H1N1 flu 'pushing hospitals to their limit'

[bunnysoft]

Source: USA Today

10-26-09

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.

Read more: http://www.usatoday.com/news/health/2009-10-26-swine-flu-hospitals_N.htm

---

I'm thinking of getting the h1n1 flu shot soon. These reports are scaring me. I'm 32.

[nadinbrzezinski]

1. I am calling the clinic tomorrow to see if they already have it

agreed

[Heddi]

2. my ER is seeing more and more kids and families

(i'm a nurse in an ER). Used to be that when Mom, Dad, and 2 kids came in, Mom and one kid would be in one room, dad and other kid in another room...now we're so short on space that we're putting all 4 in the same room...we don't have the room to triage them separately and housekeeping is being killed with the cleaning of the rooms between patients.

I'm in Florida, and we're getting into "season" now, which means all the sick old Snowbirds are coming down to clog the ER's like they normally do with their CHF and chest pains and such...add their ridiculous, yet expected, numbers on top of the drastic increase in children and younger (meaning 20-40 year olds) and our ER is going to be bursting at the seams come January. We'll be putting them in tents outside....

[still_one]

3. You may be thinking about it, but unless the supply increases most likely it will take some time

before you can get the vaccination

The youngest will have the top priority because they are most vulnerable

[SPedigrees]

7. Yes, it is taking longer to culture the vaccine than expected.

We're going for the regular flu shots tomorrow, but will have to wait for the swine flu jabs.

[LeftyMom]

4. There are almost no shots to be had.

If you're not in a high risk group you'll have to wait a while.

[XemaSab]

5. I am in a high risk group

but all they have here are the sprays, which I can't get. :(

[LeftyMom]

6. I read in the Bee that they're only offering the shot/spray to preggos and babies here right now.

And there's not nearly enough for that, let alone anybody else. There's a huge shortage of the seasonal flu vax as well, some counties didn't get any at all delivered (Yolo, for one.)

[Techn0Girl]

13. No Shots to be had....

That's what I am hearing as well. Apparently they are using rather old technology (outdated?? I'm not sure) to make the vaccine - I understand they're incubating it in Chicken eggs and that is taking a long time to do.

I can't help but wonder if the Bush administration gutted the CDC and NIH like it did to FEMA. Does anyone know?

[kestrel91316]

27. In this case, the "old" technology is the tried-and-true chicken egg culture.

It works very well, everybody knows how to do it, and when the virus is interested in growing, they can seriously crank out vaccine. Unfortunately, this H1N1 doesn't like to grow, so that slowed things down a lot. And then there was a delay in getting one of the necessary chemical ingredients in the process. Followed by trouble with some NEW packaging equipment.

Sometimes it's "better the devil you know than the devil you don't". DON'T complain about "old" flu production technology. Thank your maker that such even exists.

[Techn0Girl]

8. I have no idea how this season's impact will be ....

But I remember the last H1N1 variation that was called The Russian flu around 1977. I was in the military working in a field medical unit and the base hospital was so overwhelmed that we had to set up our field unit in the parking lot of the hospital for a couple of weeks. I got the flu and had a 102 degree temo for a few days myself. Just like this variation , the 1977 H1N1 outbreak caused relatively few deaths but a lot of people did get sick and it interfered with all aspects of work on base.

I have no idea how much of an issue this season's flu will play out. The thing to do is just follow proper precautions: wash your hands regularly and before eating, stay away from sick people, if you get sick don't go to work or school and if you can, if it becomes a bigger outbreak , avoid public places and cook food at home instead of eating out.

Remember : it's just the flu, a nasty one for sure and the vast majority of people will just suffer a week of inconvenience and discomfort - but don't panic. It's just the flu :)

[boppers]

10. Medicine's gotten a lot better in the last 91 years.

1918's H1N1 pandemic killed 50-100 million, and lasted until the mid 50's... those exposed to the 1918 and 1977 variants seem to be doing better off so far.

[Techn0Girl]

12. Lasted to the mid 50's ???

I'm really quite unsure what you mean by that. The 1918 pandemic lasted about a year as far as I have ever seen. What do you mean "lasted to the 50's" and where did you get such information from?

Additionally your "50-100 million killed" figure seems rather high.

According to Stanford University, less than 700 thousand Americans died from the flu that season. An astonishing figure by today's standards.

The CDC reports that 50 million people died worldwide by their estimate.
http://www.cdc.gov/ncidod/eid/vol12no01/05-0979.htm

We should all keep in mind that we are far removed from 1918. Since the majority of deaths then were attributed to opportunistic bacterial pneumonia infection back then we should keep in mind that we have vastly improved treatments for bacterial pneumonia so the survival rate is far far higher today. Additionally we are more informed and have better communications so we can get the word out to people to simply stay home from work and avoid crowds if the need arose. Such information disemination was not available back in 1918.

It may be a nasty flu season but I suspect we'll get through it just fine :)

[RobinA]

41. Killjoy!

You are no fun at all. Facts, "don't panic," "we'll get through it just fine." Sheesh. Mentioning the unmentionable, that medicine has changed since 1918... Way to ruin a good panic!

[Techn0Girl]

49. Mea culpa

LOL - (and thank you :) )

[boppers]

50. H1N1 didn't just infect people for one year in 1918, and then vanish...

..it was the prevalent strain of flu, though not at the same pandemic levels, well into the 50's, eventually superceeded by H2N2, H3N2, etc. Just like the strain this year will likely bounce around the globe for many years to come, with more and more folks building immunity, or being vaccinated, until another strain comes along that we're more susceptible to.... or another old one comes back.

Have a chart:
http://en.wikipedia.org/wiki/File:Influenza_subtypes.svg

The 50-100 million killed is from 'Patterson, KD; Pyle GF (Spring 1991). "The geography and mortality of the 1918 influenza pandemic". Bull Hist Med. 65 (1): 4–21' and 'Knobler S, Mack A, Mahmoud A, Lemon S, ed. "1: The Story of Influenza". The Threat of Pandemic Influenza: Are We Ready? Workshop Summary (2005). Washington, D.C.: The National Academies Press. pp. 60–61.'...in other words, I used wikipedia, and then copied the citations. :P

[Techn0Girl]

52. Thank you for the refrences ....

Thank you. I hate to use Wikipedia for anything but the chart you refer to there is cited to a valid source. However I see the chart as showing that H1N1 is merely existing in the milieu . All viruses exist long after people become immune to them - for thousands or tens of thousands of years. Chicken pox , for instance, still exists as does Rubella yet they are of no concern because people are generally immune to them (through infection or inoculation as children).

So of course H1N1 exists in the human population as the chart shows - but it is of no concern unless a new variation of it pops up that people are less immune to. This does NOT mean that the 1918 flu pandemic went on for 50 years. The CDC link I gave earlier clearly shows that it was considered to have lasted for only one year. Deaths from the Spanish flu went to essentially no more than seasonal flu after only 1 or two years.

Thank you for the Parrerson et al article regarding Spanish flu mortality rates, I went and read the 1991 article which says , "Mills uncovered a death toll of over 21 million in India alone and more recent revisions have raised probable global influenza mortality to between 50 and 100". So I suppose it may be possible that up to 100 million from that epidemic - although keep in mind two things:

1. That is an upper limit by one researcher. In fact , back in 1918, the communications and world medical infrastructure was not in place to accurately assess actual casualty rates from this sort of thing.

2. The CDC sets the figure at 50 million.

However , be it 50 or 100 million - that's a horrendous number of deaths to be sure. But almost a century later, new antibiotics have cut down the death rate for opportunistic infections due to influenza to an extremely small fraction of what they were.

Today , in the US only 36,000 people die from flu each year which quite frankly is to me an astonishing figure i this day and age. I wonder what the figure is for poeple in countries that have Public health care options. I would bet that it is a substantially smaller percentage.

[sandnsea]

9. Only 3 kids were at grandson's preschool, no teachers

They found someone who is a dance teacher to stay with the 3 kids who are well. My entire family is sick. Whichever flu we have, it lasts forever. I thought I was well, and now moving into the respiratory area. If I get any worse, I'm going to the doctor. Grandson went to ER yesterday with fever, cough and horrible leg pain. I think it's pneumonia but they sent him home. He seems a lot better today. Granddaughter was at the ER 2 weekends ago with horrible breathing problems. When you read of kids dying from this in 3 days, you just can't wait.

[Techn0Girl]

14. I hope you get better soon!!

Get well - you and yours :)

Make sure you go to the doctor if you need to.

Everyone should remember that there is no real cure for the flu (although the new antivirals I understand do more or less help) - so only take antibiotics if you get bacterial bronchitis. Remember antibiotics will have ZERO effect on the flu itself.

It's bed rest (LOTS of it ) , aspirin , fluids and sleep basically. Eat well Sleep well and everyone should remember to stay home from work and out of public for several days if you have the flu for heavens sake.

[melm00se]

24. aspirin: NO!!!

especially for kids with the flu. they run the risk of Reyes Syndrome which has the potential to cause liver and brain damage to children.

[Techn0Girl]

31. Aspirin Yes.

Aspirin is just fine. PLease don't be hysterical about such things, According to the Mayo clinic , reyes syndrome is rare. They do recommend that children and teenagers not take asprrin when recovering from the flu but it's just fine for adults.

http://www.mayoclinic.com/health/reyes-syndrome/DS00142

[Hardrada]

11. My wife who teaches Special Ed has been called into several

classrooms now to take over for the regular teachers who are out with flu. Never happened before. And she has to somehow take care of her own students too. The high school has the most kids sent home.

[Techn0Girl]

15. Out Here in Northern California....

We aren't seeing such things. Different places have different outbreaks. Right here in NoCal it's pretty normal except a month ago more people seemed to be coming down with flu or colds than normal but I'm not seeing anything in the papers about massive outbreaks or anything.

[Delphinus]

16. Wait - hold on.

I'm confused. CBS Evening News did a story on this:
Swine Flu Cases Overestimated?

(CBS) If you've been diagnosed "probable" or "presumed" 2009 H1N1 or "swine flu" in recent months, you may be surprised to know this: odds are you didn’t have H1N1 flu.

In fact, you probably didn’t have flu at all. That's according to state-by-state test results obtained in a three-month-long CBS News investigation.

When CDC did not provide us with the material, we filed a Freedom of Information request with the Department of Health and Human Services (HHS). More than two months later, the request has not been fulfilled. We also asked CDC for state-by-state test results prior to halting of testing and tracking, but CDC was again, initially, unresponsive.

While we waited for CDC to provide the data, which it eventually did, we asked all 50 states for their statistics on state lab-confirmed H1N1 prior to the halt of individual testing and counting in July. The results reveal a pattern that surprised a number of health care professionals we consulted. The vast majority of cases were negative for H1N1.

So, what is it that's making all these people sick? And, would the vaccine for H1N1 help you if it's NOT what people are sick from?

[Neurotica]

17. A great blog-Effect Measure-explained how this was poor science journalism

Effect Measure is a science blog written by epidemiologists. I first read about it here on DU a while back. Excellent, factual info on the flu and other things. Here's a link. Just look for the recent post on CBS - you have to scroll down a bit - "CBS News on Swine Flu Testing: Fail!"

http://scienceblogs.com/effectmeasure/

[Bragi]

22. Yep, Effect Measure is a terrific public health blog /nt

[Delphinus]

26. Thank you!

This was driving me crazy!

[kestrel91316]

28. OBVIOUSLY the H1N1 vaccine only prevents H1N1 flu. Did you really ask that, lol??

Nobody is type-testing "flu" cases unless they wind up in the hospital, so the people out there with fever, cough, etc who don't wind up in deep trouble could have any number of illnesses. Apparently many of them are NOT H1N1, so those people are still susceptible.

WORD OF WARNING: If you think you had H1N1 but were not actually type-confirmed by LAB testing, you probably still should get the vaccine. You may very well still be susceptible.

[Techn0Girl]

33. What's making these poeple all "sick" ...

Is hysteria. Hysteria spread by pharmaceutical companies who, make no mistake, are making big bucks from the government funded vaccine and is disseminated by the hapless news media.

I have also seen the study that most people who thought they had H1N1 either didn't have it or didn't have he flu at all (just a common cold).

Check out any flu thread from DU and you will find "Flu Birthers" . People who are convinced that we're headed for a flu apocalypse and nothing - not one darn thing you can do - including quoting CDC stats regarding the low death rather from this variation, will sway their beliefs at all.

Watch for it - I'm sure they will show on this thread as well.

[lefty369]

35. so there is a big conspiracy and everyone is in on it, lol

obama, federal, state, and local gov, big pharma, tv, radio, newspapers, doctors, WHO, CDC, etc.

LMFAO!

[Techn0Girl]

37. No ....

I said nothing about a conspiracy.

But if you don't believe that government organizations have NOT been cooperating and in fact been directed by big business than you have not been following the last 8 years of then Bush administration very closely.

And I am not going to get into this with you. I have no time for "Flu Birthers" spreading their fear . Nothing I could ever say to you would ever convince you so I'm putting you on ignore now and avoid the hassle.

[lefty369]

38. That still does not address

how the WHO, CDC, doctors, scientists, media and so on all recommend the vaccine. Are they all in on the conspiracy with big pharma and the gov?

[barb162]

43. Consider yourself lucky

you're on ignore. Trust me. And if you ask another sensible and perfectly legit question about Obama or Who or the CDC , you will be put on double secret probation.

:) :) :)

[Robb]

44. That is the stupidest fucking idea I've read here.

I'll beat you to the "ignore" punch. :eyes:

[Techn0Girl]

47. The stupidest idea....

I'll admit I could have phrased my post better. When I say "what's making all these people sick" of course I was referring to the original poster talking about all the people claiming they had swine flu when the really had something else. I wasn't talking about everyone in general.

I did assume that people reading the article would have enough innate intelligence to take the remark in context (perhaps even noticing the quotes I put around the word "sick") but in retrospect I could have phrased it better.

And, yes - I think people such as we , would be better off ignoring each other. We come from two different worlds, you:reactionary and me:contextual so I'll be happy to do likewise, especially considering I have a low tolerance for people who use gratuitous profanity to bolster a view that has no basis in reality.

[KillCapitalism]

57. Hysteria? LOL

I've heard some sources say that 150 million Americans could become infected with H1N1 before it's all over.

[Techn0Girl]

58. I've heard some sources say ....

Some people say ....
That Fox News is so popular because there are so many gullible people in the world.

[barb162]

60. "What's making these poeple all "sick" ...Is hysteria." REALLY?

So coughing, upper respiratory problems, fevers, etc., are hysteria? Puhleeze.

[defendandprotect]

55. Quite a mystery there . . . what's going on???

[Le Taz Hot]

18. A perfectly healthy 20-year-old college student

just died yesterday from it and she had NO pre-existing conditions. And we've had a grand total of 9,000 H1N1 flu vaccinations provided for the ENTIRE Central Valley (CA). I understand the Emergency Rooms are overflowing here and several children have already died from it. I'm a 54-year-old asthmatic with no health insurance with a LO-O-O-O-ONG history of pneumonia and that vaccine is AT LEAST a month away. It looks like I'm housebound for awhile.

[Techn0Girl]

40. We don't really know....

What conditions the college student had or didn't have unless we saw their medical records and had enough medical training to interpret them. Anything else is really just hearsay in my opinion.

The good news is that f you are 54, you may well have a degree of immunity to the H1N1 virus from past outbreaks, such as the 76-77 outbreak. If you are a Veteran than the VA can assist you with the vaccine. I don't think you have to shut yourself away indoors and avoid contact with people. Just be sensible and stay away fro obviously sick poeple, or places like the schools where flu outbreaks have occurred. Wash hands regularly - especially before eating - and you could even use hand sanitizer from time to time if you wanted to be really cautious.

Just be sensible and aware about what's going on.

[defendandprotect]

56. Stay away from children if you can . . . and their parents!!!

Every time my kids would get sick, I'd get sick with them!!

Doctors say after the kids, the parents are in --

[Burma Jones]

19. Here in my Maryland household, I have two kids with H1N1

We took my 9yo to the Doc yesterday, made a 1:30 appointment and was out by 2:15

My 9yo daughter developed the flu Friday night, my 3 yo daughter started yesterday. So far, this flu seems milder than what we've seen before.

There hasn't been H1N1 vaccinations generally available, but the kids have had their regular seasonal flu shots.

My 11 yo son hasn't shown any symptoms

Last Thursday, our regular Monday evening Sitter called to tell us she had H1N1, she's a preschool teacher......

My 9yo daughter's class was almost half empty last Friday

My son's class is about a quarter sick.

My wife and I haven't come down with anything yet, but I have already been asked to not come in for meetings at work for the week....



I have the feeling it's already too late to bother with an H1N1 vaccination for wife and I

[Robb]

20. It's not too late unless you're sick.

I'd try to get it if I were you. I don't believe we've seen the worst of this any more than I believe we've seen the bottom of the housing debacle. :hi:

[Techn0Girl]

34. A few things to keep in mind ....

1. Not every flu one gets is necessarily H1N1. There still is regular influenza and common colds which are going around just like always.

2. A lot of people who claim to have H1N1 don't really know what they're talking about. They're just scared and ill informed. The only way to tell if one's sickness is H1N1 is to have either a DNA test done on it OR some antibody related test - EACH of which costs big bucks and hospitals and doctors rarely do for the obvious reason. Other than that - there is no way to distinguish a common cold from H1N1.

A few threads above you a DUer posted a link to a news study that found out that the vast majority of people claiming to have H1N1 and who were actually tested - had something other than H1N1 (common cold, seasonal flu...etc)

[Burma Jones]

59. The wife and I can't get H1N1 vaccinations yet

They're still being rationed to folks under 24 here and all they seem to have is the mist.


My kids got their seasonal flu shots over a month ago, and the swab test was positive for H1N1

Now, my Daughter's test was a swab, which I know has a significant chance of a false positive, but given that she had her regular flu shot and she hasn't ever had a cold, we're assuming H1N1.

It wasn't very severe, her temp never exceeded 102 and we didn't give her Tylenol or Advil.

[excess_3]

21. short of being at death's door, why would anybody ...

short of being at death's door, why would anybody
go into
a room with hundreds of sick people?

[TwilightGardener]

23. There needs to be a public education campaign--unless there's respiratory distress,

chest pain, high fever that can't be lowered, change in consciousness, or dehydration from vomiting, don't go to the ER--call your doctor. ER's are not meant to see people who are merely suffering from typical flu symptoms.

[Techn0Girl]

36. Lots of poeple don't have doctors ...

I really do agree with you. I think what contributes to people going to the ER is that lots of people don't have doctors. And even if you have one, have you ever tried to contact your HMO doctor? Lots of luck there. If you're LUCKY you may get to talk to a nurse who is paid to try to keep you home.

So people made afraid from H1N1 hysteria - end up going to the ER because that's the only place they can actually talk to a doctor. This all brings in huge bucks to both the pharmaceutical and the medical industries and if you don't believe that both are, behind the scenes spreading unnecessary fear of this , then you don't believe the meat industry has to power to change the CDC designation of Swine flu to something else.

[kestrel91316]

30. In a similar vein, why would somebody with a child home sick with the flu,

or themselves home sick with the flu, choose THAT time to take the cat in to the vet for its annual checkup and vaccinations?? People do this without thinking, to the point that I alert my staff to pick up on subtle phone cues that this is in the works so they can encourage the client to wait a bit, because annual checkups aren't so urgent that they require one to spread dangerous diseases around needlessly.

[barb162]

39. Why? You know why.

They don't care (and don't bother thinking about it) if they infect someone else with thatever they have. There can be an immune compromised person sitting in ther waiting room...they just don't care. :(

edit, glad you talked to the staff about taking the calls from these types :)

[Techn0Girl]

51. Why would anybody .....

That's a very good question. Hospital acquired infections are a huge source of sickness. Unless you're tending to bronchitis or have greater than a 102 degree fever or are immunocompromised for more than a day or two - you should really stay away from the ERs.

If influenza gets really nasty in your area down the road than probably staying away from things like mass transit (if possible) , movie theaters and eating out are probably sensible ideas until things calm down. Right now - for the vast majority of places nothing like that is even remotely needed.

[kestrel91316]

25. THIS is why immunization against H1N1 is so important - so we don't have

so damned many UNNECESSARILY sick people overwhelming the healthcare system.

[goforit]

29. This hype scares everyone to run to the hospital at the slightest sniffle.

Once again.....profits to be made by all except the public, the true pawns of it all.

[Techn0Girl]

32. I have to agree somewhat ....

You can see the hypochondriacs acting out even on DU - especially on these flu threads. Several of them are even quoing from a place called flucount.org which claims to be a resource for the flu however it really appears to be more a resource to promote getting the vaccine. That website does little than to suggest getting vaccinated and throw a bunch of scare tactics out to make sure that you do. The websit has all it's identifying information completely shielded from the Internet registry - something that Astroturf campaigns bu Big business always do. Yet you see hysterical DU'ers quoting it for fact

I have heard several reports of hospital ERs being overwhelmed by people coming in ...with the flu! No major complication - just flu . And of course there's no treatment for flu save bedrest, fluids...etc. There's nothing a hospital can do for you (unless there is a complication) but hysterical people easily made fearful keep flooding the system because of the hype.

[RobinA]

42. I Believe

the Philadelphia hospitals have experienced just this. They said they were mobbed and sending people home because there's no treatment for the flu. At least they aren't throwing antibiotics at everyone like they used to. Quite...as...much.

[Robb]

45. You realize, even in a worse-case scenario

...the money drug companies stand to make off flu vaccines this year would never top 10% of their revenues, right?

[LanternWaste]

46. I get the flu shot every year.

I get the flu shot every year. I'm a pawn of the conspiracy. I feel dirty now-- must take a shower. :P

[Techn0Girl]

48. There's nothing wrong with taking a flu shot....

It does provide an up to 30% (I believe the figure is ) greater chance of not getting the seasonal flu. Of course the flu shot will not prevent you from getting and of the tens of thousands of common cold viruses that most of us get each year.

Me, I personally have had only 2 or 3 flu shots in my life and once I got a cold a weeks or so after lol. I suppose it's a personal preference and I don't see anything wrong with getting a shot if you are in a risk factor group. Several years agoI got a horrible cold - that was probably the flu and ended up with a pre-pneumonia condition tha put me out for the count for about 10 days - a really ling time. It was very bad bronchitis that took antibiotics and several days to eliminate. I didn't take the flu vaccine that year but then again having a vaccination would have only given me about 30% better odds of not falling sick. Meh. Sometimes you get sick - that's just part of living on Planet Earth.

Keep in mind though that there are considerations: for instance the thimerosal mercury-based preservative that is used in American flu vaccines is prohibited in Europe and Canada - they get a different formulation without the cheaper thimerosal based preservative in it. I also recall the ill-conceived 1976 Russian flu vaccine that caused excessively large numbers of paralysis cases (was it Epstein-Barre?? I forget) .

I am not trying to fear monger not getting the vaccine at all - just mentioning that one should be informed and ask your family doctor (if you're lucky enough to have one lol) . If you are in a risk group it's probably a great idea - but for the vast majority of us - well... we'll spend 3-6 days in bed feeling awful - and that's it.

Stay informed. Make informed and sensible decisions.

[LanternWaste]

53. I've been lucky...

I've been lucky and have dated RN's more often than not in the past twenty years. I defer to their judgments since I don't have the time available to stay absolutely informed about every mundane health decision I'm presented with.

Heck, I don't think I could remember what all the chemical additives are in the shampoo I use everyday were I to even read the ingredients, let alone try to keep myself informed about it.

[defendandprotect]

54. Perhaps children should be being kept home for a period of time?