Will H1N1 overwhelm USA ERs, as it did in NZ?

[Guest guest]

Worries that H1N1 fears will overwhelm ERs

Public health officials urge ill to consult family physician

By Becker Wednesday, September 16, 2009 11:50 AM CDT

Worried that public concern over H1N1 influenza, also known as swine flu, will

lead to overcrowding of local emergency rooms, local health officials are

warning that most people experiencing flu-like symptoms should not go to the ER.

Unless an individual is experiencing severe symptoms such as difficulty

breathing or dehydration, local hospitals are recommending individuals who do

not have chronic medical conditions or are not younger than five years old stay

home, consulting a family physician over the phone if desired.

" For most people, this has been a very mild illness, " said Dr. is Elward, an

infectious disease expert with Washington University in St. Louis Medical School

and St. Louis Children's Hospital.

Elward said local health facilities have learned from incidents in the Southeast

where emergency room volumes ballooned as individuals who did not require

antiviral treatment headed to the ER.

Infectious disease specialists say unnecessary hospital visits have been due to

misinformation as to the primary risks groups for contraction of H1N1.

The primary risk group for H1N1 flu is children under five years of age, a

population in which respiratory function can become seriously impaired. Thus

far, Elward said, populations over 65 have not proven to be a H1N1 risk as they

are for seasonal flu.

Schools from Wentzville to Chesterfield to Granite City, Ill. reported suspected

cases of H1N1. Wentzville was by far the hardest hit, with 33 reported cases of

flu through September 2. According to the Centers for Disease Control in

Atlanta, the hardest hit population as been between five and 25 years of age.

Last Thursday, Washington University in St. Louis reported its first three

suspected cases of H1N1 novel flu. Interestingly, a CDC study indicated that

more than 80 percent of children who died from swine flu in the U.S. were

between five and 17.

Dr. Heinrichs, an infectious disease and public health specialist at SSM

St. ph Health Center and St. ph Hospital West in St. County,

said misinformation from local schools and other sources have led individuals

with flu-like symptoms to obtain a flu test unnecessarily.

" In Wentzville, one of the school nurses had been telling parents that call in

with a child that maybe just has cold symptoms that they have to go to the

doctor and get a flu screen and that the child can't come back to school unless

they have a negative screen, " Heinrichs said. " Our concern is that we're going

to run out of test kits before the big push starts. "

The big push is expected to hit later this month.

Though tests exist, they often just identify whether the strain of flu is

influenza A or B. Thus far, strains of influenza A have been tied to H1N1 flu;

but some kits only have 30 percent accuracy, Heinrichs said.

" People need to be communicating with doctors offices and not just go in for a

visit that may not give them much more information than they can get over the

phone, " Heinrichs added.

Emergency rooms prepare for potential onslaught

Though hospital officials say they prefer those with flu symptoms contact their

family physician first if there are no acute breathing or dehydration symptoms,

many are preparing for an uptick in ER volume.

SSM Health Care St. Louis has a multidisciplinary pandemic flu team composes of

employees throughout the system's health care facilities across the St. Louis

metro area, from North County to St. Lake Saint Louis. Like other local hospital

chains , SSM is aiming to have all employees vaccinated with a seasonal flu

shot. A limited amount of H1N1 vaccines are expected to be available near

mid-October, though at lower levels than previously expected and not necessarily

sufficient to cover the estimated 160 million people nationwide who fall into

risk groups. Those in the high-priority group for swine flu vaccines include

pregnant women, people who have household contact with anyone under 6 months

old, health-care workers, emergency management personnel, and anyone with a

chronic illness. Hospital chains like SSM and -Jewish expect to vaccinate

those working closely with infected populations.

Deena Fischer, director of communications for SSM Health Care St. Louis, said

each hospital in the SSM system has signs directing ER patients with flu

symptoms to a kiosk with face masks. Currently, she said, hospital

administrators are preparing plans in case of a patient surge.

Marie Reyne, a registered nurse and infection control coordinator at Gateway

Medical Center in Granite City, Ill. said Gateway Medical had devised a surge

plan consisting of separate areas to triage patients with flu-like symptoms that

could accommodate upwards of 100 people at a time. The 382-bed hospital-which

serves Granite City, Madison and areas stretching to Alton and Carbondale-is

aiming to vaccinate 90 percent of its employees with a seasonal flu shot to

reduce risk to patients.

In order to limit the number of unnecessary flu tests, however, Gateway will not

administer a flu test to anyone visiting the emergency room. The facility has

determined that patients won't receive H1N1 tests unless they are hospitalized.

Gateway has seen an uptick in flu swabs in the last week, but not a sustained

trend as yet.

Symptoms different

Importantly, Heinrich said, the symptoms for H1N1 are different from the stomach

flu that often occupies the public imagination. H1N1 is largely a respiratory

illness.

The big message, public health specialists Heinrich and Elward say, is that this

is largely a mild illness that requires no special testing.

" People should only seek medical treatment if they are in a high-risk group, "

Elward said. " We would like to avoid the experience of the Southeast region. "

http://suburbanjournals.stltoday.com/articles/2009/09/20/south/news//0916sc-h1n1\

0.txt

[Guest guest]

Unless I knew it to a true medical emergency I would never go to an ER with flu symptoms. ERs are already chock-a-block swamped with people who are often in very dire situations.

Do one thing every day that scares you.

Eleanor Roosevelt

From: rumjal <rumjal@...>Flu Sent: Sunday, September 20, 2009 6:00:35 AMSubject: [Flu] Will H1N1 overwhelm USA ERs, as it did in NZ?

Worries that H1N1 fears will overwhelm ERsPublic health officials urge ill to consult family physicianBy Becker Wednesday, September 16, 2009 11:50 AM CDT Worried that public concern over H1N1 influenza, also known as swine flu, will lead to overcrowding of local emergency rooms, local health officials are warning that most people experiencing flu-like symptoms should not go to the ER.Unless an individual is experiencing severe symptoms such as difficulty breathing or dehydration, local hospitals are recommending individuals who do not have chronic medical conditions or are not younger than five years old stay home, consulting a family physician over the phone if desired."For most people, this has been a very mild illness," said Dr. is Elward, an infectious disease expert with Washington University in St. Louis Medical School and St. Louis Children's Hospital.Elward said local health facilities have learned

from incidents in the Southeast where emergency room volumes ballooned as individuals who did not require antiviral treatment headed to the ER.Infectious disease specialists say unnecessary hospital visits have been due to misinformation as to the primary risks groups for contraction of H1N1.The primary risk group for H1N1 flu is children under five years of age, a population in which respiratory function can become seriously impaired. Thus far, Elward said, populations over 65 have not proven to be a H1N1 risk as they are for seasonal flu.Schools from Wentzville to Chesterfield to Granite City, Ill. reported suspected cases of H1N1. Wentzville was by far the hardest hit, with 33 reported cases of flu through September 2. According to the Centers for Disease Control in Atlanta, the hardest hit population as been between five and 25 years of age. Last Thursday, Washington University in St. Louis reported its first three suspected

cases of H1N1 novel flu. Interestingly, a CDC study indicated that more than 80 percent of children who died from swine flu in the U.S. were between five and 17.Dr. Heinrichs, an infectious disease and public health specialist at SSM St. ph Health Center and St. ph Hospital West in St. County, said misinformation from local schools and other sources have led individuals with flu-like symptoms to obtain a flu test unnecessarily."In Wentzville, one of the school nurses had been telling parents that call in with a child that maybe just has cold symptoms that they have to go to the doctor and get a flu screen and that the child can't come back to school unless they have a negative screen," Heinrichs said. " Our concern is that we're going to run out of test kits before the big push starts."The big push is expected to hit later this month.Though tests exist, they often just identify whether the strain of

flu is influenza A or B. Thus far, strains of influenza A have been tied to H1N1 flu; but some kits only have 30 percent accuracy, Heinrichs said."People need to be communicating with doctors offices and not just go in for a visit that may not give them much more information than they can get over the phone," Heinrichs added.Emergency rooms prepare for potential onslaughtThough hospital officials say they prefer those with flu symptoms contact their family physician first if there are no acute breathing or dehydration symptoms, many are preparing for an uptick in ER volume.SSM Health Care St. Louis has a multidisciplinary pandemic flu team composes of employees throughout the system's health care facilities across the St. Louis metro area, from North County to St. Lake Saint Louis. Like other local hospital chains , SSM is aiming to have all employees vaccinated with a seasonal flu shot. A limited amount of H1N1 vaccines

are expected to be available near mid-October, though at lower levels than previously expected and not necessarily sufficient to cover the estimated 160 million people nationwide who fall into risk groups. Those in the high-priority group for swine flu vaccines include pregnant women, people who have household contact with anyone under 6 months old, health-care workers, emergency management personnel, and anyone with a chronic illness. Hospital chains like SSM and -Jewish expect to vaccinate those working closely with infected populations.Deena Fischer, director of communications for SSM Health Care St. Louis, said each hospital in the SSM system has signs directing ER patients with flu symptoms to a kiosk with face masks. Currently, she said, hospital administrators are preparing plans in case of a patient surge.Marie Reyne, a registered nurse and infection control coordinator at Gateway Medical Center in Granite City, Ill. said

Gateway Medical had devised a surge plan consisting of separate areas to triage patients with flu-like symptoms that could accommodate upwards of 100 people at a time. The 382-bed hospital-which serves Granite City, Madison and areas stretching to Alton and Carbondale-is aiming to vaccinate 90 percent of its employees with a seasonal flu shot to reduce risk to patients.In order to limit the number of unnecessary flu tests, however, Gateway will not administer a flu test to anyone visiting the emergency room. The facility has determined that patients won't receive H1N1 tests unless they are hospitalized. Gateway has seen an uptick in flu swabs in the last week, but not a sustained trend as yet.Symptoms different Importantly, Heinrich said, the symptoms for H1N1 are different from the stomach flu that often occupies the public imagination. H1N1 is largely a respiratory illness.The big message, public health specialists Heinrich

and Elward say, is that this is largely a mild illness that requires no special testing."People should only seek medical treatment if they are in a high-risk group," Elward said. "We would like to avoid the experience of the Southeast region."http://suburbanjour nals.stltoday. com/articles/ 2009/09/20/ south/news/ /0916sc-h1n10. txt