Ongoing response to COVID-19

As the Delta variant began to circulate in late summer and early fall of 2021, the timing of school resuming and children less than 12 years old not being able to be vaccinated combined to produce more disease in children than had been seen in past surges. As a result, the South Carolina Children’s Hospital Collaborative began to report cumulative state numbers of hospitalizations and ICU care.

On Sept. 17, the collaborative reported 38 children hospitalized in South Carolina. Those on ventilators and requiring ECMO for support reached an all-time high during that surge.

By the time Omicron emerged as the predominant strain, a vaccine had been approved for children 5–12 years old. When the holidays arrived, transmission of the highly contagious Omicron and lower vaccine protection were leading to the highest pediatric admissions we had seen since pandemic’s start.

In South Carolina on Jan. 20, 2022, 61 children were admitted to hospitals with COVID-19. Not long beforehand, the EUA was expanded for adolescents 12 years old and above to receive a booster.

With the Omicron surge, a change in therapeutic options and an expanded EUA brought alternatives for children older than 12 to help avoid hospitalizations. Unfortunately, these treatment and prevention therapies were in short supply. Outpatient options remained unavailable for children younger than 12.

Therapies for those age 12+

Sotrovimab was the only effective monoclonal antibody available for Omicron; however, allocation of the drug to South Carolina was very limited. PaxlovidTM, an oral option, was only available at eight pharmacies across the state. Remdesivir™ was in greater supply but as an outpatient required a child to come in for an IV and infusion three days in a row.

In addition to the vaccine, Evusheld™ became available for severely immunocompromised children age 12+ to provide protection against infection for those unable to receive or mount antibodies to the vaccine.

The toll of COVID-19 on the children of South Carolina continues to be evaluated. According to DHEC reporting in the 2020–21 school year through February 2022, 117,836 children had isolated due to the virus and 405,460 children had been quarantined.

The medical sequela of severe COVID-19 disease and MIS-C will continue to be delineated over time. Meanwhile, other educational and developmental impacts the pandemic has wreaked on children will require pediatricians, parents, and schools to seek creative solutions for recovery. COVID-19 mobile vaccine events

Throughout much of the fall and winter, Prisma Health’s Bradshaw Institute for Community Child Health & Advocacy continued hosting dozens of mobile vaccine events around the Midlands and Upstate, with an emphasis on targeting rural and underserved areas. Six mobile units, three in the Upstate and three in the Midlands, were outfitted to dispense vaccinations to children and adults, with 11,260 shots given since March 2021.

• Safe rooms for patients with psychiatric disorders • A new outpatient facility that houses our special care center, resident clinic and certain specialty clinics • Expansion and upgrade of our special care nursery • PICU upgrade – operationalizing four additional rooms

Our plans for the Upstate include: • Expansion of the PICU to an 18-bed unit by adding six rooms (see photo) • Initiation of outpatient pediatric physiatry services by collaborating with the Midlands rehabilitation program

These monies will benefit children throughout the state and is a result of the collaboration we have with our sister hospitals. We hope to make the dollars recurrent so that we can all continue to provide the most up-to-date, regionalized care that preserves limited resources and ensures the best services locally.