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SHM Sends Letter Urging Emergency Declaration for Pediatric Hospitalization Surge

November 29, 2022

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The Honorable Joseph R. Biden
The White House
1600 Pennsylvania Avenue, N.W.
Washington, DC 20500


The Honorable Xavier Becerra
Secretary of the Department of Health and Human Services
U.S. Department of Health and Human Services
Washington, DC 20201

Dear President Biden and Secretary Becerra:

On behalf of our nation’s pediatric hospitalists, the Society of Hospital Medicine (SHM) fully supports the American Academy of Pediatrics and the Children’s Hospital Association’s call for an emergency declaration to support and bolster the national response to the alarming surge of pediatric hospitalizations.

Pediatric hospitalists are pediatricians who work primarily in hospitals, including large freestanding children’s hospitals and smaller hospitals that serve the entire community. In the latter setting, pediatric hospitalists are often the only physicians trained to care for children. They are on the front lines of this crisis.

Pediatricians are accustomed to seasonal surges in viral illness. This year, however, is different. The current unprecedented surges of both RSV and influenza infections produced unexpectedly high pediatric patient volumes and acuity of illness, straining the capacity of all facilities equipped to care for children. Emergency rooms across the country are holding pediatric patients for many hours, and in some cases days, while sick children wait for an available hospital bed. For some patients, the nearest available and appropriate pediatric inpatient bed can be hundreds of miles away. Staffing shortages further hinder the response to this crisis. Fully equipped pediatric wards and children’s hospitals are unable to operate at full capacity due to lack of other critical pediatric-specific personnel, such as nurses and respiratory therapists.

A federal emergency declaration would help alleviate the burden of illness afflicting our children and those who care for them. To adequately respond to this crisis, we need increased flexibility and liberalization of licensure. We need the ability to repurpose available hospital beds and other spaces to accommodate more pediatric patients. Increased flexibilities and reimbursements for telemedicine services will also allow some children to stay closer to home while receiving their care.

As we witnessed with the COVID-19 pandemic, provision of oxygen is the key to survival for viral respiratory illnesses. Unlike adults with COVID, however, supplies like nasal cannulas must vary in size to accommodate patients who range from newborn babies to preteens. Adequately maintaining necessary pediatric-specific supplies, which includes even basic equipment like intravenous catheters and pediatric gowns, will require increased funding and ongoing investment in robust supply chains. Funding for pediatric research and development, such as RSV vaccines, will also help prevent or minimize future health care crises.

The United States’ formidable response to the COVID-19 pandemic sought to lessen the societal and economic devastation of the virus. We are asking for the same response for the current crisis in pediatric medicine and to prioritize those who depend on us the most – our children.



Rachel Thompson, MD, MPH, SFHM, FACP


Society of Hospital Medicine