Huge flu season slams hospitals
Emergency rooms are packed as administrators ask: Has the influenza outbreak peaked yet?
The emergency room at Good Samaritan Hospital has been so packed with patients suffering from miserable flu symptoms the past few weeks, with incoming ambulances lined up outside and hospital rooms jammed, the staff has gone to its “Code
Green” nearly every day.
“It’s all hands on deck,” said
Dr. David Feldman, chairman of
Good Samaritan’s Emergency Department.
Hospital CEO Joe DeSchryver has picked up a broom to sweep out emergency rooms for the stream of patients. Grace Ibe, a vice president, has wheeled patients in gurneys upstairs. And
CFO Jody Dial has come in at midnight to troubleshoot and bring pizza.
“There have been times we’ve had two or three times the number of patients we have space for,” Feldman said. “For a 10-day period around Christmas, we were setting a new record every day.”
At hospitals around the Bay Area and across the country, those on the front lines of what is shaping up to be the worst flu season in a decade are struggling to keep up — and wondering whether it will get worse.
“It also struck early. What we’re not sure yet is whether we’ve hit the peak,” said Dr. Jonathan Blum, infectious disease and flu leader at Kaiser Permanente Santa Clara. “If it turns out we keep going up, it would make it a very bad season.”
Doctors and nurses are working overtime and double shifts. Some have become sick themselves, causing staff shortages when they are needed most. As one doctor put it, in emergency departments where misery is often hidden behind ubiquitous blue masks, “there’s a lot of coughing, sneezing, crying and fever.”
Across California, at least 42 people younger than 65 have died since Oct. 1 because of flu-related illnesses — including at least 19 in the Bay Area — compared with three statewide last year. In Santa Clara County, five people have died this season — including a 40-yearold woman last week at Good Samaritan — and six in Contra Costa County. In Alameda County, hospitals are seeing a surge in flu patients, but no flu-related deaths had been reported by late last week.
“I definitely don’t think we’re over the worst of it. Not at all,” said Stacey Hanover, director of emergency and trauma services at UCSF Benioff Children’s Hospital Oakland. When it comes to staffing, “we are not reducing in any kind of way. In fact, we’re ramping up.”
Because the Oakland hospital is a “Level 1” pediatric trauma center and always ready for a major crisis, she said, the staff isn’t overwhelmed. “This isn’t our first rodeo.”
On Thursday, El Camino Hospital in Mountain View disbanded its flu “command center.” But the same day, Good Sam in San Jose — which was in the midst of an emergency room expansion project when the flu hit — opened a converted storage room/former pediatric nursery decorated with
choo-choo train wallpaper into a spillover emergency room, adding 10 beds with screen dividers to give a semblance of privacy and ease the overcrowding.
Other factors are compounding overcrowding in emergency rooms. Many patients are having trouble getting appointments at their private doctors’ offices, which are also overloaded with flu patients, so they head to emergency rooms instead. And news of flu deaths is making parents anxious and more inclined to go directly to the hospital whether symptoms are severe or not.
Dr. Eric Weiss, an emergency medicine doctor at Stanford Health Care, treated the children of a worried mother whose family friend died this month from the flu.
“The tears start to well up and it became an understandable, frightening moment when the mother realizes they’re at the risk of a deadly infection and that’s every parent’s nightmare,” Weiss said.
It turned out the family’s risk “was not that great,” he said, but excellent care and compassionate bedside manner is critical.
At nearly every emergency room dealing with the flu, health care workers are required to wear face masks and patients are handed them as they arrive. But those blue masks tend to fog up glasses, Weiss said, and “sometimes getting that personal touch, you don’t get that until the mask is removed. If you can imagine talking to me, if we were both wearing masks, there’s all that interpersonal nuance that gets lost.”
At El Camino Hospital in Mountain View, “all the beds are taken. The emergency room is full. The waiting room is full,” Dr. Daniel Shin, the hospital’s medical director of quality and patient safety, said. “We have tracked the number of flu patients admitted compared to last year and the number almost doubled.”
Overall, the numbers from the Santa Clara County Public Health Department are not encouraging. Visits to emergency departments for flu-like symptoms rose 22 percent the first week of January over the last week in December. And that week showed a 60 percent increase in flu patients compared with the week before Christmas.
It’s not too late to get a flu shot. While it appears to be only 30 percent effective against the H3N2 flu strain, it’s still worth getting and can reduce the severity or duration of the illness, doctors say.
On one afternoon last week, with the emergency annex up and running, Good Sam actually experienced a lull in flu patients. “You never use the ‘q’ word” in the ER,” Feldman said, avoiding the word “quiet.” “We don’t want to jinx it.”