Saturday, May 16, 2009

Swine Flu: The View From a Brooklyn ER

by Trudy Whitman (edit@broVisits Increase, But Most Have Only Mild Symptoms

By Trudy Whitman
Brooklyn Daily Eagle

COBBLE HILL — On the average, the Long Island College Hospital Emergency Department logs in 170 patients daily. But on Monday, April 27, after a weekend of media blitz about the swine flu outbreak, or what health officials are now referring to as the H1N1 virus, the LICH Emergency Department examined 231 patients.

And the numbers topped 200 for the remainder of the week, according to Dr. Tucker Woods, who heads this LICH department.

Contrary to city, state, and federal Health Department recommendations, most of these patients visited the E.D. with only mild flu-like symptoms; health authorities are telling people with minor coughs and sore throats to just remain at home. Others represented a group the health experts are calling the “worried well.”

Only patients with severe symptoms are being swabbed at LICH for swine flu testing, following again following recommendations, said Dr. Woods. But these practices could change overnight.

“This is an ever-changing situation,” Dr. Woods explained. “The Department of Health puts out recommendations pretty regularly, and what might be true today isn’t necessarily true tomorrow. We’ve been very aggressive emailing staff to give them the latest updates.”

In addition to e-mail updates from health agencies, Woods participates in conference calls initiated by the Department of Health every afternoon at 4:30. On these calls, the city’s key emergency department personnel receive the latest news and up-to-the-minute policy procedures regarding flu treatment.

On the morning of April 27, the LICH Emergency Department organized a meeting where staff members were debriefed about the situation and told what LICH would be doing to handle it.

“We already had policies in place for any pandemic-type outbreak,” Dr. Woods noted, “but we assembled a team to review these and to make sure that everyone knew what to do if there is a pandemic.”

Preventive Measures

Among the measures taken by LICH are the posting of signs in all the waiting rooms in multiple languages about hand hygiene and the provision of hand sanitizer pumps prominently displayed in the hospital. The hospital has also assembled a large supply of masks, should they be needed in the coming weeks. In addition, Dr. Woods has met with pharmacy personnel to ensure that there are plentiful supplies of the antiviral medications Tamiflu and Relenza.

LICH’s stockpile of antivirals is impressive, Dr. Woods stressed: “The hospital is always thinking ahead and worrying about worse-case scenarios.”

Asked why the virus appears to be more virulent in Mexico than in the United States, Dr. Woods replied that experts don’t know yet. “But that is a big question,” he agreed. “I expect that we will see more severe cases in the U.S.” (News stories this past weekend suggested that Mexicans may not be getting as sick as initially reported.)

Dr. Woods said that he is “not too worried” about a possible pandemic and that “people shouldn’t be alarmed.” “What’s reassuring to me is that back in 1918, they didn’t have the medications to treat viruses. I feel encouraged that it [the swine flu] is sensitive to these medications, and I also feel encouraged that we haven’t seen a high number of deaths so far.”

“I think we’re going to be O.K.,” Dr. Woods concluded.

Swine flu facts can be obtained from the New York City Health Department at www.nyc.gov/html/doh/html/cd/cdinflu.shtml and from the Centers for Disease Control and Prevention at www.cdc.gov/swineflu/general_info.htm.

oklyneagle.net), published online 05-04-2009

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