Disaster Plans Being Revised For Swine Flu Strains on Emergency ...
BALTIMORE -- It was a slow day for Maryland's hospitals. But one Baltimore emergency room and an intensive care unit were already maxed out. And the computer monitor tracking the ER and ICU at a medical center in nearby Washington was flashing yellow and red -- signaling that they, too, had run out of room. The next car crash victim would have to go elsewhere; the next heart attack patient risked losing precious minutes before getting lifesaving treatment.
As the second wave of H1N1 infections begins in the United States, scenes like this from the command center of the Maryland Institute for Emergency Medical Services Systems have federal, state and local health authorities nationwide scrambling. Even if swine flu remains a mild infection, the pandemic could be the tipping point for an emergency medical system teetering on the edge.
"The worry is, the health-care delivery system could be overwhelmed by people who are sick or think they are sick," said Kim Elliott of Trust for America's Health, a nonpartisan think tank and advocacy group.
In response, officials across the country are rewriting disaster plans and stocking up on masks, gowns, drugs and other supplies -- and inventing new strategies. One key line of attack will be encouraging people who are not really sick or are suffering only mild symptoms to recover at home. And in a move creating intense debate, experts are searching for ways to help health-care providers quickly screen those who do seek help and separate bad cases from less-severe ones.
The swine flu virus, also known as H1N1, could infect up to half the U.S. population, making as many as 1.8 million sick enough to need hospitalization, including as many as 300,000 who might need intensive care, according to a presidential advisory council estimate. Even though scientists reported Thursday that the vaccine appears to work much better than hoped, the second wave of U.S. infections is expected to peak next month -- well before the shots become widely available.
"There will be millions and millions of people seeking care in a relatively short period of time," said Eric Toner of the University of Pittsburgh's Center for Biosecurity, noting that the nation has only about 85,000 critical-care beds. "Only a small percentage of those people will require hospitalization and a small percentage will require intensive care. But it's still an awful lot of people."
The federal government is sending $350 million to state and local governments, including $90 million to help the nation's 4,897 hospitals and 3,829 emergency rooms prepare. In addition, the Strategic National Stockpile has more than 116 million masks, more than 52 million doses of antiviral drugs and 4,500 ventilators.
Federal officials are asking hospitals to report more current details about how stressed or well-equipped they are so the officials can help coordinate care in a crisis. They have also begun to count available ventilators, which could be crucial in caring for the sickest patients.
After the virus emerged in Mexico this spring and spread to the United States, many hospitals experienced a surge in patients, and some emergency rooms in New York City and elsewhere were overwhelmed. Experts say they expect the virus to linger longer this fall and winter, raising deep concern about whether the stockpiles of supplies, the contingency plans to improvise extra beds and backup plans to call up reserves of doctors, nurses and other health-care workers will be sufficient.
The first line of defense will be to persuade those with mild symptoms to stay home to minimize the spread of the virus and to make sure those who really need care receive it, while still providing treatment for the usual number of heart attack, gunshot and accident victims.
Federal, state and local health officials are planning multimedia campaigns -- including radio and television ads, subway signs, refrigerator magnets and Twitter feeds -- to convince Americans that they do not need to run to a doctor or emergency room at the first sign of cough or fever.
Many states and some cities are creating Web sites and hotlines for people to get information and, in some cases, talk to a nurse to find out what kind of care they need.
Source: Washington Post
