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January 18, 2018

Spike in flu patients is straining hospitals—and public health officials are concerned

Daily Briefing

    Stretched thin with an influx of patients amid a severe flu season, hospitals are adopting creative measures to care for patients—and alarming emergency preparedness experts who are voicing concerns about whether hospitals would be able to handle an influenza pandemic.

    Traveling this winter? How to avoid the flu when you fly.

    How hospitals are addressing this year's flu season

    Hospitals are implementing a variety of tactics to address an influx of patients amid this year's flu season—particularly in California, which is dealing with an outbreak of an influenza A strain, known as H3N2, that is so severe it may result in the state's worst flu season in a decade, the Los Angeles Times reports.

    For instance, Connie Cunningham of Loma Linda University Medical Center said her hospital was triaging so many flu patients after the New Year that they put together a "surge tent" in the hospital's parking lot—a tactic several hospitals are adopting. According to the Times, the hospital has been seeing an average of 60 more patients per day than is typical. "In my career, I've never seen anything like this," Cunningham said.

    Palomar Medical Center Escondido in northern San Diego County also erected a tent for flu patients this month. Michelle Gunnett, a nurse who oversees emergency services at the facility, said the medical center has seen so many patients that many are being seen in hallways, single rooms are being treated as doubles, and surgeries are being canceled to free up space. "Those are all creative things we wouldn't typically do, but in a crisis like this, we're looking at," Gunnett said.

    Meanwhile, some hospitals have asked patients who aren't seriously ill to not seek medical treatment at hospitals, and others are restricting visitors in an effort to avoid spreading the illness. For instance, Dominican Hospital in Santa Cruz—which is treating about five times the number of patients it usually sees, according to Nanette Mickiewicz, a physician at the hospital—has introduced rules they haven't used since the H1N1 outbreak in 2009 that bar visitors under 16 and restrict patients to one visitor at a time.

    Experts say funding cuts jeopardize hospitals' response efforts

    According to STAT News, some experts say hospitals' difficulty coping with this season's influx of flu patients raises questions about whether they would be able to handle less predictable, large-scale health events, such as an influenza pandemic—and shines a light on the need for bolstering public health resources.

    Influenza is particularly susceptible to becoming a pandemic because of how it attacks, STAT News reports, affecting large numbers of people, including care providers, in very short periods of time. According to STAT, the surge can catch hospitals unaware and make it difficult to get help from neighboring providers.

    Emergency preparedness experts say recent cuts to programs aimed at helping hospitals and public health officials prepare for outbreaks and similar health events have undermined the infrastructure necessary to provide care in such crises, STAT reports. Overall, investments in such programs have declined by 30% in recent years, according to Oscar Alleyne, a senior adviser with the National Association of County and City Health Officials. Alleyne said the limited funding for emergency preparedness programs "is a concern to us."

    Tom Inglesby, the director of the Center for Health Security at Johns Hopkins University, said a CDC modeling program called FluSurge shows that hospitals facing a pandemic could have four times more people in need of a ventilator than ventilators available, and not enough beds in ICUs. If a pandemic were to occur, Inglesby said, "There would be a big mismatch between demand for care, lifesaving care, and the ability to provide it." He added, "We would have a huge problem in this country" (Branswell, STAT News, 1/15; Karlamangla, Los Angeles Times, 1/16).

    Traveling this winter? How to avoid the flu when you fly.

    Download this infographic to learn about both the obvious and less obvious locations where germs on planes are rampant.

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