Early flu siege swamps hospitals

Leading edge of epidemic spotted by area doctors

No `health-care crisis'

January 06, 2000|By Jonathan Bor and Diana Sugg | Jonathan Bor and Diana Sugg,SUN STAFF

Flu and other winter illnesses have struck the Baltimore area early and hard, straining the ability of many hospitals to deal with the flood of patients.

Yesterday, 18 of 22 hospitals in the region were declaring "code yellow," saying their emergency rooms were so busy that they couldn't handle any more patients brought in by ambulance. Most hospitals continued to accept patients, however, because the ambulances had to go somewhere.

"There is not a health care crisis," said Dr. Peter L. Beilenson, Baltimore health commissioner. "The hospitals are overloaded, including the emergency rooms, but we don't want people to think if they have a life-threatening emergency like a stroke that they won't be seen at the ER. They will." Doctors said they were seeing the leading edge of a flu epidemic, patients with fever, coughs and body aches that last for days.

Doctors said the flu season usually arrives in force in late January. This year, it struck before Christmas.

Lab studies have found that the germ responsible is the same one that has caused suffering for the past several seasons, Influenza A, called the Sydney virus because it originated in the Australian city, said Dr. Jeff Roche, acting state epidemiologist.

No deaths have been attributed to the flu this season in Maryland.

Contributing to the overload at area hospitals is an intestinal bug that causes diarrhea and vomiting.

The patients most severely affected have been the elderly and those with chronic illnesses such as heart disease, diabetes and hypertension who contracted the seasonal infections and developed serious complications. Some were given intravenous fluids or placed on respirators.

Hoping to relieve the crowding, the state's emergency medical system called on hospitals to take steps to accommodate additional patients. Regional administrator John Donohue suggested adding staff members, discharging patients early, postponing elective surgery and opening units that were not being used.

"The alert's not saying, `We're not going to take anybody,' " Donohue said. "It's, `We're a little busy right now. If you can take them somewhere else, take them somewhere else.' "

The severity varies, but the strain on hospitals has occurred in each of the past few winters during flu season. Many have closed down beds to cope with the difficult economics of health care, and practically all are having trouble finding enough nurses.

Hospitals add beds

To handle the influx of patients this week, Sinai Hospital has added a few intensive-care beds and asked nurses to work extra shifts. Franklin Square Hospital Center turned over beds on its obstetrics floor to ailing patients. The emergency department at Greater Baltimore Medical Center took over a cardiac recovery room to handle the overflow.

"This is the first day probably in about three weeks that we aren't really inundated," said Dr. John Wogan, GBMC's chairman of emergency medicine. The hospital plans a permanent expansion of its emergency room to ease crowding in the future.

The Johns Hopkins Hospital emergency department has seen 709 patients over the past four days, up from 509 in the same period last year. Sinai's emergency room has been seeing 220 to 250 patients a day over the past week, up from an average of 180, a hospital spokeswoman said.

`The normal mix'

"We're seeing the normal mix of patients, just more of them and sicker," said Dr. Linda DeFeo, the hospital's chief of emergency medicine. "What patients have to understand is that there isn't a lot we can do for the flu," DeFeo said. "I know they feel awful. They have high fevers, they feel like they are dying."

Ultimately, she said, most patients have to rely on such remedies as acetaminophen, aspirin and fluids.

Beilenson advised those with the flu to stay away from emergency departments unless they are seriously ill. In general, they should stay in bed and drink plenty of fluids. In healthy people, the flu generally runs its course in a week to 10 days.

Public health officials said people can get a flu shot and be protected for the last half of the flu season. They should call their local health department or primary care physician. The shot takes effect after two weeks.

Roche, the state epidemiologist, said it's too early to tell whether this year's flu season will be worse than last year's.

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