Sunday, October 22, 2000

If flu hits hard, Tristate may have trouble coping




By Tim Bonfield
The Cincinnati Enquirer

        A late flu vaccine. One less hospital in town. And a citywide nursing shortage.

        Much like weather forecasters declaring a tornado watch, Tristate health officials say conditions are ripe for trouble should influenza season strike early or hard this winter.

        No one can say for sure that the flu season will be worse than average. But with local flu shots just getting started in some locations — nearly a month behind schedule — there is a chance that fewer people will be vaccinated once the flu peaks in January, February and March.

WHERE TO GET FLU SHOT
    The Health Improvement Collaborative of Greater Cincinnati offers the area's most comprehensive list of flu-shot sites. For information, call 931-SHOT.

   Places offering flu shots in October include:
   • Monday: Walgreen, Hyde Park Plaza.
   • Tuesday: Cleves Senior Center.
   • Tuesday: Dunham Senior Center, Price Hill.
   • Wednesday: Lincoln Heights Senior Center.
   • Wednesday: Colerain Senior Center.
   • Wednesday and Saturday: Costco store, Deerfield Township, Warren County.
   • Thursday: Whitewater Senior Center, Whitewater Township.
   • Friday: North College Hill Senior Center.
   • Saturday: Little Flower Catholic Church, Mount Airy.
   • Oct. 30: Senior Citizens Service Center, Neeb Road, Delhi Township.
   • Oct. 30: Walgreen, 4090 E. Galbraith, Dillonvale.
   • Oct. 31: Walgreen, 5508 Bridgetown Road, Green Township.

        That could mean more people, especially seniors, in need of hospital care this winter. Should the peak hit earlier than normal, the situation would be even worse.

        “The thing we don't want to have happen is people thinking, "Well, the vaccine was late this year, so I think I'll skip it,'” said Cincinnati health commissioner Malcolm Adcock.

        Some places have received their first vaccine shipments. Many more campaigns will be launched in November as shipments come in.

        Influenza is a common, upper-respiratory disease started by a viral infection. It makes healthy adults feel as if they've been run over by a truck and can be deadly to people in weaker shape. Typically, influenza and related illnesses kill about 20,000 Americans a year.

        Concerns about hospital capacity have added urgency to flu-season predictions. On Oct. 16, the American College of Emergency Physicians issued a national press release calling on hospitals to take steps to “prepare for possible severe strains in resources during this year's flu season.”

        In Greater Cincinnati, hospitals are in especially weak condition to handle a surge of patients. During the past two winters, routine levels of flu and other winter infections taxed the system, forcing several hospitals to divert patients.

        Going into this winter, hospitals have been struggling even more than in years past to hire enough nurses to meet day-to-day needs, much less a crisis. With the closing this year of Bethesda Oak Hospital, there's also one less hospital to share the burden.

        “We're concerned. The issue of surge capacity is definitely a question throughout this community,” Dr. Adcock said. “But we also think Cincinnati is as prepared as any place else to respond. We think hospitals will do what they have to do.”

        While the flu peak may not hit until January, the virus is already making people sick.

        This week, Ohio, Kentucky and Indiana were listed among eight states nationwide reporting “sporadic” flu activity by the federal Centers for Disease Control and Prevention.

        In Ohio, that means one lab-confirmed case in northeast Ohio and scattered unconfirmed reports, said Randy Hertzer, a spokesman for the Ohio Department of Health.

        As a result, public health offi cials are urging all people at high risk to get their flu shots, even if that means getting the shot in mid-December.

        High-risk people include:

        • People over 65 (especially people living in nursing homes).

        • Health-care workers.

        • Pregnant women.

        • People with chronic illnesses, such as diabetes, asthma or HIV infection.

        While Tristate hospitals have flu-season plans — including a sophisticated diversion communication plan — they also acknowledge they have fewer staffers to provide care.

        “Will it be more difficult this year? Yes. It probably will be more difficult with the staff shortages being what they are,” said Colleen O'Toole, vice president of the Greater Cincinnati Health Council.

        Hospital plans include:

        • Launching a stepped-up public-awareness campaign about the flu, so people know when they need hospital care.

        • When possible, using more of two anti-viral drugs approved in 1999 to treat influenza. The limitation is that such drugs work only when given within the first two days of noticing symptoms.

        • Making sure health-care workers get flu shots to avoid sick days aggravating staff shortages.

        • Expecting full-time staff to work overtime, part-time nurses to work more and nurses in administrative roles to help with patient care.

        • Commandeering beds normally intended for rehabilitation and other uses to serve flu cases.

        • If necessary, canceling or delaying elective surgeries to free up staff and beds.

        Will such plans be enough?

        “We don't know how severe (the flu season) might be,” said Pat Samson, a spokeswoman for the Health Alliance of Greater Cincinnati. “But nobody has extra nurses sitting around.”
           



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