Hospitals Could Reach Capacity With H1N1 Outbreak
Fifteen states could run out of available hospital beds during the peak of a swine flu outbreak if 35 percent of Americans fell sick from the H1N1 virus, according to a new study released on Thursday.
Twelve states could reach or exceed 75 percent of their hospital bed capacity, according to the report released by Trust for America’s Health (TFAH).
The study was based on estimates from the FluSurge computer model developed by the U.S. Centers for Disease Control and Prevention (CDC), and shows the strain hospitals and health departments could face as a second wave of swine flu hits the U.S.
“Health departments and communities around the country are racing against the clock as the pandemic unfolds,” said Jeff Levi, PhD, 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,” he said.
Indeed, if the H1N1 virus were to effect 35 percent of Americans, the number of people who fell ill could range from a high of 12.9 million in California to a low of 186,434 in Wyoming. The number hospitalizations could range from a high of 168,025 in California to a low of 2,485 in Wyoming, according to the new report, entitled: “H1N1 Challenges Ahead”.
Many states could also face bed shortages or be forced to reduce the number of non-flu related discretionary hospitalizations.Â
“Our point in doing this is not to cry Chicken Little but really to point out the potential even a mild pandemic can have and how readily that can overwhelm the healthcare delivery system,” said Levi during a telephone briefing with Reuters.
“States around the country will also have to figure out how to manage the influx of people in doctors’ offices and ambulatory care settings, in addition to the surge in hospitalizations,” he said.
The study also looked at other H1N1 outbreak concerns related to vaccines, antiviral medication, health care, and special needs of at-risk communities.
The findings show that just 36.1 percent of adults were vaccinated against the seasonal flu last year, with rates ranging from a low of 30.8 percent in California to a high of 49.2 percent in South Dakota. This means that there will need to be a major increase in vaccination rates in order to vaccinate the entire population for H1N1.
For seniors over the age of 65, annual vaccination rates are significantly higher, with 69.5 percent receiving seasonal flu vaccines compared with just 24.1 percent of younger adults ages 18 to 49.  Since the H1N1 virus is considered to be more dangerous for young adults and children, outreach for vaccinations must be conducted differently than seasonal flu vaccination efforts, the report said.Â
Dr. Levi said state and local health departments are moving to establish distribution systems for the vaccine as it becomes available this month. But the process is not without its challenges.
“These systems are untested, and glitches are sure to arise along the way,” he said.
State and local budget cuts and layoffs are also hindering preparedness efforts. Local health departments eliminated 8,000 staff positions in the first half of 2009, in addition to the 7,000 local public health jobs that were lost last year.  Meanwhile, federal public health preparedness funding was cut by 25 percent from fiscal year 2005 to 2009.
While the federal government funds the purchase and distribution of vaccines, paying for the administration of vaccines will largely fall to insurance providers, state and local health officials or to individuals.
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The study also found that roughly half of all private sector workers do not have any paid sick leave benefits, meaning millions face losing their jobs if they become sick. However, going to work while ill risks contaminating others.
The report offered short-term guidelines to address some of the immediate concerns for the upcoming H1N1 season, as well as longer-term recommendations for improving the nation’s overall capacity to prepare for health emergencies.
Among the short-term recommendations are refining plans for a quick distribution and administration of vaccines, and continuing vaccination campaigns past the fall to prepare for potential future outbreaks.
The report also recommends that health providers follow the guidance from the U.S. Department of Health and Human Services and the Occupational Safety and Health Administration on the best way to protect health care personnel. Health providers and health departments should also develop and distribute clear public messages about ways to practice good hygiene and understand symptoms and treatments.
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The report estimated hospital bed capacity at five weeks into a pandemic — the peak of an outbreak.Â
Based on the CDC’s model and expert predictions of a relatively mild H1N1 strain that could sicken up to 35 percent of Americans, the study found that 15 states would be at or exceed hospital bed capacity. These include Arizona (117%), California (125%), Connecticut (148%), Delaware (203%), Hawaii (143%), Maryland (143%), Massachusetts (110%), Nevada (137%), New Jersey (101%), New York (108%), Oregon (107%), Rhode Island (143%), Vermont (108%), Virginia (100%) and Washington (107%).
Meanwhile, 12 states would be at 75 to 99 percent of their hospital bed capacity, including Colorado (88%), Florida (80%), Georgia (78%), Maine (83%), Michigan (79%), New Hampshire (84%), New Mexico (93%), North Carolina (95%), Pennsylvania (77%), South Carolina (93%), Utah (83%) and Wisconsin (75%).
The 35 percent sickness rate used in the report is based on the 1968 flu pandemic, which was considered relatively mild. The study also assumes an outbreak would last around eight weeks.
Dr. Levi said the figures were consistent with World Health Organization (WHO) predictions that up to a third of the world’s population will become sick with the new H1N1 virus.
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