SPECTRE Blog

Disaster hits: what about the kids?

In the past few years, Texas and the world has experienced quite a few disasters: COVID-19, Snowvid, tripledemic, hurricanes, and the list goes on. For the most part, there are plenty of safeguards in place to handle disasters. Hospitals have plans, protocols, trainings, and practice drills for most disasters, but they are made with the majority in mind: adult patients. What about the kids? How often are they taken into consideration when these safety measures are being developed? Children have different needs than adults and require different management during disasters like pandemics and epidemics. They need specialized medical care as they have physiological differences than adults at baseline. They have different social needs such as maintaining proximity to care givers and ongoing support to meet developmental milestones. Children make up a quarter of the population.1 Are they being adequately considered in planning?

A National Health Statistics Report from 2008 demonstrates that previously, children were not adequately considered in disaster planning.  Only about 32.4%of hospitals had guidelines for increasing pediatric surge capacity. In addition, only 56.2% had agreements with one or more children’s hospitals to accept pediatric patients when no beds were available in the hospital compared to 87.8% of hospitals that had agreements with one or more hospitals to accept adult patients. The study also found that only 29.4% of hospitals had plans for acquiring supplies to shelter healthy displaced children, 42.6% had a tracking system for accompanied and unaccompanied children, 34.0% had plans for reunification of children with families, and 31.1% had protocols to identify and protect displaced children.2 There has not been a repeat statistics report since that time, however, changes made since 2008 provide promising expectations that pediatric populations are being considered in disaster planning.

In 2019, the Department of Health and Human Services (HHS) with the Administration for Strategic Preparedness and Response (ASPR; formerly Assistant Secretary for Preparedness and Response) created a $3 million grant for the start of Pediatric Disaster Care Centers of Excellence (COE) with the goal of ensuring pediatric patients are taken care of when disaster hits.1 The first two COEs formed were the Eastern Great Lakes Pediatric Consortium for Disaster Response (Region V) led by UH Rainbow Babies with the Children’s Hospital of Cleveland and the Western Region Alliance for Pediatric Emergency Management (WRAP-EM) led by University of California, San Francisco Health System (UCSF) with UCSF Benioff Children’s Hospital.3 These COEs have made great progress in creating and instituting pediatric-focused hazard vulnerability assessments, surge exercises, toolkits for children with special needs, mental health resources and so much more. They even supported regional COVID-19 response efforts.4 These two COEs cover the states of Washington, Oregon, California, Nevada, Arizona, Ohio, Michigan, Illinois, Indiana, Minnesota and Wisconsin.56

An exciting addition to these COE was announced in November 2022: The Gulf 7-Pediatric Disaster Network (G7) headed by Texas Children’s and Baylor College of Medicine. G7 will join WRAP-EM and Region V in taking care of the pediatric response in the southern United States in the states of Alabama, Florida, Georgia, Louisiana, Mississippi, and Texas – and Puerto Rico.7,4  The goals of this new COE include: developing a coordinated pediatric disaster care capability for pediatric patient care in disasters, strengthening pediatric disaster preparedness plans and health care system coordination related to pediatric medical surge in disasters, enhancing statewide and regional medical surge capacity for pediatric patients, increasing and maintaining health care professional competency through the development and delivery of a standardized training program, and enhancing situational awareness of pediatric disaster care capabilities and capacity and assess regional pediatric readiness.7

With these centers focused on contemplating the care of pediatric populations during emergencies and implementing plans and protocols to protect them, there is increased confidence that should a disaster strike that involves children, hospitals will be prepared to handle it. More work and preparation is needed to look ahead for what may come, but these Centers of Excellence and the institutions supporting them are working to ensure as much preparedness as possible.

Shailey is a third-year medical student at the University of Texas Medical Branch and is double majored in Biology and Chemistry at the University of Mary Hardin-Baylor. She is interested in working in pediatrics in the future. 

  1. 1.         Pediatric Disaster Care Centers of Excellence Funding Opportunity Announcement. Public Disaster Care Centers of Excellence. Published July 23, 2019. Accessed January 22, 2023. https://www.phe.gov/Preparedness/responders/ndms/Pages/ndpi.aspx
  1. 2.         Richard W. Niska, M.D., M.P.H, Iris M. Shimizu, Ph.D. Hospital Preparedness for Emergency Response: United States, 2008. National Health Statistics Reports. 2011;37. https://www.cdc.gov/nchs/data/nhsr/nhsr037.pdf
  1. 3.         Pediatric Disaster Care Centers of Excellence Cooperative Agreement. National Disaster Medical System. https://aspr.hhs.gov/NDMS/Pages/PDCCOE.aspx
  1. 4.         Welcoming the Newest Pediatric Disaster Center of Excellence. EMSC Innovation and Improvement Center News & Events. Published November 30, 2022. Accessed January 22, 2023. https://emscimprovement.center/news/welcoming-the-newest-pediatric-disaster-center-of-excellence/
  1. 5.         Region V for Kids (formerly EGLPCDR). EIIC EMSC Innovation and Improvement Center. Accessed January 29, 2023. https://emscimprovement.center/domains/preparedness/asprcoe/eglpcdr/
  1. 6.         WRAP-EM Charter Guidelines. Accessed January 29, 2023. https://wrap-em.org/index.php/about
  1. 7.         Texas Children’s Hospital & Baylor College of Medicine to Lead New Federal Pediatric Disaster Network to Coordinate Care Across Five Gulf States, Georgia and Puerto Rico. Press Releases. Published November 15, 2022. Accessed January 22, 2023. https://www.texaschildrens.org/about-us/news/releases/texas-children%E2%80%99s-hospital-baylor-college-medicine-lead-new-federal-pediatric-disaster-network

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