Since January 2020, there has been a worldwide pandemic of COVID-19, caused by a novel coronavirus–severe acute respiratory syndrome coronavirus 2. The United States has been particularly affected, with the largest number of confirmed cases in a single country in the world. Healthcare systems for adults as well as children have dealt with challenges. This article will reflect on the experiences of selected children’s hospitals in Seattle, New York City, and New Orleans, three of the “hotspots” in the US and share common aspects and lessons learned from these experiences. This article discusses testing and cohorting of patients, personal protective equipment utilization, limiting workplace exposure, and information sharing.