swine flu warning, hospital sign, hospital visitors
Charles Dharapak/AP
A sign alerting visitors to new policy
regarding H1N1 is seen at the Inova
Alexandria (Va.) Hospital.

How Are Hospitals Preparing for the H1N1 Pandemic?

November 17, 2009 12:00 PM
by Denis Cummings
With flu season approaching, the scare of the H1N1 pandemic has hospitals in the Northern Hemisphere developing procedures to handle an influx of flu patients.

Hospitals Develop Contingency Plans for H1N1

Hospitals are likely to see an increase in flu patients this winter, potentially causing crowding and draining hospital resources. According to a recent study by the Australian and New Zealand Intensive Care Research Centre, ICUs in Australia and New Zealand had flu patients occupying as much as 20 percent of their beds this past winter (June-August).

“Intensive Care Units specialise in the management of patients with life-threatening illness and the surge of patients with H1N1 placed substantial strain on staff and resources. … The number of patients admitted to ICUs with this complication represented a 600 per cent increase compared to previous years,” said Dr. Ian Seppelt.

Hospitals in the Northern Hemisphere are looking to Australia and New Zealand to help prepare for the upcoming flu season. Hospitals in Oklahoma, where a state report said that half of all hospital beds could be filled by H1N1 patients, are prepared to cancel elective surgeries and release stable patients.

Many hospitals are restricting visitors, particularly children and those with cold or flu symptoms. However, doctors admit that visitors can still spread the virus. “We cannot hermetically seal the institution,” says Dr. William Schaffner of Vanderbilt University. “You can have people who are going to get sick tomorrow who already are excreting the virus.”

In Britain, the MRSA Working Group has advised hospitals to discharge patients with Methicillin resistant Staphylococcus aureus if there is a rush of flu patients in need of hospital beds. Hospitals overcrowded with MRSA patients, say the organization, could lead to a 40 percent increase in MRSA cases.

Other hospitals are preparing for more drastic situations. Florida has drafted a plan to determine who will be cared for in the event that a hospital is overwhelmed by flu patients.

The sickest patients, including those with incurable cancer and end stage multiple sclerosis, would likely lose care in favor of those with a better chance of survival. For example, if there were a shortage of ventilators, patients whose condition declines while on the ventilator would be removed from it so that it could be given to another patient.

Health officials in southwest Washington are taking a different approach. They are advising people who believe they have H1N1 to remain at home and not see their doctors unless they are “severely ill.” Cowlitz County Health Department official Carlos Carreon told KPTV (Portland, Ore.), “If folks are in general pretty healthy and they are having general flu like illness, it's a common course to stay home and get a lot of rest and a lot of fluids.”

Related Topic: How businesses and schools are preparing

Health officials warn that businesses must be prepared to deal with outbreaks of flu, with the Occupational Safety and Health Administration estimating that as much as 40 percent of the workforce could be lost at the peak of the flu.

Businesses are advised by the Centers for Disease Control and Prevention to stress the importance of personal hygiene at work, encourage sick workers to remain at home until 24 hours after a fever has passed, and have a plan to remain productive when key workers are out.

Daniel Shields, a director of emergency-planning company RiskLogic, recommends that businesses maintain updated contact information and have protective masks, gloves, disinfectants and other protective items on hand.

Colleges are taking similar steps, providing students with information on how to prevent the disease and where to find care, and installing procedures for students to receive class information if they miss class.

“The worst part of any of these health crises is not the disease itself,” said Dr. Pierre-Paul Tellier, director of student health services at McGill, to the Toronto Star. “It's really dealing with the population around who become very anxious and very stressed and that you have to … constantly clear up issues and matters on an ongoing basis, and that's where a lot of your energy is spent.”

Reference: Pandemics and epidemics


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