections in children, and in adults too, your immune system gets really revved up, and starts driving inflammation, which normally isn't bad because that's how your body drives off infections."

"The problem with these post-infection inflammation syndromes is that you're post the infection so these kids have already had COVID and they've either recovered from it or they've had very mild symptoms, but now for some reason, their immune system gets highly turned on, and that's where you start to see the fevers, the rashes, the irritability," he said.

Dr. Rister says it’s important to be aware of MIS-C symptoms and to consult your pediatrician if they appear, regardless of whether or not your child tested positive for COVID-19. The symptoms to watch for include stomachache, fever, rash, and headache.

"If there have been family members with COVID and then weeks later a child is acting sick, then it's something that needs to be considered," he told “GMA.” "It's very tricky because it's kind of non-specific, but usually with something like MIS-C, it's going to be severe enough that it's not something that most family members would be comfortable watching at home, they're going to be like, 'My child needs to get checked out. This is too much.'"

Since the beginning of the pandemic, more than two dozen children have been treated for MIS-C at Cook Children’s. Five MIS-C patients, including Peyton, were being treated at Cook Children’s in early January.

Peyton spent nearly two weeks in the hospital before being released on Jan. 7. Tara says she is at home now and expected to make a full recovery.

“It started as a normal sickness. It was a fever, she looked pale and she was very tired and all she wanted to do was sleep,” Salazar said.

Natalie had gone to her pediatrician twice and was sent home with the diagnosis of “something viral.” Knowing the little girl was not getting better, Salazar’s family urged her to take Natalie back to the emergency room. That’s where they learned she was severely ill.

The hospital knew Natalie needed a higher level of care, so they called Teddy Bear Transport, which took her via ambulance to Cook Children’s Medical Center. From that point on, her mother knew it would be a long road ahead.

“One of the doctors turned to me and told me, your daughter is very sick and we see inflammation in her heart and she may need to be placed on the heart transplant list,” Salazar said.

Little did Alyssa know, her daughter was suffering from a rare, but serious condition. At Cook Children’s, Natalie tested positive for COVID-19 and her family later learned she had multisystem inflammatory syndrome (MIS-C). Her doctor, infectious diseases pediatrician Marc Mazade, M.D., says he is happy Natalie got to Cook Children’s when she did.

“MIS-C stands for multi inflammatory syndrome associated with COVID-19 and it is a hyper immune response to the COVID-19 virus infection. It usually happens sometime between two and four weeks after the infection and the infection doesn’t have to be symptomatic,” Dr. Mazade said.

Natalie had been exposed to COVID-19 a month before she started showing any symptoms. When Natalie got to Cook Children’s, her blood pressure was low. Her care team gave her fluids and could tell she needed to be admitted to the intensive care unit (ICU). Because Natalie had MIS-C, advanced treatment was required by a team of specialists familiar with the newly-described condition.

After five days at Cook Children’s, Natalie was sent home to recover. Thankfully, she didn’t need a heart transplant, however, her mom says COVID-19 is real and impacts everyone differently. She and her family are living proof.

“It could have ended differently if we didn’t take her in that third time. I feel like she probably could have died. I would have brought her home thinking I was going to be helping her, and the whole time I was going to be watching her die,” Salazar said.

Dr. Mazade hopes this is a teachable moment for all parents.

“If parents see those things developing or they know also know there is a history of COVID-19 infection within a close contact or a family member, then they should be highly suspicious of MIS-C,” Dr. Mazade said.

“All of these children presented to the hospital with symptoms that resembled a severe case of Kawasaki disease,” said Nicholas Rister, M.D., an infectious diseases physician at Cook Children’s.

Kawasaki disease is an illness that creates inflammation in blood vessels with no proven cause, but is generally thought to follow various infections after they have otherwise resolved. Dr. Rister said the patients with MIS-C arrived at Cook Children’s following exposure to COVID-19 and had symptoms including fever, abdominal pain and outward evidence of inflammation including diffuse rashes, conjunctivitis and swelling. In the more severe cases, evidence of multi-organ dysfunction including respiratory distress, low blood pressures, liver and kidney damage and altered mental status were also seen.

“Of particular concern to us is inflammation of the heart and surrounding major blood vessels which is also seen in Kawasaki’s disease. We have seen this same thing in several of these COVID inflammatory disease patients,” explained Dr. Rister. “Minimizing the degree of inflammation in these children, while providing supportive care for any organ damage, has been a key component of treatment.”

All four patients were tested for COVID-19. Three tests came back negative and one was positive.

“We believe all of these cases are related to COVID-19,” said Dr. Rister. “The three negative results are evidence of how far the infection had progressed, resulting in the inflammatory syndrome.”

Three of the patients have been released from the hospital. One remains in the pediatric intensive care unit.

In addition to the recent appearance of MIS-C cases, the infectious diseases team at Cook Children’s is also looking closely at increased reports of unexplained fevers in our area.

“We want parents to be aware of these cases as COVID-19 continues to spread in our community,” said Dr. Rister. “Unexplained fevers for several days and evidence of generalized inflammation may be signs of this illness.”

Symptoms of more severe MIS-C cases include severe abdominal pain, shock from low blood pressure, respiratory distress and lethargy. If your child exhibits any of these symptoms, seek emergency medical care immediately.

Less severe symptoms include fever, abdominal pain and rash. Caregivers should call their pediatrician if these symptoms appear, as they overlap with many other common infections and medical conditions. It is important for these children to be fully evaluated.