posted 07-19-2000 10:40 AM            

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Hospitals Buckle During Flu Season [excerpt]
by Monica Schoch-Spana, Ph.D.

Hospitals Try to Cope

At the peak of the nation's flu season, large numbers of patients seeking care at the same time faced impediments to prompt medical attention, while hospitals struggled to find creative solutions for acute shortages in staff, beds, and sometimes equipment. Sufferers of influenza and other respiratory illnesses streamed into overflowing doctors' offices, urgent care centers, and emergency rooms (ER). Some patients en-route to hospital by ambulance endured extended rides while dispatchers attempted to find institutions that had available beds. Many ER patients tolerated long waits to be seen by an overworked staff, and those identified for in-patient admission often experienced further delays because critical care unit (CCU) and intensive care unit (ICU) beds were in short supply. Ventilators for patients with severe respiratory symptoms were sometimes scarce, given hospitals' increasing reliance - out of economic necessity - on rented or leased equipment, and the resulting competition among institutions over a locally finite inventory.

To curtail the stream of people into ERs, hospitals adopted a number of strategies: coordinating with local emergency medical systems to develop a plan of action; appealing to influenza sufferers to stay at home, contact their doctors, and avoid the ER unless indicated; requesting physicians to extend office hours and accommodate heavy patient loads; establishing nurse triage phone lines to aid patients in determining the best care option.

Overcoming staff shortages proved difficult given the limited, often non-existent, relief pools from which to draw. More frequently, existing staff skipped breaks and meals, cancelled leave time, and worked extra shifts. Strategies for dealing with deficits in bed capacity were varied: using alternative space - e.g., a solarium - to set up beds, postponing or canceling elective surgery, providing for early discharges, and drawing upon rehabilitation, psychiatric and other specialty departments for additional beds and staff.

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I'm presenting these two excepts out of sequence, for a reason. Please read the introductory paragraph to this essay:

quote:

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Hospitals Buckle During Flu Season [excerpt]
by Monica Schoch-Spana, Ph.D.

The prevalence of crowded emergency rooms and ambulance diversions around the country during the 1999-2000 influenza season might suggest that an unusually potent virus was at work, sending sick people to the hospital in droves. Epidemiological data, however, made it clear that the recent flu outbreaks were nothing more than the annual appearance of a familiar respiratory illness, only appearing earlier than expected.

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Hmmm. It "might suggest that an unusually potent virus" was making so many people sick that the health care system practically broke down in attempting to deal with it. After reading this staggering description, do you find it interesting that the only difference that Dr. Schoch-Spana reports is that it was just the familiar flu "appearing earilier" than normal? It is hard for me to believe that everything was the same as it has always been, just a little early. If you are not familiar with the CDC 'Pnu' and Flu Mortaility Chart please see it:

http://www.cdc.gov/ncidod/diseases/flu/bigpi.htm

This chart shows that we had a doubling in the usual seasonal flu mortality. It wasn't just early, it was an epidemic. An epidemic beyond the normal seasonal epidemic. I agree with the Doctor that we are ill-prepared for a bioterrorist attack, but there may be an integral part of the story missing here. Perhaps the increase in illness was actually due to attempts to aerially innoculate the populace. Perhaps this is related to why the flu season began early. What do you think?