Dr. Kevin Churchwell

that everyone would continue to be paid as we moved forward.

And we found out that was a very important decision in terms of how everyone who worked at Boston Children's felt about working there, the anxiety that they were encompassing and how we could help them work through that.

It continues to be a work in progress because the issues continue to change.

But our goal is to keep in front of us how can we be the best servant leaders we can possibly be because that is the impact that will truly make a difference in what we're trying to achieve as a hospital, as an institution.

So Megan, that's a really important question.

I will tell you that for the most part, we have not seen a large number of children who are COVID positive presenting to the hospital with their infection.

It remains a small number in the Northeast, certainly in the South, as you know, the numbers have increased dramatically over the last three months.

And we are very much looking out for that.

But what we have seen and what I've described as our pandemic during this time, during this 20 months, is the pandemic of children, pediatric patients, adolescents, young adults with behavioral and mental health issues that are presenting to our emergency department, to our inpatient psychiatric units in just exploding numbers.

I'll just give you a couple of examples and some numbers.

Prior to the COVID pandemic, the number of children that we were seeing per day, we thought that number was extremely high.

That number was in the 20s.

During the pandemic and currently, those numbers are now in the 50s to 70.

And I get asked, well, how are you managing that?

My usual answer is, well, hour by hour.

That's our challenge to how do we create a system of care for our children with behavioral and mental health issues that we currently don't have.

Why is this problem exploding?

The issues around social isolation, the issues around not going to school, the issues around social media, issues that we were seeing pre-pandemic have certainly exploded during this pandemic.

And we've got to get a handle on those.

We've got to create more of a continuum of care that encompasses the family, the primary care pediatrician, the school system, the hospital, the state in terms of providing and supporting programs and care for our children who are presenting because we cannot lose this generation.