Dr. Beth Pathak
An Open Letter to the #PedsICU Community
The United States is approaching 1,000 *reported* child patients admitted to PICUs with #COVID19. Today (29-Jul) @COVKIDProject (www.covkidproject.org) reports 924 cumulative patients, and we’ll reach 1,000 in the next week or so.
The problem is, this reported total is far from complete. There are dozens of PICU hospitals that are NOT currently or routinely reporting patient data to the free and voluntary registry run by @VPS_LLC.
Because of hospital non-participation, many pediatric ICU patients remain uncounted. How many? Our guess is that we are missing >200, and the number could be much higher.
Why does this matter? Simply put, navigating our way through this *unprecedented* pandemic without *complete* surveillance data is like trying to fly an airplane at night without instrumentation.
In the care of individual patients, clinicians rely on lab tests, diagnostic imaging, and physical exams to correctly diagnose the patients and develop treatment plans.
In the care of populations, epidemiologists and public health leaders rely on timely, accurate surveillance data to correctly and comprehensively understand and control epidemics.
PICU admission is a sentinel event for understanding COVID-19 in children. We need geographically complete data – a full count of PICU admissions from every state!
We need YOUR help.
Is your hospital submitting data to the COVID-19 PICU dashboard at myvps.org?
If your hospital is not participating, please advocate for immediate participation.
There is neither cost nor obligation for any PICU to participate!
Hospitals do NOT have to be paying members of VPS to submit COVID-19 data!
No PHI is required, and the required data items are minimal.
Simply send an email to email@example.com to get started.
Perhaps your hospital has concerns about the effort required to submit COVID-19 data to VPS. Of course it will take some staff effort, as all hospital disease registries do. At some PICU hospitals, it is the physicians themselves who have committed the time to participate in the COVID-19 registry. It only takes ONE physician champion to change hospital practices. Only ONE. And once there is a physician champion, additional volunteers will come forward to share the workload.
Perhaps you think your PICU COVID-19 caseload is too small to matter. Nothing could be further from the truth. Every child and family impacted by COVID-19 deserves to have their case recognized and counted. At the same time, the documented absence of cases is as important as the documented presence of cases. PICUs that regularly report zero cases also perform a very important public service and contribute to the accurate surveillance of this disease.
Perhaps your hospital has concerns about sharing data. The good folks at VPS have created a truly outstanding COVID-19 dashboard, and all of their efforts on COVID-19 are voluntary and uncompensated. This is a quintessential public service effort, and your participation will help to improve our understanding of COVID-19 in children.
Detailed patient data are not required for registry participation. At the COVKID Project, we use very minimal, anonymous data (age, date of admission, and state) in our national surveillance reporting.
Take a look at the cumulative case epidemic curves for kids on the COVKID Project’s regional data page. Cases are increasing in every single region of the U.S. We are far from the end of this crisis. Despite a low criticality rate for COVID-19 in kids (our team calculated the criticality rate to be 0.00042, or 1 in 2381 infected children), the number of critically ill children will continue to rise as infections in children increase over time. The devil is, most unfortunately, in the denominator.
Our progress in mitigating this virus depends on strong, interdisciplinary, cross-institutional collaboration. Toward that end, a pandemic is simply not the time for data-hoarding or complacency in reporting. Think of the pilot trying to fly by night with no navigation instruments. We do not yet know the long term sequelae associated with novel coronavirus infection. And remember that NO ONE predicted MIS-C before cases started appearing. A robust pediatric COVID-19 surveillance system will enable us to respond quickly and effectively to future unexpected challenges posed by SARS-CoV-2.
In closing, if your hospital *IS* currently submitting data regularly to the VPS COVID-19 dashboard, we thank you and are truly appreciative of your efforts. The COVKID Project is not a part of VPS, and we receive no financial benefit from any hospital’s participation. We are simply end-users of this extremely valuable surveillance resource, focused on translating complex scientific data for a broader audience. To date nearly 30,000 unique persons have visited our data dashboards or watched one of our video blogs.
We hope that you find our national, regional, and state surveillance updates on COVID-19 in kids timely and useful, and we are always happy to hear from interested stakeholders via email: firstname.lastname@example.org.
Elizabeth Pathak, PhD, COVKID Project Director
Janelle Menard, PhD, COVKID Project Director of Education
Jason Salemi, PhD, COVKID Project Director of Research