We're not even in flu season yet, and already hospitals are overloaded. I have to wonder how many cities are ready for this: BALTIMORE — To Mitch
October 27, 2009

We're not even in flu season yet, and already hospitals are overloaded. I have to wonder how many cities are ready for this:

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."

[...] To many analysts, swine flu appears to be two overlapping epidemics: one a cascade of mild to moderate cases that is stressing hospital emergency rooms, and the second a narrow stream of unusually young patients who need intensive care.

[...] Connie Price, chief of infectious diseases at Denver Health, the city's public hospital, says, "I've been living this" since Aug. 28, when the hospital's lab reported 12 positive tests for swine flu.

"Since then we've been inundated," she says. "In a typical flu season, we may hospitalize 15 patients. With H1N1, we've hospitalized 10 times that many. We're not even in flu season yet."

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