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Swine Flu Could Create Hospital Bed Shortage
Report finds demand could exceed supply in 15 states
 
 
  "A lack of antivirals -- 13 states don't have enough to cover one in five residents and another 11 have only enough for a quarter of their citizens."
 
Posted October 1, 2009
 
THURSDAY, Oct. 1 (HealthDay News) -- There could be a shortage of hospital beds in 15 states if 35 percent of Americans get sick from the H1N1 (swine) flu virus, and 12 other states could reach or exceed 75 percent of their hospital bed capacity, a study released Thursday shows.
 
The number of people who could get sick with H1N1 flu in the United States ranges from a high of 12.9 million in California and a low of 186,434 in Wyoming, and the number of people who are hospitalized could range from a high of 168,025 in California to a low of 2,485 in Wyoming, according to the report from the non-profit group Trust for America's Health.
 
The 15 states that could be at capacity or exceed hospital bed capacity are: Arizona (117 percent); California (125 percent); Connecticut (148 percent); Delaware (203 percent); Hawaii (143 percent); Maryland (143 percent); Massachusetts (110 percent); Nevada (137 percent); New Jersey (101 percent); New York (108 percent); Oregon (107 percent); Rhode Island (143 percent); Vermont (108 percent); Virginia (100 percent); and Washington (107 percent).
 
The 12 states that could be at 75 percent to 99 percent of hospital bed capacity are: Colorado (88 percent); Florida (80 percent); Georgia (78 percent); Maine (83 percent); Michigan (79 percent); New Hampshire (84 percent); New Mexico (93 percent); North Carolina (95 percent); Pennsylvania (77 percent): South Carolina (93 percent); Utah (83 percent); and Wisconsin (75 percent).
 
The estimates were created using the FluSurge model developed by the U.S. Centers for Disease Control and Prevention.
 
"The country's much more prepared than we were a few short years ago for a pandemic, but there are some long-term underlying problems which complicate response efforts, like surge capacity and the need to modernize core public health areas like communications and surveillance capabilities," Jeff Levi, executive director at Trust for America's Health, said in a news release.
 
Among the other findings in the report:
 
* Vaccinating the entire population against H1N1 will require a much larger effort than what states and communities have managed in the past for seasonal flu vaccinations.
 
* H1N1 flu pandemic preparedness efforts are being hampered by budget cuts and layoffs in states and communities. In the first half of 2009, local health departments cut about 8,000 staff positions. In 2008, an estimated 7,000 public health jobs were eliminated. From 2005 to 2009, federal public health preparedness funding was slashed by 25 percent.
 
* Nearly half of private sector workers don't have sick leave benefits. That means millions of people will have to choose between losing their jobs by not going to work if they're sick or going to work and contaminating others.
 
* If 35 percent of the U.S. population becomes infected with H1N1 flu, about 15 million of the 47 million uninsured Americans could become sick and either go without care or seek treatment in already crowded emergency departments.
 
* Because they suffer from more underlying chronic health conditions, such as diabetes and asthma, black and Hispanic Americans are more likely to develop severe cases of H1N1 swine flu. But there are major deficiencies in systems designed to reach minority communities. For example, emergency preparedness information is often disseminated on the Internet, but many people don't have access to the Web. In addition, there is limited availability of non-English information.
 
The report offered recommendations for improving the nation's ability to deal with the upcoming H1N1 swine flu season, including:
 
* Make risk communication a top priority. Special efforts are needed to encourage vaccination in at-risk groups such as young adults and minorities. This should include messages in many languages.
 
* Refine plans for rapid distribution and administration of vaccines.
 
* Vaccination campaigns must continue past the fall, to prepare for a potential third-wave outbreak.
 
* Establish an emergency health benefit to care for the uninsured and under-insured and provide an emergency sick leave benefit for workers without sick leave benefits.
 
* Public and private insurers should waive co-payments for H1N1 vaccines and out-of-network care for people sick with H1N1 swine flu.
 
* Health professionals and health departments should develop and distribute public messages about good hygiene practices and how to understand H1N1 flu symptoms and remedies.
H1N1 Flu May Cause Hospital Bed Shortage
 
MedPage Today
October 01, 2009
 
Even if the second wave of the H1N1 pandemic is mild, 15 states could run out of hospital beds, assuming that 35% of Americans are sickened by the flu, a new report says.
 
Another 12 states would be hard-pressed, with influenza patients occupying at least 75% of their bed capacity, said Jeff Levi, PhD, of Trust for America's Health, the New York-based nonprofit organization that prepared the report.
 
Even at a 25% attack rate, five states would have more patients than beds, according to the 38-page report, entitled "H1N1 Challenges Ahead."
 
Levi and his co-authors used a mathematical model developed by the CDC, dubbed FluSurge, to arrive at those numbers, assuming that the current pandemic will resemble the 1968 Hong Kong flu, which is generally regarded as being a mild outbreak.
 
Thanks to years of planning, pandemic preparedness is at an "unprecedented" level, Levi said, "but we still face a number of challenges."
 
One of those challenges is going to be the sheer number of people seeking treatment, both ambulatory and hospital care, he said.
 
The report estimates the number of inpatients could range from a high of 168,000 in California to a low of about 2,500 in Wyoming.
 
At the peak of the outbreak -- week five according to the FluSurge model -- Delaware hospitals would have twice as many patients as available beds and Connecticut would have three patients for every two beds.
 
The remaining states on the list of those that will run out of beds are Arizona, California, Hawaii, Maryland, Massachusetts, Nevada, New Jersey, New York, Oregon, Rhode Island, Vermont, Virginia, and Washington, the report said.
 
As well as dealing with that surge, Levi said, health officials need to ensure that the pandemic vaccination campaign -- which the CDC has said will involve some 90,000 immunization sites -- is as effective as possible, he said.
 
"It's the first time we've ever done something on this scale and there are likely to be some glitches," he said.
 
Last year, Levi said, only 36.1% of adults were vaccinated against the seasonal flu, so that getting people vaccinated will require a "major education campaign."
 
That's especially true because young adults -- one of the prime targets of the H1N1 flu -- traditionally don't get their shots, he said.
 
The report "highlights important issues that hospitals are already working to prepare for," according to Matt Fenwick, a spokesman for the American Hospital Association.
 
"We do not yet know exactly how this flu season will look, but capacity issues will be something that hospitals closely monitor," he said, adding that specific responses will vary from institution to institution.
 
"Some common approaches include delaying elective admissions, discharge of surgical cases to other settings for care, and conversion of some nursing units to infectious disease units," he said.
 
A CDC spokesman said the agency "has not had a chance to fully review" the report, adding that planning is still under way. "We expect the response and potential impact will be different in each state and community," the spokesman said.
 
The report says attention must also be paid to:
 
* A lack of antivirals -- 13 states don't have enough to cover one in five residents and another 11 have only enough for a quarter of their citizens.
 
* The financial impact to healthcare facilities of a surge of patients without insurance. If 35% of the 47 million Americans without health coverage became sick, about 15 million people would either go without care or seek treatment in already crowded emergency rooms.
 
* The 59 million people who don't have paid sick leave and may be forced to work -- and possibly spread the flu -- even if they are sick.
 
Years of neglect and underfunding of the public health system have made the situation worse, according to Robert Pestronk, MPH, executive director of the National Association of County and City Health Officials.
 
Pestronk said 7,000 local health department employees lost their jobs in 2008 and another 8,000 were let go in the first half of 2009, because of budget cuts.
 
"We are seeing an eroding capacity to get the work done," he said.
 
Levi said the possible scarcity of hospital beds is not directly related to reduced public health budgets, but is likely to affect such things as education campaigns to get people vaccinated and planning to distribute vaccine.
 

Swine flu could sicken 3M in Jersey, report says
 
Friday, October 02, 2009
 
http://www.nj.com/news/ledger
 
The swine flu this season could sicken 3 million New Jerseyans and hospitalize more than 42,000, according to a report yesterday by a national nonpartisan public health advocacy group.
 
Using projections sanctioned by the U.S. Centers for Disease Control and Prevention, many New Jersey hospitals could run out of beds, the report by the nonprofit Trust for America's Health found. New Jersey would be among 15 states deluged by the rate of H1N1-related hospitalizations.
 
Jeff Levi, the trust's executive director and associate professor at George Washington University's Department of Health Policy, said the report is not meant to incite panic, but to explain "how readily this could overwhelm our health care delivery systems.''
 
"We saw that in the first wave'' when swine flu hit during the spring, Levi added. "Over the long term, we need to have a better system of addressing these issues.''
 
The impact on hospitals is based on the assumption that 35 percent of the nation will develop swine flu over the course of the season, as federal health officials are predicting, Levi said.
 
"We're not assuming all of those people will need hospital beds at once,'' he said during a conference call with reporters.
 
The impact could be lessened if hospitals delay patients from seeking elective procedures, or use other scheduling strategies, Levi said.
 
Spokeswomen for the state Department of Health and Senior Services and the New Jersey Hospital Association stressed the anticipated swine flu outbreak this fall is not catching them by surprise, noting they have been preparing for pandemic emergencies for years. Flu season runs from October through March.
 
"New Jersey has lost about 2,100 hospital beds in the last two years due to hospital closures, but the New Jersey Hospital Association is working closely with the state and other health care providers like nursing homes to expand bed availability as the need arises,'' Kerry McKean Kelly, the association's spokeswoman, said. "No one knows how prevalent H1N1 may be this fall and winter, but plans are in place to rapidly expand our surge capacity.''
 
The state Department of Health and Senior Services would work with hospitals to free up more beds by also discharging people early if they are well enough, doubling-up single rooms, and assigning additional staff, department spokeswoman Donna Leusner said.
 

One-third of Texans could get H1N1
 
Austin Business Journal
 
The Trust for America's Health released a new report Thursday that estimates 105,287 people in Texas may need to be hospitalized, if 35 percent of Americans get sick from the H1N1 virus as predicted.
 
All tolled, roughly 8.5 million people in Texas could contract the flu this season.
 
That would mean 66 percent of the state's hospital beds could be filled during the height of the outbreak, based on estimates from the FluSurge model developed by the U.S. Centers for Disease Control and Prevention.
 
An estimated 15 states could run out of their available hospital beds during the outbreak, the report said. Twelve additional states could reach or exceed 75 percent of their hospital bed capacity, based on estimates.
 
"Health departments and communities around the country are racing against the clock as the pandemic unfolds," said Jeff Levi, executive director of TFAH. "The country's much more prepared than we were a few short years ago for a pandemic, but there are some long-term underlying problems which complicate response efforts, like surge capacity and the need to modernize core public health areas like communications and surveillance capabilities."
 
Last year, only 35 percent of adults in Texas were vaccinated against the seasonal flu. That means that there will need to be a major upsurge in vaccinations in order to vaccinate the entire population for H1N1, compared to what states and communities have managed in the past.
 
 
 
 
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