Flu Spread Opens Hospital Wings in U.S. as Cases Rise

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Hospitals in the U.S. are adding more beds and boosting staff to meet increasing admissions of patients stricken by the influenza outbreak that prompted Boston to declare a health emergency in the city.

Lutheran Medical Center in Brooklyn, New York, is adding 40 new beds after a 20 percent jump in emergency admissions, while Boston’s Beth Israel Deaconess Medical Center has opened a wing that wasn’t being used so it could handle additional patients. At the University of Chicago Medical Center, patients with antibiotic-resistant infections, who are normally isolated, are being paired together to make more room for flu cases.

“We’ve expanded as much as we can and opened up an area of beds,” Stephen Epstein, an emergency room physician at Beth Israel Deaconess, said in an interview. “The hospital is full. We’re holding admitted patients in the ER.”

The U.S. Centers for Disease Control and Prevention released new data on the flu outbreak today showing 47 U.S. states reported widespread flu, an increase from 41 as of Dec.

29. With at least six to eight weeks of the flu season remaining and waiting rooms already swamped, Boston is working to avoid a more dire situation, said Barbara Ferrer, director of the city’s Public Health Commission.

“I don’t think we’re in a more serious situation than some other cities, but we want to be very proactive,” she said in a telephone interview. “If we don’t dampen the epidemic we will be in serious trouble in the city of Boston. I don’t want to see our caseload continue to grow at this rate.”

Boston Cases

In a report released this morning, the Boston Public Health Commission raised the number of confirmed influenza cases thus far to 750. The total number confirmed in the city during the previous season was 70. Boston Mayor Thomas Menino declared a public health emergency Jan. 9, when the commission said 700 confirmed cases had been reported.

Brigham & Women’s Hospital in Boston yesterday declared a “code amber” because of the influx flu patients, said Lori Schroth, a hospital spokeswoman. The code is used to alert hospital staff to plan for increased numbers of patients because of disasters and emergencies.

“The bottom line: it’s flu season,” Thomas Frieden, director of the CDC, said today during a conference call with reporters. “Most of the country has seen the flu and this will continue for a number of weeks.”

At the University of Chicago Medical Center, 166 people have been confirmed with the flu, including 31 cases in the last week, as of Jan. 8. Last year, 43 people tested positive the entire season, said hospital epidemiologist Emily Landon.

Making Room

The Chicago hospital is now at a point where it can’t keep patients with antibiotic-resistant diseases in isolated rooms because it needs their beds for flu patients, Landon said. The hospital is putting them with other patients with the same illness to free up beds. People who test positive with the same strain of flu are put together as well.

“Our hospital is more full than it’s been in all the years I’ve been here,” Landon said. “We can’t afford to have these rooms have just one patient for isolation. I’ve been here since 2003 and we’ve never done that before.”

In Minnesota, 401 people were hospitalized with the flu and 23 died from it through the first week of 2013, according to the Minnesota Department of Health. For all of last season, 552 people were hospitalized and 33 died.

Minnesota Plan

Hospitals statewide have created a task force to respond to the outbreak and coordinate care, said Patrick Devlin of Fairview Health Service, a provider with 50 primary-care clinics and six hospitals in the state. While many hospitals in Minnesota are close to capacity, “we’re not to the point of putting people on cots in hallways,” he said, because officials report the number of beds available twice a day to ensure patients can be properly treated.

In Houston, the Methodist Hospital System has seen an increase in patient volume of 20 percent, which is attributable to the flu, said Jeff Kalina, the associate director of emergency medicine. The majority of the patients are people who didn’t get the vaccine, he said.

“It’s not too late to get the vaccine,” Kalina said. “This flu season is probably going to last into March and April.”

Influenza normally causes symptoms such as coughing, sneezing, headaches and body aches, fever, chills, and sometimes vomiting and diarrhea. Severe cases of flu are normally seen in very young and very old people whose immune systems are too weak to fight off the virus, and annual vaccination is recommended for vulnerable people and those who come into contact with them.

While flu activity is high in the U.S. and started early it may be decreasing, based on trends for the week Dec. 30 through Jan. 5, the CDC said today in a weekly surveillance report.

State Reports

Twenty-four states and New York City reported high levels of out-patient visits for flu-like illness, according to the report. Sixteen states had moderate levels, five had low levels, and one state, Hawaii, saw minimal levels of the illness.

Some states may be getting past their peak, the CDC said.

Vaccine manufacturers produced 135 million doses of the immunization this year and had distributed 128.1 million as of Jan. 4, the CDC reported yesterday. At least 112 million people, 35 percent to 40 percent of those eligible, have gotten a flu shot this season, Michael Jhung, a CDC medical officer in the influenza division, said in a telephone interview.

Vaccine Supply

“There is plenty of vaccine available, though people may not find it at the first pharmacy they go to,” Jhung said. “It’s perhaps even more important to be vaccinated, and quickly, because of the high rate of influenza we are seeing now.”

It takes two weeks for full protection from the vaccine to kick in, Jhung said.

The effects of the 2012-2013 flu season are hitting New York hospitals especially hard in the wake of Hurricane Sandy. Brooklyn’s Lutheran Medical Center was already seeing an 11 percent increase in patient visits before the flu outbreak because of damage to a nearby hospital from the storm.

In addition to opening new beds to meet the demand, Lutheran Medical Center has also ordered 25 new stretchers. Employees are working overtime, and the hospital is hiring temporary doctors to beef up staff, said Bonnie Simmons, chairwoman of emergency medicine at the hospital.

“It is a bad season,” Simmons said. “It started for us in mid-December and it grew slowly and consistently.”

Long Island

At North Shore University Hospital on New York’s Long Island, emergency room visits have increased as much as 30 percent and there has been a spike in hospitalizations, said Andrew Sama, chairman of emergency medicine.

“It has been as bad a flu as we have seen in at least five years,” Sama said. “It is stressing the infrastructure quite a bit.”

The hospital has brought in extra beds and staff, and has doctors and nurses working overtime as patients have to wait longer than usual in the emergency room. The hospital is seeing a lot of patients with the flu who received this year’s flu shot, he said.

“We have been hit particularly hard in New York at the moment, but everyone is probably going to have their moment in the sun,” Sama said in a telephone interview. “It’s probably going to be the worst at doctors’ offices and urgent care centers and really bad with elderly having complications.”