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H1N1 Flu 'Pushing Hospitals to Their Limit'

BALTIMORE — To Mitchell Goldstein, the flood of sick children seemed endless. Day after day, nearly three times as many kids as usual streamed into the rainbow-colored pediatric emergency room at Johns Hopkins Hospital, sniffling and feverish, worried parents hovering.

The press of children with swine flu was so relentless that doctors opened an annex in a hospital dining room to handle the overflow. “Our worst day” was Sunday, Oct. 11, says Goldstein, one of the ER doctors. “We had 15 to 20 patients an hour. It was 24/7. There wasn’t a lull.”

Last week, the epidemic of ailing children let up somewhat. But doctors here are expecting a new run of flu patients — the children’s parents. “What we see first in (children) we see two to three weeks later in adults,” says Trish Perl, the hospital’s director of infection control.

The scenes at Johns Hopkins are being repeated at hospitals in Denver and Duluth, Seattle and San Diego, as waves of flu patients arrive at their doors, doubling their emergency room volume. Just as significant is the effect on intensive care units: A relatively small number of flu patients are requiring intensive care, but some are so ill they will need round-the-clock care for weeks.

Doctors at Johns Hopkins and elsewhere expect the number of patients needing hospitalization and intensive care to rise. Such an influx of intensive care patients eventually could force some hospitals to cancel services such as elective surgery, they say.

“Why did President Obama declare a national emergency? Because what’s going on at Hopkins is happening across the country,” Perl says. “An infection that generally doesn’t appear to be severe is pushing hospitals to their limit.”

The White House declaration, announced Saturday, was designed to give hospitals the flexibility to move patients to satellite facilities if they are overwhelmed in dealing with an outbreak that is now widespread in 46 states and afflicting millions of people, says Reid Cherlin, an administration spokesman.

“H1N1 is moving rapidly, as expected,” Cherlin says. “By the time regions or health care systems recognize they are becoming overburdened, they need to implement disaster plans quickly.”

Thomas Frieden, director of the Centers for Disease Control and Prevention, reported Friday that the swine flu virus, also known as H1N1, has killed more than 1,000 people nationwide and prompted 20,000 to be hospitalized. For the second week in a row, deaths from flu and pneumonia increased last week, reaching a total of 2,416 from Aug. 30 to Oct. 17. Ninety-five children have died of swine flu since April, 11 more last week, he says.

Seasonal flu typically kills about 36,000 people and hospitalizes 200,000, the CDC says.

Flu’s unpredictability makes planning a challenge.

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