Is NYC running out of children’s hospital beds? State officials won’t say

Last week, a viral tweet gave off the impression that New York City hospitals had run out of beds for children. After parents flagged the social media post, Gothamist dug into whether it had any merit, given a surge of three respiratory diseases — respiratory syncytial virus (RSV), the flu and COVID-19 — is driving public concern this autumn.

However, health officials say that there’s no clear way for New Yorkers to quickly know if their neighborhood hospital has room for their sick child. When asked, the New York City health department deferred any questions to the state, given it has broader leeway to monitor individual hospitals.

And while the New York State Department of Health collects data on pediatric bed capacity from individual hospitals, it told Gothamist that it doesn’t release this specific information to the public.

“The Department is monitoring regional hospital capacity and engaging hospital and health care systems that may be seeing larger than normal patient volumes in their emergency departments and inpatient units,” Cadence Acquaviva, a spokesperson with the New York State Department of Health, said in an email. The New York state health department wouldn’t publicly elaborate on why pediatric hospital bed data is being withheld.

The lack of public data is surprising, given the lessons learned in past three years of the pandemic.

COVID-19 taught the value of sharing such information during a crisis — through online dashboards. Rather than head to a hospital without space and lose precious time, people facing an emergency could check the status of all the medical centers and plan ahead. During the COVID-19 crisis, the state health department developed a hospital tracker. It’s still active, but the health department said it only shows the overall capacity for adult hospital beds.

“I'd take any dashboard, any dashboard that I felt that I could trust — for how available things are? What are the levels of illness in my community?” said Sara Hames, a 39-year-old mother in Brooklyn who posted the Nov. 14 tweet saying there was a lack of pediatric hospital beds in the city.

Hames' tweet came after she took her 2-year-old son Caleb for a regular visit to a pediatric pulmonologist (a respiratory doctor) at Mount Sinai Hospital in Manhattan. He’s immunocompromised “and has had a number of respiratory issues over the course of his life,” she said.

“I was talking to his doctor,” Hames said in an interview. “I said everyone's kids seem to be sick, and I'm seeing this thing on Twitter that there are no beds in hospitals in New York. She sort of nodded solemnly and she was like, 'we're totally full.'”

Hames said she didn’t mean for the post to go viral or suggest all city hospitals were full — she was just referring to Mount Sinai.

“It definitely adds an extra layer of anxiety to like every decision we make,” Hames said. “Should I send my daughter to gymnastics this afternoon? Like, what if she breaks her arm and can't get in a hospital? Or what if she falls on the playground?”

The situation is an example of how better data transparency from local officials could help allay public fears. State health officials reassured Gothamist that while New York City hospitals are facing some strain, they still have room.

"While individual hospitals have indicated high capacity, we continue to see available pediatric bed capacity within the New York City region,” said Cort Ruddy, the New York State Department of Health's director of communications.

Are NYC hospitals in trouble?

Some public information does exist about pediatric hospital capacity — but it comes from the federal level and it’s incomplete. The data shows New York City hospitals are facing steep rises in demand for pediatric beds.

In April 2020, about four months into the COVID-19 crisis, the U.S. Department of Health and Human Services launched HHS Protect, a central repository for coordinating health care and hospital data that’s spread across thousands of federal, state and municipal sources.

The information lands in the HHS Protect Public Data Hub, including regular stats on hospital utilization or how many beds are occupied. That includes pediatric beds. New York state currently ranks 27th in the nation — with 76% of its pediatric hospital beds occupied. New Jersey ranks 35th with 72% occupied, while Connecticut is 10th at 89%.

But that data is published on a delay. As of Monday, the most recent and complete reporting was uploaded the week ending Nov. 4. The database contains hospitals registered with the Centers for Medicaid and Medicare Services (CMS) and some non-CMS hospitals, but HHS states that “it does not include psychiatric, rehabilitation, Indian Health Service facilities, U.S. Department of Veterans Affairs facilities, Defense Health Agency facilities, and religious non-medical facilities.”

In other words, the data isn’t reported in real-time, nor from every hospital. These beds could also be occupied due to conditions outside of RSV, flu and COVID-19, as the dataset doesn't describe individual diagnoses.

Across New York state, HHS Protect provides regular info on approximately 160 hospitals — about 40 in the city. The data suggests that pediatric bed capacity has dwindled in some spots but not fully across the five boroughs. Back in early September, before the RSV surge took off, only four NYC hospitals had 20% or less beds for children. By Nov. 4, the number of hospitals with low capacity had more than doubled to 10 hospitals.

Among those with the least space were Jacobi Medical Center in the Bronx, New York-Presbyterian branches in both Upper Manhattan and Brooklyn and Mount Sinai Hospital — the medical center visited by Hames.

"We are taking measures to expand doctors, staff, services and beds to best meet this rising demand and will continue to be vigilant in monitoring and adapting to this growing concern," Marlene Naanes, Mount Sinai Health System's director of media, said in a statement. "Currently, we are not at capacity but are ready to scale up or down as needed. In the meantime, we encourage everyone to get boosted and wear masks as much as possible.”

And several hospitals were also reporting that most of their beds were still empty, and the state health department said medical centers often coordinate with each other when they’re overrun.

“The Department will continue to monitor regional hospital capacity and work closely with hospitals to assist them in meeting patient needs,” said Acquaviva of the New York State Department of Health. “Facilities are typically capable of coordinating transfers independently, but do reach out to NYSDOH for assistance with transfers when needed.”

How to keep your child safe: Prevention and testing

While COVID-19 and flu remain ever present, RSV is the virus driving headlines and respiratory illness so far this autumn, as temperatures drop and people spend more time inside. As Gothamist previously reported, people catch RSV for the first time as newborns and then get reinfected at random times throughout the rest of their lives.

The overwhelming majority of kids will be totally fine and recover normally. But that first bout can cause problems, as infant immune systems are still naive and developing. The Centers for Disease Control and Prevention states about one to two out of every 100 infants under 6 months old who catch RSV may need to be hospitalized.

In a recent public awareness campaign, New York Health Commissioner Mary T. Bassett said prevention is one of the first steps in keeping children out of the hospital. Wash hands regularly to stem the spread of germs. Teach kids to sneeze into their elbows or tissue. Consider wearing a mask when indoors or in crowds.

Being able to distinguish the differences between RSV, flu and COVID-19 can also help parents with decision-making.

The state health department released a guide, including a table of the major differences. The state says one of the clearest distinguishing symptoms is that kids with RSV tend to lose their appetites, echoing what doctors and health researchers told Gothamist earlier this year. If your child seems ill, the state health department recommends that parents contact their pediatricians before heading to the hospital.

Unlike with at-home tests for COVID-19, people must visit a doctor’s office, hospital or clinic to get a rapid test for flu or RSV. If people living in New York City are unsure of what’s causing their sniffles, they can access a range of rapid tests for flu, RSV and COVID-19 via NYC Health + Hospitals.

The public health care system uses a three-in-one test for flu, COVID-19 and RSV. It typically turns around results in less than 24 hours, said Christopher Miller, a spokesperson with NYC Health + Hospitals. Gotham Health clinics also carry the same test — but only for existing patients rather than walk-ins.

“New Yorkers can call 844-NYC-4NYC (844-692-4692) to make an appointment,” Miller said.

To address COVID-19, NYC Health + Hospitals officials launched 75 mobile vans that conduct onsite testing and treatment for the respiratory disease. They said as of Monday, 50 of these Test-to-Treat clinics can offer two-in-one tests for flu and COVID as well as RSV tests to symptomatic patients. The combined flu and COVID-19 test is rapid, offering results in 15 to 30 minutes.

“The technology's always been there. Rapid tests for influenza and RSV have been around since before COVID,” said Dr. Matthew Robinson, an assistant professor of infectious diseases at Johns Hopkins School of Medicine who studies diagnostic test. “They're just not available for over-the-counter purchase at a pharmacy.”

Also, people who use at-home COVID-19 tests should be mindful of new guidelines from the Food and Drug Administration, which differ depending on whether a person is showing symptoms. Last week, the FDA said:

• If you test negative initially but have COVID-19 symptoms, test again 48 hours after the first negative test, for a total of at least two tests.
• If you do not have COVID-19 symptoms and believe you have been exposed to COVID-19, test again 48 hours after the first negative test, then 48 hours after the second negative test, for a total of at least three tests.

If you test positive during any of those points, get a follow-up PCR test and consult a doctor, the FDA said.

NYC Health + Hospitals and the city health department are also urging people to get vaccinated against flu and COVID-19. (There’s currently no approved vaccine for RSV).

Uptake of the updated boosters shots — the bivalent vaccines made by Pfizer or Moderna — remains low in New York City. In late October, about two months after authorization, the bivalent boosters had been taken by only about 7% to 8% of the eligible population (anyone fully vaccinated over the age of 5).

City health department spokesperson Patrick Gallahue said as of last Wednesday, the number of recipients had risen to 807,716. That’s about 12% of the eligible population.

This article was updated with a statement from Mount Sinai and the New York State Department of Health.