When Pediatric Hospitalists Took Care of Adults During the COVID-19 Pandemic

In April 2020, the coronavirus disease 2019 (COVID-19) pandemic raged through our hospital system in Connecticut.¹ Medical teams for adult patients mobilized their staff and units for the incessant surge. Patient volume and acuity on the adult units began to rise amid the uncertainty of personal protective equipment (PPE) supplies, fear of a formidable impact, and potential depletion of the clinical workforce. In preparation, the pediatrics department chair of our children’s hospital within a larger academic medical center asked for volunteers to help the adult teams. The pediatric wards were strangely quiet as patients and families stayed away from the hospital and elective surgeries were canceled. In comparison, admissions to adult units in our hospital continued to rise exponentially (3 cases of COVID-19 on March 15 and 354 on April 9), further displaying the disproportionate impact of the pandemic on adults. Because pediatric hospitalizations to COVID-19 remained low and the demand for beds for hospitalized adults continued to rise, we initially gave two of our pediatric units to internal medicine clinician teams for adult admissions.

Along with more hospitalized patients, the need for more clinicians to care for patients became more apparent. We heard that our pediatric critical care and pediatric emergency department faculty were helping to staff with adult medical ICUs. We knew that would be us soon and began work to brush up on our internal medicine skills.² Instead of waiting to be asked, we decided proactively to offer our services to the internal medicine department as a team of pediatric nurses, pediatric housestaff, and pediatric hospitalists under the guidance of medicine-pediatrics hospitalists and medicine-pediatrics housestaff. Shortly, we were deployed to open a new adult COVID-19 …