After a surge of respiratory viruses early this winter, many children's hospitals are finally returning to normal. But next time they surge, beds for young patients could again be hard to come by.

Transcript

MARY LOUISE KELLY, HOST:

OK. Here is some good news. Many children's hospitals are finally getting back to normal after the surge of respiratory viruses in early winter. For parents who waited hours or even days for their kids to get beds, one thing became clear - there just weren't enough of them. As Michigan Radio's Kate Wells reports, this surge exposed cracks in how we care for sick kids, but it also highlighted possible solutions.

KATE WELLS, BYLINE: One night last year, Dr. Marc Auerbach was sound asleep. He was on vacation with his family in the rural Adirondack Mountains in upstate New York. It was quiet and calm, and then suddenly, he's woken up by his 8-year-old son saying, Dad, I can't breathe. At first, Auerbach was able to help his son take deep breaths and get back to sleep.

MARC AUERBACH: But then he woke up again and this time was really gasping for air and said he can't breathe. He can't breathe. And hearing that (imitates gasping) sound recognized that we needed to get him to the hospital.

WELLS: This is a very familiar experience for a lot of parents whose kids also had RSV. But Auerbach is a pediatric emergency medicine doctor at Yale, so he knew a lot of ERs just don't treat that many critically ill kids. Their infrastructure, their equipment, their staff, it's set up to treat adults, not kids. Hospitals can actually get graded on this, on whether their ER is what's called pediatric ready. The average ER gets a D. So as Auerbach put his own kid in the car and starts speeding through the mountains, he is worried.

AUERBACH: Frankly, am I going to need to treat him myself and find the equipment? And are they going to have the equipment?

WELLS: The fact that ERs often are not set up to care for critically ill kids is a big part of why the surge got so bad this winter. Another one is that over the course of more than a decade, U.S. hospitals have cut nearly 20% of their pediatric units. That's because hospital beds for kids just don't make as much money as adult beds do. Dr. Larry Kociolek is with Lurie Children's Hospital in Chicago.

LARRY KOCIOLEK: During a surge, when volumes may double or even more in some communities, that leaves a gap, a major gap, and children suffer the consequences of that.

WELLS: That is exactly what happened this past fall. Lots of little kids whose immune systems had not been exposed to stuff during the pandemic got really sick with common viruses like RSV. They poured into ERs, but with fewer beds overall, hospitals were quickly overwhelmed. Dr. Kris Bryant is a pediatric infectious disease doctor at Norton Children's Hospital in Louisville, Ky., and she says we don't know if in the future we're going to be dealing with as big of a surge in flu, RSV and other viruses.

KRIS BRYANT: But I suspect all of those viruses will continue to circulate and cause their own surges. And if they all happen at the same time, we will be pressed for beds again.

WELLS: But this is not a hopeless situation. There are solutions - No. 1, getting more kids regular childhood vaccines, like the flu shot, which can keep them out of the hospital in the first place. No. 2, insurers, namely Medicaid, could give hospitals more money for pediatric care. And No. 3, get more emergency rooms the training and support that they need to handle critically ill and injured kids. Dr. Marc Auerbach says the vast majority of kids who go to ERs can and do have really good experiences, like him and his son when they went into this rural ER in the mountains.

AUERBACH: They rapidly assessed him, began very appropriate breathing treatments and medical treatments. And after about six hours of observation, we are able to actually stop at Dunkin' Donuts on the way home and come and see his mom and his brother.

WELLS: It turns out the ER that Auerbach went to had partnered with a big university hospital in the area. They had the right equipment, the right policies, the right staff training to handle seriously sick kids. And if every ER was like this, he says, it could save thousands of children's lives. For NPR News, I'm Kate Wells. Transcript provided by NPR, Copyright NPR.