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Hospital capacity an issue in preparing for flu pandemic
By DAVE COLLINS
Associated Press Writer
December 16, 2006, 12:31 PM EST
HARTFORD, Conn. -- Connecticut officials say a flu pandemic could force them to close schools and shopping malls, isolate some patients and urge others to ride out illnesses at home if they can.
State government, local health departments and hospitals have prepared detailed plans to respond to a massive flu outbreak. But some major questions remain unanswered, including how hospitals would handle overflows of patients and staff shortages.
"This is one of those situations that keeps you awake at night. It's very difficult," said Christopher Cannon, emergency preparedness director for the Yale-New Haven Health System, which includes Yale-New Haven, Bridgeport and Greenwich hospitals.
Several hospitals are contacting community health centers, private providers and others about handling surges of patients during a pandemic. They plan to cancel elective surgeries to free up beds and to beef up security to maintain order. They are also looking for former health care workers to fill in when regular hospital employees get sick.
"We are prepared to handle a pandemic flu of a certain level," said Brian Cooper, chief of infectious diseases at Hartford Hospital. "If a pandemic struck that is similar to 1957, I would say we're ready. If it's significantly bigger than that, I think we would be in trouble this year."
There were three pandemics in the 20th century. The worst was the Spanish flu in 1918-19, which killed more than 500,000 people in the United States. The 1957-58 Asian flu caused about 70,000 deaths in the U.S., while the 1968-69 Hong Kong flu killed about 34,000 Americans.
Cooper said Hartford Hospital is revising its response plan and needs about a year to be ready to handle a pandemic at the high end of federal projections of severity.
The state Department of Public Health estimates that a pandemic would hospitalize 10,000 to 14,000 people and kill as many as 3,300 people, based on "attack rates" of 25 and 35 percent of the state's 3.5 million residents.
Dr. J. Robert Galvin, commissioner of the Public Health Department, said there are about 7,800 staffed hospital beds in the state. He said that number could be expanded to 10,500 or 11,000 without too much difficulty, but staff shortages could cause major problems.
"You eventually get to the point where you don't have enough professional staff and room to handle all the patients," Galvin said. "We do have concerns about a lot of people getting sick all at the same time."
Health officials say not everyone who gets the flu would be sick at the same time. They estimate that the pandemic would be spread out over about 12 weeks, with each person needing about a week to recover. Most people who get the flu will be able to ride it out at home.
But Galvin said he is concerned about hospitals being overwhelmed. He said one of the most important actions the state will take is educating the public.
"We need people to understand that when they don't feel well, their first thought should not be 'I've got to get to the emergency room,"' he said, "because then we'll spread the disease and we'll have pandemonium.
"We need people to understand that they may have to stay home for a while, they'll need to stockpile some things so they don't have to go to the grocery stores," Galvin said.
Informing the public is a key part of the state's 29-page pandemic flu response plan. The state has already launched a Web site, http://www.ct.gov/ctfluwatch . Health officials have also met with newspaper editorial boards and are working on advertisements to run in the media.
The state has printed a "Guide to Emergency Preparedness," which recommends supplies for emergency kits and actions to take during a variety of emergencies. It also says to be prepared for quarantines and to practice good hygiene such as washing hands frequently.
The first statewide exercise to practice the response to a flu pandemic is scheduled for Feb. 28. Public health officials held a flu drill at Bradley International Airport in June involving an incoming flight with sick passengers.
Hospitals and local health departments have also held their own exercises on what they would do in a pandemic. They say much work remains, including stockpiling protective gear like face masks and medical equipment such as respirators.
Hospital officials say a major issue still unresolved is how to handle staffing shortages during a pandemic.
Cooper said Hartford Hospital is working on a new policy that will spell out what will be expected of hospital employees during a pandemic, including showing up to work if they're not sick and working longer shifts.
Cannon, of the Yale-New Haven Health System, said his hospitals are still working on their plans to handle overflows of patients. Some of the proposals include moving some patients to community health centers and others to their homes to free up beds.
"If there is a very signficant event, the personnel issue becomes really critical," Cannon said. "There's no question we would have to be extremely creative."
He also said it will take another 10 months for Yale-New Haven to stockpile all the supplies it needs, mainly because of supply issues created by high demand around the country.
Local health officials say their preparedness plans include educating the public and using existing vaccination clinic locations to administer the flu vaccine when it becomes available.
Robert Miller, director of the Eastern Highlands Health District that handles 10 towns in eastern Connecticut including Mansfield and Coventry, said local officials are spending a lot of time on planning for a pandemic, but recent drills have shown that much work remains.
"There's a concern right now that we could be better prepared," Miller said. "I think our concerns are the same as on any local level: What are we going to do faced with a significant number of flu cases? That's a daunting concept."