City's health system feels H1N1 strain
FIGHTING THE FLU
October 28, 2009
Naomi Powell
The Hamilton Spectator
http://www.thespec.com/News/Local/article/661703
Hamilton is considering opening specialized H1N1 assessment centres as family doctors and hospitals strain against a surge of patients with flu-like symptoms.
Local hospital emergency rooms, family doctors and ambulance dispatch centres all reported a significant increase in demand yesterday as the second wave of the H1N1 virus spreads.
"For now the system is coping," said Dr. Elizabeth Richardson, the city's medical officer of health. "But we need to be ready with an alternative if that coping falls down."
Signs of stress were evident throughout the city's health-care system yesterday:
* The number of people hospitalized with H1N1 in Hamilton went from 17 Monday to 27 yesterday, Richardson said;
* Ambulance services experienced a prolonged "code zero" situation, when one or no ambulances are available to respond to emergencies;
* Family physicians associated with Hamilton Health Sciences reported a 30 per cent increase in patient demand even after postponing non-essential appointments, such as annual physicals.
The city will finalize plans for the assessment centres over the next few days and will be ready to open the doors if the system becomes overwhelmed, Richardson said.
It would be the first time the city has taken the step. An assessment centre was established to handle patients during the SARS crisis but it never opened.
Plans are in place to provide two kinds of centres: one for patients with flu symptoms who can't get an appointment with a family doctor, and a second for patients requiring more significant care but "who don't need all the resources of an emergency room," Richardson said.
Specialized assessment centres were set up in Kingston yesterday after patient loads overwhelmed emergency rooms and family doctors, she said.
But not everyone is keen on the idea. The clinics would likely be staffed by family doctors who are already struggling to manage their own practices, said Dr. David Price, chief of family medicine at Hamilton Health Sciences.
"I know they've had to do this elsewhere but we really hope we won't get there," Price said.
At St. Joseph's Healthcare, administrators worried about a potential "double whammy" of patients and staff coming down with the flu.
"It's already a significant burden on the emergency department to do this work on top of the other work we have to do," said Dr. David Higgins, chief of staff at St. Joseph's. "The number of cases in the community are rising rapidly and our staff live in the community."
Halton is also experiencing significant stress on its emergency rooms, but has no plans for stand-alone assessment centres. If the situation becomes much worse, the region will establish secondary emergency rooms within hospitals to handle only flu patients, said Halton medical officer of health Dr. Bob Nosal.
Hospitals received their first shipment of the H1N1 vaccine yesterday to be doled out to front-line health-care workers. St. Joseph's received 1,000 doses for its staff of 4,000 workers.
The province delivered 23,000 doses of the vaccine to Hamilton on Friday. A second shipment of 26,000 doses was expected this weekend but hasn't yet arrived, said Dr. Chris Mackie, Hamilton's associate medical officer of health.
"We are expecting the next 28,000 (doses) within the next day or two," Mackie said. "But until we have it, we don't have it."
Mackie hopes to make the vaccine available to all health-care workers within a week. If enough additional doses of the flu shot arrive, local vaccination clinics could open to the public as early as Monday.
Niagara's public health department has confirmed plans to open their clinic to the general public on Monday.
In the meantime, health officials are urging residents with moderate symptoms to call TeleHealth Ontario (1-866-797-0000) before going to their doctor.
People with underlying health problems or experiencing significant dizziness or shortness of breath should go to the hospital, Mackie said.
"We are absolutely relying on the public to be thoughtful about when they are seeking care," he said. "If everybody who gets the flu goes to see their doctor it will completely overwhelm the system."
THE NUMBERS
38
The number of Hamilton public schools with outbreaks, six more than reported Monday.
27
The number of people hospitalized with H1N1 in Hamilton. It was 17 on Monday.
120
The number of family doctors affiliated with HHS, all of whom have stopped accepting routine appointments to see flu cases.
65
The percentage of Halton public schools with absence rates of more than 2 per cent, up from 5 per cent in early September.
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