April 14, 2020

The development of a COVID-19 vaccine is the greatest medical need of our generation—and Texas Children’s is on the front lines.

Drs. Peter Hotez and Maria Elena Bottazzi, who co-direct Texas Children’s Center for Vaccine Development, are rapidly advancing their work on vaccines that will protect against COVID-19 and other coronaviruses.

“Without a vaccine, we’re using 14th-century methods of prevention—that’s what quarantining and social distancing are, and we have to use these methods, “ Hotez said. “But vaccines have always been our best and most powerful front-line public health defense against widespread infection, and they are the answer—now and in the future—for COVID-19 and other coronaviruses.”

Most people aren’t aware that there is an entire family of coronaviruses. The one that has ignited our global pandemic is SARS-CoV-2, the virus that causes COVID-19. Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) are two others that have emerged in recent years.

Drs. Hotez and Bottazzi, along with their teams, have already developed recombinant protein-based vaccines against SARS and MERS. One of them is ready to be tested in humans; the other is ready for scaled-up production. We are now using our extensive expertise with these related viruses to develop a vaccine for COVID-19 and quickly move it into the clinic.

In a recent interview on the nationally syndicated health show “Dr. Oz”, Dr. Hotez shared his thoughts on COVID-19 and what he feels the future will bring. You can view part one and part two of the interview.

To learn more about the work taking place at Texas Children’s Center for Vaccine Development visit TexasChildrensVaccines.org.

April 13, 2020

After Hurricane Katrina slammed into New Orleans in 2015, thousands of people poured into Houston looking for food, shelter and medical care. Many of them were housed at NRG Stadium, including children. Texas Children’s – one of the only pediatric medical institutions on site – set up shop inside the stadium and started caring for the children – more than 2,500 in all.

In 2009, Texas Children’s used a similar concept during the H1N1 pandemic setting up what we now call our Mobile Pediatric Emergency Response Team (MPERT) in the physician parking lot across from our Emergency Center in the Medical Center. Medical staff working MPERT saw about 60 children a day during that crisis, providing capacity for the surge of patients coming to our Emergency Center.

Several weeks ago when the COVID-19 pandemic hit the United States, leaders asked themselves whether they should launch MPERT again. Even though the disease’s target is not children, they decided to move forward with the effort not only at Texas Children’s Hospital in the Medical Center but at Texas Children’s Hospital West Campus, Texas Children’s Hospital The Woodlands and the Pavilion for Women.

“Texas Children’s has always had a keen eye to preparedness whether it be H1N1, Ebola or COVID-19,”said Medical Director of Emergency Management Dr. Brent Kaziny. “We have never faltered in our commitment to provide exceptional care in times of crisis including the one we are facing today with COVID-19.”

Teams across the Texas Children’s system, including Facilities, Information Services, Pharmacy and Emergency Services, have been working hard over the past few weeks to set up MPERT in the Medical Center, at West Campus and in The Woodlands. The teams are tailored to their locations. One is set up in a parking garage, the other in a clinic waiting room and another in a large, low-traffic hallway. If needed, Texas Children’s also has tents that can be set up in parking lots to handle additional overflow patients.

Each site includes intake, waiting, triage and clinical areas equipped to treat patients who do not have a significant medical history but are exhibiting upper respiratory symptoms. Members of the mobile teams can test patients for flu, strep, urinary tract infections and COVID-19.

The Mobile Maternal Emergency Response Team at the Pavilion for Women is set up in the ambulance dock area in the Medical Center. If a surge of patients occurs, the team will be ready to triage, test and even deliver babies, if necessary. The team is currently being used to test for COVID-19 expectant mothers who are scheduled for an induction.

“We have weathered many things at Texas Children’s and this crisis will be no different,” said Lynda Tyer-Viola, vice president of nursing at the Pavilion for Women. “Because of our resilience, we will come out of this stronger and better.”

Senior Vice President of Facility Operations Bert Gumeringer said his team situated the mobile teams so they can quickly and efficiently triage and treat as many patients as possible.

“This was a large undertaking but everyone worked together and got it done for the good of our patients, families and staff,” Gumeringer said. “Doing what is best for them and for our colleagues is and always has been our primary goal.”

Simulations have been held at all of the mobile sites, all of which will only be launched if there is a surge of patients coming into our system wanting to be tested for COVID-19 or are exhibiting symptoms of the disease. Until then, these teams will stand ready to serve.

“We are here and we are ready to take care of any and all patients who need us during this time,” said Ryan Breaux, director of business operations and support services at West Campus. “I’m extremely proud to work for an organization that is committed to disaster preparedness and to fulfilling our mission no matter the circumstance.”

Eric Allum, director of business operations and support services in The Woodlands, agreed and said Texas Children’s is recognized nationally when it comes to disaster preparedness and that the organization’s dedication to such efforts has paid off.

During Tropical Storm Allison, for example, Texas Children’s was able to stay open and continue to care for patients and families because leaders had the forethought to invest in flood doors in the hospital’s basement.

“We were the only operational hospital in the Medical Center that didn’t flood,” Allum said. “It’s a phenomenal commitment that the organization put forth then and has continued with each new challenge.”

In an effort to implement additional measures to help protect our patients, families and staff, Texas Children’s Pharmacy Services is now offering curbside pick-up.

All Texas Children’s patients are eligible for this prescription service and can pick up refills and new prescriptions at the following locations:

Texas Children’s Medical Center Pharmacy
6651 Main St.
(valet drive at corner of Southgate and Main)
Hours: 9 a.m. to 5 p.m. Monday through Sunday

The Center for Children and Women at Southwest Houston Pharmacy
9700 Bissonnet St.
(Look for parking spaces designated for curbside pick-up. Pharmacists bring prescriptions to families while they are sitting in their cars)
Hours: 9 a.m. to 7 p.m. Monday through Friday

The Center for Children and Women at Greenspoint Pharmacy
700 N. Sam Houston Pkwy. W.
(Look for parking spaces designated for curbside pick-up. Pharmacists bring prescriptions to families while they are sitting in their cars)
Hours: 9 a.m. to 7 p.m. Monday through Friday

How does curbside pick-up work?

The patient family contacts one of the three participating pharmacies to request curbside pick-up. When the patient family arrives at the pick-up location, they will:

  • Follow signs to park in the designated prescription pick-up area.
  • Call the phone number listed on the sign to notify the pharmacy team of their arrival
  • Review important information about the prescription with the pharmacist over the phone or by video (in certain situations) and payment is collected if applicable.

A member of the pharmacy team will deliver the prescription to the patient family’s vehicle and provide instructions on how to contact the pharmacy team with any future questions. Please note, only credit/debit card payments are accepted for curbside pick-up at this time.

Launched last week, several families have used the curb-side service and have expressed their gratitude for Texas Children’s commitment to their safety. Pharmacy staff is proactively calling families that have not yet picked up their prescriptions. During one of those calls, a family with 13 prescription refills told the technician they were thinking of requesting a transfer to another pharmacy because they did not want to come into the hospital during this pandemic, said Director of Community & Ambulatory Pharmacy Services Yemi Abudu. When they learned about our curbside service they were elated and scheduled to pick their prescriptions up the next day.

Abudu said families can continue to come into to the pharmacy if they wish, but now have the option to pick it up curbside, especially if they do not have any other reason to come into the hospital.

“This is an innovative way to keep our business going and to meet the ongoing needs of our patients and families,” she said. “We are pleased to be able to offer this to them during this unprecedented time of need.”

April 7, 2020

As COVID-19 continues to dominate the news, cause widespread closures and cancellations, and disrupt our normal way of life, it can be especially challenging for patients and their families who depend on us for their care. As we adjust to this new change, there’s one thing that has not changed – our commitment to ensuring our patients and families have convenient access to the care they need, when they need it.

One of the ways to help stop the spread of COVID-19 is to limit the number of patients and visitors at all of our locations across Texas – including hospitals, specialty care clinics, Pavilion for Women community clinics, Texas Children’s Pediatrics, Texas Children’s Urgent Care and The Centers for Children and Women. To keep everyone safe, many in-person visits can now be converted to a phone or video appointment. Texas Children’s e-Health team – in collaboration with other departments across the system – has rapidly expanded and enhanced e-Health services to make it easier and more convenient for patients to connect with a Texas Children’s provider without leaving their home.

“Providers are very eager and excited to offer virtual visits to ensure the continuity and convenience of care to children and women especially during these challenging times,” said Dr. Robert Ball, maternal fetal medicine physician and medical director of e-Health. “As more physicians are trained and enabled to provide virtual care to their patients, we are rapidly transforming the landscape across Texas Children’s.”

Texas Children’s providers and patients are taking advantage of the benefits of e-Health capabilities. On March 23, providers began having telephone appointments with patients. In the first three days alone, almost 2,500 patients were able receive care via telephone from the safety of their home across Texas Children’s Hospital, Texas Children’s Pediatrics and Texas Children’s Health Plan. On March 26, almost 1,000 providers across the hospital were introduced to training to be able to give face to face care through video visits to their patients. This is also expected to take off rapidly and be a “customer obsessed” solution for our patients. The roll out of video visits across care locations change how Texas Children’s delivers care, not just during this emergent time, but for the long-term.

With the demand for e-Health services on the rise due to COVID-19, our e-Health team, nurses and leaders have worked collaboratively to develop other strategies to meet our patients’ needs. Below is an overview of some of the enhancements that have been recently implemented:

COVID-19 Nurse Triage Line – This new feature allows parents of current patients to call 832-822-6843 (832-82COVID) if they think their child has symptoms or has been exposed to COVID-19. The line is available 24 hours a day, 7 days a week and operated by specially trained pediatric nurses. The nurses will triage calls, provide basic COVID-19 information, or schedule a video visit with a provider for further evaluation. The COVID-19 nurse triage line is for pediatric patients only.

Virtual Visits – To keep our patients, their families and our staff safe, many pediatric and women’s services in-person visits are now being converted to a phone or video appointment. If a patient’s appointment is a fit for either option, clinic team members will contact patients directly to provide more details. We encourage patients to continue to schedule appointments with their Texas Children’s providers, and to visit texaschildrens.org/appointment for more information about current options.

Texas Children’s Pediatrics (TCP): TCP has changed its scheduling work flow to have a physician review all appointment requests for the health and safety of all patients arriving at TCP locations across Houston, Austin and College Station. If a patient’s health screen indicates symptoms or exposure to COVID-19, TCP will convert the patient to a phone or video appointment. e-Health options are new for TCP practices and is growing quickly. Between March 12 and March 27, TCP completed 567 video and 1,653 phone appointments.

Texas Children’s Health Plan (TCHP): TCHP has also been focused on getting key provider communications pushed out, with the most important messaging being around supporting the delivery of telemedicine services. The Centers for Children and Women are conducting their visits via phone and have added nine trained providers to the ranks of approved physicians licensed to conduct video visits. Additionally, Texas Children’s telemedicine platform Anywhere Care has seen an uptick in patient visits. For more information about Anywhere Care, click here.

“The COVID-19 pandemic has really impacted the way we provide care,” said Texas Children’s Chief Information Innovation Officer Myra Davis. “This health crisis has presented an opportunity for us to leverage the benefits of e-Health. Historically our outpatient care has been provided at Texas Children’s locations, and e-Health has created a paradigm shift where we our meeting patients where they are.”

Ball has seen the benefits that e-Health offers to our providers and patients, especially those patients and families where physical access to a Texas Children’s facility can be difficult.

“I think e-Health has been an incredible game changer for us,” Ball said. “Everybody deserves a Texas Children’s provider, and this is an effective tool that we can use to create this opportunity for them.”

E-health Resources

Please visit Texas Children’s Coronavirus Connect page where you will find links to internal documents with updated information about COVID-19, as well as our e-Health Training and Resource page that includes information on telephone and video visit requirements, consenting, and FAQs.

March 17, 2020

 

Texas Children’s Apheresis Program led by Dr. Poyyapakkam Srivaths has reached a milestone with the addition of a new service, photopheresis. Photopheresis is a medical treatment that causes photoactivation of white blood cells by separating them from blood, which are then exposed to a medication called 8-methoxypsoralen followed by UVA irradiation before returning the blood to the patient.

Texas Children’s is currently using this apheresis therapy for bone marrow transplant patients who are experiencing graft-versus-host disease and lung transplant patients who are undergoing organ rejection. Photopheresis is typically used when other treatments have failed.

We are the second institution in Houston to offer photopheresis, and the only program dedicated solely to pediatric patients.

“There was a tremendous multidisciplinary effort to make this happen,” said Dr. Tina Melicoff, medical director of Texas Children’s Lung Transplant team. “We are thrilled to now offer some of our transplant patients with rejection issues another treatment option through photopheresis.”

To be able to offer the service, two photopheresis machines were purchased and a core group of dedicated nurses were trained to operate it. Clinicians expect to treat about five patients a year with each patient receiving about three sessions a week for about 10 weeks. Each session lasts around two hours.

Texas Children’s recently conducted its first photopheresis treatment on a bone marrow transplant patient. The patient is expected to receive additional treatments over the next several months.

“By offering this therapy, we are offering hope to patients who already have been through so much,” said Dr. Robert Krance,” director of Texas Children’s Pediatric Bone Marrow Transplant/Stem Cell Transplant Program. “Photopheresis is a promising therapy for our patients experiencing host-versus-graft and organ rejection.”

Photopheresis is the second new extracorporeal therapy introduced in the past 20 years at Texas Children’s. The last extracorporeal therapy, Molecular Adsorbent Recirculating System, or MARS, was introduced six years ago for liver failure patients.

“MARS helped to transform our liver transplant program,” said Chief of Renal Services Dr. Michael Braun. “I am hopeful photopheresis will have a similar impact for our BMT and lung transplant patients.”

March 2, 2020

Texas Children’s Neurosciences Program is all about improving patient outcomes. Every day, our team of neurologists, neurosurgeons, geneticists, physician-scientists and researchers are working together tirelessly to pioneer innovative therapies to improve the lives of children with neurological disorders.

On February 21, neuroscience leadership at Texas Children’s together with faculty and staff convened for the inaugural Neurosciences Retreat at the Jan and Dan Duncan Neurological Research Institute (NRI). This informative and engaging event provided our multidisciplinary team of neurologists, neurosurgeons, clinicians, researchers, behavioral health experts, and more the opportunity to reflect on past successes, discuss areas of possible improvement, identify transformative goals and actively plan for the future.

After welcome remarks from Executive Vice President Dan DiPrisco, the retreat began with a moderated panel discussion with two patient families who shared their inspiring stories that brought them to Texas Children’s Hospital. One of the guests was Debbie Sukin, the daughter of the late Dr. Ralph D. Feigin.

Sukin’s two sons, 18-year-old Jacob and 15-year-old Eli, were born with neurological challenges. Jacob was diagnosed with Angelman’s syndrome and Eli was diagnosed with a very rare neurological disorder caused by a CASK gene mutation diagnosed through genome DNA sequencing at Texas Children’s Hospital and Baylor College of Medicine.

“Texas Children’s holds a very special place in my family’s heart,” Sukin said. “We always knew about the hospital’s focus on clinical care and research, and didn’t quite know at the time that it would be so beneficial and important to our family. We are very much involved, on both the basic science and clinical sides, and the multidisciplinary components that are necessary to care for a child with neurological issues.”

The Sukin family’s journey, like so many other patient family stories shared at the retreat, highlight our clinical and research partners’ collaborative efforts in advancing neuroscience research, ultimately leading to the development of novel treatments and discovery of cures for neurological disorders.

“We’re always striving to do things better, and I think this retreat is one step towards getting us there,” said Texas Children’s Chief of Neurosurgery Dr. Howard Weiner. “Everyone here is ready to embrace a new idea if it’s going to advance the field forward. The key to our success is the ability for everyone – in Neurosurgery and our amazing colleagues in Neurology and the NRI – to work together for our patients.”

Weiner, along with Dr. Gary Clark, chief of Neurology and Developmental Neuroscience, and Dr. Huda Zoghbi, director of the NRI, participated in a panel discussion that highlighted the organization’s bench-to-bedside achievements in neuroscience research and neurological care over the last 20 years, and outlined collaborative opportunities to accelerate innovation and research to improve patient outcomes.

“We’re entering the renaissance of neuroscience in pediatrics,” Clark said. “Neurology and neurosurgery are not the same programs they were five or 10 years ago. Neurological diseases that we thought for years were not treatable, have become approachable with new DNA therapies, enzyme replacement therapy to treat lysosomal disorders, and minimally-invasive surgical approaches like laser ablation, that was pioneered at Texas Children’s, and has yielded successful outcomes for treating epileptic seizures.”

The panel also discussed strategies to ensure a seamless flow from bench to bedside, that will help researchers accelerate the discovery behind the causes of neurological diseases so that effective therapeutic interventions can be developed to improve the quality of life and outcomes for patients.

“At the NRI, our teams have identified the causes of about 66 different neurological disorders, some degenerative, others developmental or psychiatric, and have identified the path for therapeutics,” Zoghbi said. “Together, with our collaborators and trainees, we are charting new paths towards viable therapies that will have an immeasurable impact on families suffering from unexplainable neurological diseases.”

After the panel discussions, attendees split up into pre-selected breakout groups. The teams chose their groups based on the topic, and were tasked with helping to establish neuroscience goals and collectively chart the path for treatments, discoveries and cures to be realized over the next five years

The breakout groups facilitated lively discussion and engagement around these topics:

  • Operational Excellence: Facilitating support for clinical care and research
  • Translating Discoveries to Therapies: Overcoming barriers in order to accelerate the translation of research discoveries into effective patient care and better outcomes.
  • Population Health: Strategizing on how to deliver better care to the large population of people with neurological diseases in Texas by preparing and empowering pediatricians to handle straightforward simple cases so Texas Children’s experts have band width to see more complex cases promptly.
  • Educating for the Future: Training the next generation of physicians, physician-scientists and scientists who will care for patients, enroll them in studies, push the research forward to discover new paths for interventions.
  • Research Funding: Increasing NIH funding to support the basic, clinical and training missions and to advance the agenda of discovery and therapeutics development.

“One of our goals coming into this retreat was to simply facilitate discussions,” said Senior Vice President Matthew Girotto. “We have world renowned clinical and research teams that, too often, do not connect with each other. By simply bringing everyone together, we were able to uncover several opportunities that could not only help accelerate discovery to improve patient care but also increase our collaboration with Texas Children’s Pediatrics in addressing many of the common neurological needs of children.”

February 10, 2020

Texas Children’s and Baylor College of Medicine pediatric ophthalmologist Dr. Evelyn Paysse and Baylor College of Medicine refractive surgery specialist Dr. Mitchell Weikert have spent nearly two decades giving children with certain eye conditions hope of better vision.

The work they are doing focuses on children with amblyopia, a condition that if left untreated can lead to permanent vision loss.

“Amblyopia is a condition where the vision, in either one eye or both eyes, does not develop normally,” Weikert said. “If one eye has a lot more need for glasses, the brain may ignore that eye, and focus on the eye that’s creating a clearer image. If that happens, and it’s not discovered, or isn’t treated optimally, a child may never develop the vision they could have had in that eye and might end up with what we call a lazy eye, or amblyopia.”

The solution Paysse and Weikert are offering to patients who have not had success with traditional therapies such as wearing glasses or contacts, and patching the better-seeing eye, is a procedure called photorefractive keratectomy or PRK.

“Photo refractive keratectomy is a surface ablation of the cornea using an excimer laser,” Paysse said. “The laser shaves away, or somewhat sculpts, the cornea, taking away a certain amount of it to reduce the refractive error.”

The desired outcome of PRK is that the child’s refractive disorder will be improved or corrected and that their brain will then be able to better develop the vision in the weaker eye. Thus far, the majority of the more than 180 patients Paysse and Weikert have operated on have had excellent results.

“We find that the patients respond better if they are treated at a younger age,” Paysse said. “The reason is that amblyopia is a time-sensitive problem that you really must treat before the patient is visually mature in the brain.”

One patient who had success with PRK is 8-year-old Lila McLaughlin. Lila was born three months early with a myriad of vision problems that eventually led her and her mother, Laura, to Paysse, who performed PRK surgery on Lila just before her second birthday. The surgery, and a subsequent procedure, changed Lila’s life.

“She went into surgery and came back with what I say was a new set of eyes,” said Lila’s mother, Laura McLaughlin said.

Prior to PRK surgery, Lila’s vision was deteriorating quickly causing the toddler to become legally blind in one of her eyes. After undergoing PRK, Lila could see almost perfectly.

“This surgery has given her a healthy outcome,” Laura McLaughlin said. “Lila has blossomed into a phenomenal, fun-loving, feisty firecracker of a third grader.”

Lila herself is extremely thankful for the care she received from Paysse and others at Texas Children’s who have participated in her care.

“She’s a really great doctor,” Lila said. “She successfully helped me see way better than I used to.”

Currently, PRK surgery is not approved by the Federal Drug Administration in children. All the patients Paysse and Weikert have treated are part of a study led by the Institutional Review Board of Baylor College of Medicine, a consortium of committees that checks doctors’ protocols making sure they are designed safely.