Overcrowded hospitals preparing for flu influx

Health officials warn the season could be tough based on Australia’s experience

ELIZABETH PAYNE

With weeks until flu season begins in earnest, health officials are already warning that it could be a tough one.

That could cause further problems for Ottawa’s already overcrowded hospitals.

Public health officials have been watching flu activity in the southern hemisphere with concern. Australia has had its worst flu season in recent memory with at least 166,000 cases and more than 370 deaths, compared to 91,000 cases the year before.

That is often — although not always — a good indication of what the flu will be like in the northern hemisphere during the upcoming season.

“What is of concern is the heavy activity reported out of Australia,” said Dr. Michelle Murti, a public health physician at Public Health Ontario. “It is always hard to predict what exactly we are going to see, but we look to Australia and the Southern Hemisphere to sometimes give us an indication.”

In the past few years, she said, Ontario has tended to flip between two strains of flu — H1N1 and H3N2. Last year H3N2 dominated in Canada, which suggests it might not this year — which could be good news. Australia’s bad flu season has been dominated by the H3N2 strain. It has also seen both A and B strains of the flu at the same time. Typically in Canada, B strains come later in the season.

Early surveillance from the Public Health Agency of Canada points to H3N2 as the dominant strain so far and, even in late September during what is considered an “interseasonal” period, shows higher numbers than usual. Flu seasons in which H3N2 is dominant are typically more severe, Murti said.

“We don’t know the kind of season we are going to have, but it is always important to be prepared,” she said.

Public health officials are not the only ones watching the upcoming flu season with concern. Even a standard viral season puts extra strain on hospitals. A severe flu season could result in serious issues for hospitals in Ottawa, which are already chronically overcrowded. That means they have less room to manoeuvre when viruses put extra strain on emergency departments.

As of Thursday, the Civic campus was at 111-per-cent capacity, with 23 patients waiting in the emergency department for beds on a nursing unit. Overall, the hospital was at 109-per-cent capacity, with a total of 42 patients waiting in emergency departments at both main campuses to get beds in nursing units.

Queensway Carleton Hospital has also remained overcapacity throughout the summer — traditionally a time when numbers go down.

Spokesperson Ann Fuller said capacity at Queensway Carleton has been fluctuating between 114 and 124 per cent between May and September “which is typically much quieter.” During that time, hospital capacity never fell below 100. It was forced to cancel 30 elective surgeries since April to cope with the overcrowding.

“This certainly creates concern for the upcoming flu season,” she said. The hospital is investigating using “unconventional” space that could be used to increase its capacity as needed during viral season.

Meanwhile, public health officials are encouraging people to get the flu shot, wash their hands frequently and stay home if they are sick.

In Ottawa, there were just over 500 cases of flu confirmed during the 2015-16 season and 922 the year before.

Murti said those who are highest risk of complications from the flu — the elderly and those with chronic respiratory illnesses, especially — might want to talk to their physician in advance about getting access to antiviral treatment if they do get the flu, to lessen the symptoms.

Last year’s flu shot was less effective than usual — about 30- to 40-per-cent effective, according to Murti, compared to about 40- to 60-per-cent effective in a typical year.

Its coverage is not as high as vaccines for diseases such as measles, she noted, “but it is the best tool we have and still the most recommended thing to do.”

In addition to standard vaccines, which protect against two strains of A influenza and one strain of B, there is a quadrivalent vaccine, that protects against two A strains and two B strains, available for children between six months and 17. Children’s flu vaccines are also available by flu mist, both are recommended by public health officials. The mist is recommended for children from two to 17.

Flu shots are available at pharmacies, through public health clinics and at doctors offices, beginning later this month.

Ottawa Public Health is in the process of distributing vaccine to long-term care centres, hospitals and doctors offices for high-risk patients. More than 200 Ottawa pharmacies will start receiving vaccine shipments in the next two weeks. epayne@postmedia.com

What is of concern is the heavy activity reported out of Australia ... We look to Australia and the Southern Hemisphere to sometimes give us an indication.