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Amid a record high number of COVID cases - more than 1 million reported in a single day in the U.S. - children's hospitals are feeling the strain. Seattle Children's Hospital has a record number of patients. And in Cleveland, Ohio, admissions are at an all-time pandemic high. This comes as more than 325,000 children tested positive for COVID last week.

NPR's Allison Aubrey joins us now. And, Allison, I want to ask about this rise in infection rates. How many kids are actually ending up in the hospital?

ALLISON AUBREY, BYLINE: Hi there, Audie. Yeah. The latest CDC data shows about 672 children are being admitted to hospitals per day. That's quite a jump. But admissions pretty much doubled last week compared to the prior week, which really isn't a surprise to pediatricians given this huge rise in cases. Remember - vaccines are not authorized for kids under 5. And doctors tell me they're seeing a lot of very young patients.

I spoke to Shaquita Bell. She's a pediatrician at Seattle Children's where they're not only seeing COVID, but also a lot of other respiratory viruses that are common this time of year.

SHAQUITA BELL: Most ERs are at 200%. Like, our ER here in Seattle, at Seattle Children's, is operating at all-time high records of patients seeking care. And so we've had record rates of respiratory syncytial virus, or RSV infections, that are even at a higher rate than COVID, which is overwhelming many of our ERs and urgent cares.

AUBREY: They're also treating children that have both COVID and RSV, respiratory virus. So pediatricians are just dealing with a lot.

CORNISH: Did you give - did they give details about sort of the severity of disease?

AUBREY: You know, most kids being treated in the ER end up being released rather than admitted to the hospital, Dr. Bell told me. And something many parents know or will remember from when their kids were very young is that young children, when they get a respiratory virus, can get very sick very quickly. If they're congested, it can be hard to breathe, hard to eat. They can get - they can wheeze. They can cough. So often in the ER, they're doing things like administering IV fluids, giving breathing treatments. Here's Dr. Bell again.

BELL: That might be a really quick visit in normal times. But when our ERs are seeing 200% of the volumes that they would have seen a couple of years ago, that ends up being a really long visit, a really long trip to the emergency room because of all the competing limited resources.

AUBREY: You know, in addition to more patients in the ER, hospitals are also seeing more staff test positive amid this omicron surge. So, you know, those staff need to isolate for five days. They're off the job. And this is creating staffing challenges.

CORNISH: Ohio has a record high number of hospitalizations at this point. What are pediatricians seeing there?

AUBREY: You know, what I'm hearing from doctors in Ohio is similar to what I heard from Dr. Bell in Seattle - COVID cases increasing significantly, plus all the other respiratory viruses. Even though most children end up with only mild illness, think about it - if only a fraction gets seriously ill, given the huge increase in cases, this can be hard for hospitals to keep up.

I spoke to Frank Esper. He's a pediatric infectious diseases specialist at the Cleveland Clinic.

FRANK ESPER: In my personal experience, what I've been seeing, there has been a lot of COVID croup. That's the barking cough and stridor - the big areas get swollen. And they usually show up, cough, cough, cough, bark, bark, bark, cough, cough, cough. And they respond - just like with all our other croup treatment protocols, they do OK.

AUBREY: They usually get steroids or other anti-inflammatory medications, so there are clearly effective treatments. But Dr. Esper points out he's seeing a lot of this in the under-5 crowd. Remember - vaccines are just not authorized for this group.

CORNISH: Right. Can we underscore that for a moment?

AUBREY: Yes, absolutely. You know, the lack of vaccination among young kids is definitely a factor. Pediatric ERs can handle it when a small percentage of kids are getting really sick from, say, RSV or flu. They're used to that. But with omicron, it's just so infectious, and cases are multiplying.

ESPER: It just seems like everybody is getting infected at the same time. And that's why we're just seeing these huge waves.

AUBREY: Dr. Esper's hospital has the assistance of a bunch of National Guard members to assist. And he says they've just really been inundated.

CORNISH: That's NPR's Allison Aubrey. Thanks for this reporting.

AUBREY: Thank you, Audie. Transcript provided by NPR, Copyright NPR.

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