Atlanta ERs brace for flu onslaught

By Shelia M. Poole

The Atlanta Journal-Constitution

Kayla Johnson lay in Room 6 of the emergency department at Children’s Healthcare of Atlanta at Egleston, her cough muffled by a yellow mask.

The 16-year-old Tucker High School student caught the flu four weeks ago. It left and returned “with a vengeance,” her mother, Diane Bethea, said.

Dr. Dallin Randolph, the emergency room physician who examined Kayla, said it appeared to be a case of seasonal flu, not the swine flu the teen feared.

It’s a scene Randolph and her colleagues are seeing frequently.

Since mid-August, the emergency department at Children’s Healthcare has been swamped with young patients such as Kayla who are sick with the flu or flulike symptoms. Weekends are particularly busy.

“We have been overrun,” Randolph said.

Other metro hospital emergency departments have also seen a surge in patients. Many have already stocked up on masks, hand sanitizer, gloves and medications that can be used to treat flu symptoms. They have plans to bring in extra staff, even calling in retired nurses who kept their licenses current if loads jump even more or staffers start to fall ill. Some hospitals are even considering revising visitation policies.

Hospital officials are worried that a big spike in patients with flulike symptoms will tax already busy emergency departments.

A recent study found that while the United States’ initial response to the swine flu outbreak in the fall was strong and flexible, the nation’s core public health capacity would be “overwhelmed if an outbreak were more severe or widespread.”

That’s a possibility that has experts concerned because they think more people will get sick when seasonal and swine flu circulate at the same time. There are differences, however. Unlike seasonal flu, swine flu disproportionately targets school-age children, teenagers and young adults.

The Centers for Disease Control and Prevention said that novel H1N1, commonly called swine flu, is widespread in Georgia. It’s unclear how many cases are swine flu because state and federal labs have largely stopped testing for the illness that is treated the same as common flu. So far, though, 12 people have died and 302 have been hospitalized with swine flu in Georgia.

Experts think one reason the flu is widespread here is because the school year starts earlier than in other parts of the country, bringing students close together for long periods of time.

Dr. Jim Fortenberry, the pediatrician in chief for Children’s Healthcare, said some of the system’s emergency departments are seeing twice the patient load that they did this time last year.

“Thankfully, the cases have been mild to moderate,” he said.

It’s been a systemwide effort to make things run smoothly. He said other hospital staffers have volunteered to help take care of basic tasks — such as making sure the rooms are clean and that families are being taken care of — so nurses can concentrate on the patients. There’s a plan to bring in extra nursing and physician staff if needed.

To head off emergency room visits, the hospital system set up a phone line that allows parents to call with questions about the flu. During a recent 10-day period, the line fielded more than 1,000 calls.

There’s also an interactive guide online that gives information about the flu.

St. Joseph’s Hospital has seen a minor increase in ER patients with flu or flulike symptoms.

“This is like a normal flu season for us, just much earlier than usual,” spokeswoman Amanda Rosseter said. “People are asking for masks as they come in, and we have been handing out masks as conditions warrant.”

Piedmont Hospital and the Gwinnett Medical Center are also seeing increases.

Gwinnett Medical Center has a plan to increase staff when needed. This includes having two extra registered nurses and two nurse technicians during the busiest hours.

But not every hospital is seeing a big jump in patients.

Dr. Leon Haley, chief of emergency medicine at Grady Memorial Hospital, has seen very little flu activity in the ER.

“There’s been nothing to stress our capacity,” he said. “Maybe it’s too early in the equation. We don’t know.”

But he said Grady is seeing another kind of patient — worried people who think they have the flu but don’t.

He said the hospital isolates patients believed to have the flu. If the numbers increase, they will be moved to a separate area.

“Right now, we’re not having to pull any of those triggers,” he said. “Our job is really much like other institutions. We’re just trying to stay on top of it.”

Hospital officials have advice for worried parents and sick patients.

To keep overcrowding to a minimum, they’re asking patients with typical symptoms to check with their physicians first before rushing to the emergency room. If a child is having respiratory problems, they should go to the emergency department.

“Unless a child needs to be in the emergency department, they’re better off getting well at home,” said Children’s Healthcare’s Fortenberry.