Swine flu could overwhelm hospitals

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Swine flu could overwhelm hospitals, health care providers

Health experts are predicting a long, possibly deadly, flu season.
H1N1 flu targets the young and reasonably healthy, while regular flu is dangerous for the very young and very old. Both viruses could cause overflow in emergency rooms and intensive care units.
Colorado Springs hospitals are preparing for the worst case scenario: 90,000 dead and  300,000 in intensive care units nationwide. But they say, the preparation isn’t anything new.
“Pandemic preparation is ongoing, all the time,” said Cindy Corsano, emergency preparedness officer at Memorial Health System. “It’s not something we do once they declare a pandemic.”
But Memorial has stepped up the preparation, and has met with Penrose-St. Francis Health Services to discuss cooperation in case the worst happens.
“We are working together to make sure that we have the same requirements in place, the same steps to control the infection,” said Stacey Knott, spokeswoman for Penrose. “People should know that both hospitals are working to take care of them.”
Penrose plans to meet with the Centers for Disease Control and Prevention to discuss the upcoming influenza season — and the importance of the H1N1 vaccination, which is expected to be available by the middle of October.
“There are always concerns about side effects,” said Anne Dennis, infection preventionist with Centura Health, the parent organization for Penrose. “We’re hoping these meetings – we also have one scheduled with a naval epidemiologist to discuss swine flu specifically – will help ease some of those fears.”
The CDC recommends that health care workers receive the vaccination, and that providers give it to populations who are most at risk. The Colorado Department of Public Health and Environment is pre-registering doctors and other providers who plan to vaccinate people against the swine flu. Providers who are interested in administering the vaccination should register with the state.
Joni Reynolds, director of the state’s immunization program, said the pre-registration process will allow public health agencies to collect information about interested providers, as well as the populations they serve and the estimated amount of vaccine they could administer.
“The sooner local public health agencies receive pre-registration information from interested medical providers, the better they can facilitate vaccine distribution this fall,” she said.
The CDC recommends that pregnant women, people who live with or care for children younger than 6, health care and emergency medical services, people between 6 months and 24 years old, and people ages 25 to 64 who are at a higher risk because of underlying health conditions be vaccinated.
About 19 million people in the country fall into the first five risk groups, the CDC said. A vaccination shortage isn’t expected, but availability and demand could be unpredictable.
In the meantime, hospitals are gearing up for what could be a massive influx of patients. They are keeping their plans flexible, because no one is sure what will happen during the flu season.
“It could be like last spring,” said Chris Valentine, spokesman for Memorial. “And we got all geared up, and then we had only a few cases. But it could be much, much worse, so we’re preparing for that.”
Much worse – some groups are predicting up to half the U.S. population will affected with H1N1 flu.
“That would fill up our ICU beds and tax our personnel,” Valentine said. “We have a plan in place that includes bringing in additional people if that worse-case scenario happens.”
Dennis said Centura’s plan includes isolating flu patients to keep the disease from spreading inside the hospital, and  perhaps keeping visitors to a minimum to control the spread of the disease.
Businesses are urged to create plans similar to the hospital’s contingency plans, according to the Colorado Department of Public Health and Environment. The CDC has information about businesses and flu at www.flu.gov.
The guidelines for businesspeople also refer to doctors’ offices and outpatient clinics. Those groups need a plan to continue operating, the CDC said.
“Novel H1N1 flu outbreaks will impact your organization, employees, suppliers of critical material and your family,” the guidelines say. “Identify your office/clinic’s essential functions and the individuals who perform them. Make sure you have trained enough people to properly work in these essential functions and allow for potential absenteeism.”
Doctors’ offices should make sure they have alternate plans for supplies in case routes are disrupted.
“Plan to operate your facility if there is significant staff absenteeism,” the CDC said. “Are you ready for 20 to 40 percent of your employees to be not able to come to work? Be sure to ask sick staff to stay home. All personnel should self-monitor daily for signs and symptoms of febrile respiratory illness.”
Both the CDC and other public health care providers say that best option is to be prepared and to work together.
“We’re also working closely with the El Paso County Health Department and the state,” Dennis said. “We need to be able to track the virus throughout the flu season.”

CDC guidelines for health care businesses

1. Plan for a surge of patients and increased demands for your services — Consider using your telephone system to deliver messages to incoming callers about when to seek medical care at your facility, when to seek emergency care and where to go for information about caring for a person with flu at home
Consider extending your hours of operation to include telephone triage of patients during a community outbreak.
2. Care for patients with H1N1 flu in your facility — Make plans to screen patients for signs and symptoms of febrile respiratory illness at entry to the facility.
If feasible, use separate waiting and exam rooms for possible H1N1 flu patients; plan to offer surgical masks to symptomatic patients who are able to wear them (adult and pediatric sizes should be available), provide facial tissues, receptacles for their disposal and provide hand hygiene products in waiting areas and examination rooms.
3. Take steps to protect the health of your workforce during an outbreak of H1N1 — All health care personnel who come in close contact with patients who may have H1N1 flu should take precautions to include use of respiratory and eye protection for all patient care activities.
4. Provide immunization against seasonal flu at no cost to your staff — In the fall there may be several influenza strains circulating at the same time.
Although seasonal flu immunization will not provide protection to H1N1 influenza, annual influenza vaccination is recommended for health care professionals and will likely protect against seasonal influenza strains.
5. Make sure you know about the pandemic planning and response activities of the hospitals, outpatient facilities and local public health in your community — Actively seek information from and coordinate with key medical, clinical facilities and public health departments in your community to learn about how they will manage patients during a pandemic.
Medical offices, emergency rooms, urgent care centers and hospitals in communities with outbreaks will likely have difficulty managing a large influx of patients; a coordinated community response is important to manage surge and assure optimal patient care.
Develop a plan to manage your patients who do not need to seek emergency services.
6. Plan now so you will know where to turn to for reliable, up-to-date information in your local community. Staff in health care settings should monitor the CDC’s Web site and local and state health department Web sites for the latest information.
7. Be prepared for a range of situations. The true impact of novel H1N1 flu outbreaks during the coming months will not be known until it happens.
Be prepared for a possibility that your facility will have significant increased demand for services and the possibility that the fall outbreak may have greater impact than the outbreak in the spring, 2009.
Source: Centers for Disease Control and Prevention