Hospitals Unprepared for Pandemic Surge

Feb. 5, 2007 — -- At the recent gathering of many of the world's top influenza experts in Washington D.C., projections outlining how hospitals would deal with a pandemic event were easy to find.

Optimists, however, were in shorter supply.

"We need double the floor space, double the physical space," said one presenter at a poster session of the Seasonal and Pandemic Influenza conference. "It's just not gonna happen."

Another expert nearby presented her poster on possible triage strategies.

"We'll need a more effective triage system to determine who gets the care and who's too far along," she said.

Computerized training simulators. Strategies to discharge patients quickly and use hallways for bed space. All are approaches are designed to deal with what those in attendance at the meeting called a "surge" -- the increase in people needing hospitalization in the wake of a flu pandemic.

But if an influenza pandemic were to begin tomorrow, the country's hospital beds would soon be filled to capacity.

It is a projection that would surprise few public health experts. But data presented at the meeting paints a sobering picture of how profound and overwhelming the surge could be.

"It is the big unaddressed issue, and we're only beginning to talk about how to provide care to people," said Jeffrey Levi, executive director of the Trust for America's Health. "We need to be talking about this."

"Of all the things that keep you awake at night, this is the one that does the most," said Dr. Allen Craig, director of communicable and environmental disease services at the Tennessee Department of Health.

"We don't have this capacity now, and frankly it's going to be very hard for us to come up with it in a pandemic situation."

Dr. Eric Toner, senior associate at the Center for Biosecurity at the University of Pittsburgh Medical Center, conducted a study last year to determine the capacity of the nation's hospitals to accommodate a pandemic surge.

"In a moderate scenario, an additional 19 percent of non-ICU beds, 46 percent of ICU beds and 20 percent of ventilators would be in use by flu patients," Toner said. "This is pretty much all of the surge capacity we have in most hospitals, so if we're lucky and it's a mild pandemic, we will be stretched to our limit."