Inside the ‘tridemic’: North Philly children struggling to breathe are waiting hours to be seen at the ER

PHILADELPHIA — Raspy cries and barky coughs echoed across the emergency room at St. Christopher’s Hospital for Children on a recent chilly morning in North Philadelphia. Kids had just started to stream into the waiting room, yet every available bed was already filled.

Fifteen-month-old Zariya Sutton-Pack wheezed as she waited for medical attention on a hospital gurney. Her chest and rib cage heaved under a white cotton onesie. It looked as though she were trying to draw air through a collapsed paper straw.

“I just burst into tears this morning. I was so scared,” said her mom, Tyshanek Sutton, still wearing the puffy black winter jacket that she hadn’t had time to take off.

Within minutes of her arrival, emergency-room doctor James Reingold pressed a stethoscope to Zariya’s back. He didn’t like what he heard. A toddler her size should be taking 40 breaths per minute; her breathing rate was 52.

“This is really nerve-racking,” Reingold said. Zariya needed to be admitted, but the hospital was full.

St. Christopher’s sits in the bull’s-eye of what pediatricians are calling a “tridemic,” as RSV, flu, and COVID-19 strike all at once. All across the country, children’s hospitals are overwhelmed from an unusually early and severe onslaught of seasonal respiratory viruses.

In this swath of Philadelphia — the nation’s poorest large city — chronic disease and poverty have further aggravated the crisis. The neighborhood surrounding the hospital at Erie Avenue and Front Street has the city’s highest rate of childhood asthma. More than 90% of life-threatening asthma attacks in children are triggered by respiratory viruses, according to Reingold, chair of the hospital’s department of emergency medicine.

When virus and asthma collide, the resulting cyclone of respiratory distress can quickly lead to a hospital emergency for a kid who lives near St. Christopher’s.

ER veterans at St. Christopher’s have never seen anything like these last few months. And they fear the worst may be yet to come as the region heads into a winter where few people are still masking. Young children are now getting exposed to viruses for the first time.

After listening to her toddler’s ragged breaths and racing heartbeat all night, a panicked Sutton drove Zariya to the hospital at first light. Just a few months earlier, her 9-year-old niece lost consciousness during an asthma attack. She called 911, but the girl’s lips turned pale, then blue, during the long wait for an ambulance. Sutton, who herself has asthma, started chest compressions and mouth-to-mouth on her own. “It will never not be in my brain,” recalled Sutton.

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