A 2008 report by the American College of Emergency Physicians said, "many emergency departments in the United States are critically overcrowded and unable to respond to day-to-day emergencies, let alone disasters and acts of terrorism." In 2003 and 2004, between 40 percent and 50 percent of U.S. emergency departments experienced overcrowding according to the CDC.
The truth is, flu cases will be an additional burden to the normal emergency department loads. During a flu surge, normal emergencies will not cease. People will still have heart attacks, be involved in auto accidents, fall off ladders, deliver babies, be stabbed or shot.
Imagine yourself becoming sick in the middle of the night with a high fever, cough, headache and difficulty breathing. Your spouse takes you to the local hospital emergency room where you encounter 20 or 30 other people sitting on benches hacking and coughing. The expected wait to see a doctor is two to three hours or more and you feel terrible. Will you wait or will you tough it out and go home?
If you decide to wait to see a doctor, there isn't much that can be done to help you. If no Tamiflu or Relenza is available, there may be nothing that can be done to relieve your symptoms because these drugs must be started within 48 hours of the onset of symptoms to be effective.
If you are sick enough to be admitted to the hospital, but not deathly ill, there may not be a bed or even a cot available for you. If you are lucky enough for a bed to be available, you are likely to be warehoused in a hallway or other makeshift treatment area.
The truth is, the coming flu surge also will test the economic recovery now in its early stages. The economy will decline as a consequence of a flu surge. If not managed properly, the decline could become disastrous. Under the best of circumstances, the economic consequences of a flu surge are likely to linger far longer than the disease itself.
We have yet to see any specific estimate of the economic impact of this coming flu surge or any plans for recovering from that impact once the flu passes over us. When the flu strikes, people will stay home. They will miss work, stop going to restaurants and concerts or attending movies and sporting events. They probably won't go to the mall or look for cars and homes. The impact on the merchandizing and production sectors of our economy will be significant.
The President's Science Advisory Council report called for a single person within the White House to coordinate all efforts across agencies in response to a flu pandemic. We believe that is an excellent idea that should be implemented immediately. There will be no time or ability to establish procedures, or even to create a telephone list of who to call once the flu strikes.
The facts are, H1N1 flu has lingered in the United States at camps and other gathering places over the summer and schools that have reopened early have experienced outbreaks of flu. The truth is, planning for distribution of needed resources to meet a flu emergency should begin immediately, and planning for the economic impact of a long flu surge must be initiated quickly if it is to have any significant impact.