On the Front Lines of the H1N1 Pandemic

The H1N1 virus is not only taking a toll on patients, but on hospitals, too.

October 27, 2009, 12:57 PM

Oct. 27, 2009— -- The flu season is barely under way, but a sharp rise in the number of H1N1 swine flu cases is already stretching scarce resources at many hospitals.

At the University of California, Davis, Medical Center, in Sacramento, there's been a four-fold increase in H1N1 cases in just three weeks.

One of those cases is 4-year-old Ferris Labban, who is fighting off a nasty infection.

"Ferris basically went from having the typical flu to a complete collapse of lung and pneumonia in a week," Ferris' mother Wendy Labban said. "This H1N1 is completely aggressive, the way it affects our child's body was unbelievable."

Due to the severity of Ferris' condition, doctors inserted a tube into his left lung to drain it of fluid.

"The care that he got here was around the clock," Labban told "Nightline."

Round-the-clock treatment for H1N1 patients is typical in the pediatric intensive care unit. Nearly half the kids admitted to hospitals with a case of the H1N1 virus wind up in intensive care. No part of the hospital is under more strain than pediatrics.

Watch the full story on "Nightline" tonight at 11:35 p.m. ET

"We're scared about H1N1 and how severe it can be and the resources it needs and the toll it is going to take on all of our staff," said Dr. Mac Wayment, a specialist in pediatric critical care.

Two weeks ago in the same hospital room where Ferris was being treated, "Nightline" met Benjamin Oback, who was also infected with a severe case of the H1N1 virus. Then in critical condition, the 10-year-old was fighting for every breath. His parents prayed and stood vigil.

"I feel like part of my soul has been crushed," Benjamin's father Eric Oback told "Nightline." "It's the worst imaginable feeling to see your kid fall that quickly and to be that ill. The night that he went to the emergency room was the scariest moment I've had in my entire life."

Benjamin's mother, Julie Oback, said her son appeared to have a minor case of the flu earlier this month, but quickly "became unresponsive" and was rushed to the hospital.

Like so many of these critical pediatric cases, Benjamin's illness required coordinated care from every corner of the hospital.

"For Benjamin it required all the different services in the children's hospital," said Dr. Laura Hufford, a pediatrician treating Benjamin. "He needed all the physicians and the nurses there. He needed respiratory therapy, physical therapist. ... So really, he kind of uses all units of our hospital."

Benjamin has now moved out of intensive care into the general pediatric wing, where he is slowly regaining his strength.

"Benjamin is doing well, has begun the road to recovery from his illness," Hufford said. "He's stopped having fevers, been able to get out bed, and he has started eating again."

Pediatric Units Hit Hard

While Benjamin's prognosis is good, the pediatric wing has a heavy caseload. Hufford and her team are dealing with eight confirmed cases of H1N1; that's up from three last week, but another 18 kids have to be checked out.

In each one of these cases, Hufford must put on a gown, gloves, and a special mask to protect herself and the patient from contracting infections.

"I have to use different ones for each patient. It's a lot of masks a lot of gowns," she said. "We probably have to change over 40 times a day, I would say."

Ferris' condition is improving. He must wait for a bed to open up in the pediatric unit, which is full of sick kids.

"[In] pediatrics for the last couple of days, we've definitely had a waiting list, but we have the patients wait in the emergency room or beds that they're in and when we have a bed [in pediatrics] they come right up," Hufford explained.

The emergency room, too, is busy with H1N1 cases. Sara Carter, 28, was admitted this week with flu-like symptoms, a day after her 4-year-old son came in for similar symptoms.

But instead of worrying about her own health, she said it was difficult not being able to be with her son Arista, who was upstairs in the ICU for a fever of more than 104 degrees.

"It kind of makes me cry because I think I should be up there with him," she said.

Emergency Room Traffic Up 20 Percent

The already hectic emergency room is seeing 20 percent more traffic than usual because of H1N1. One big problem is what hospital staff calls the "worried well," patients whose fear of the flu is far more severe than their actual symptoms.

Nurses warn parents that bringing children into the emergency room is itself a risk.

"I have to say it would be better for you not to go to the emergency room unless you have a concern over an emergency condition," emergency room nursing supervisor Deborah Trainor said. "Sometime you have a bit of a wait to see us, sometime you're in a waiting room that may be contagious."

In spite of the many precautions, Trainor said she worries about her own staff getting sick.

"Our big concern is if we lose 30 percent of our own staff, that is going to put a strain on us," she said.

"This is probably going to be one of the most challenging flu seasons that I have seen in my professional career and I have been a nurse for 30 years," said veteran nurse Veronica Boyd, who works for the UC Davis advice line. "I have seen many epidemics, but think this is going to challenge all health-care systems to the absolute max."

A deluge of concern from the public is flooding the advice line, she said. Calls to the advice line -- many of them about H1N1 -- have doubled since July.

"We can assess whether or not they should be worried, whether the child needs medical care, or the child needs supportive care or monitoring to make sure they're not getting a serious illness," said Jenny Moser, a registered nurse. "Today we have people who have been waiting to talk to us for over an hour is what patients are telling me."

The pandemic is already raising practical and profound concerns. In the adult intensive care unit, N95 protective masks are now in short supply.

At UC Davis, the infectious disease team is planning for the worst possible case scenario.

"It's possible that we may have to start allocating resources based on the prognosis of patients," said Dr. Stuart Cohen, professor of infectious diseases at the school.

Dr. Dean Blumberg, the head of pediatric infectious diseases at the UC Davis Children's Hospital, said he worries that even mild cases of H1N1 could overwhelm the biggest and best hospitals in the future.

In the children's wing, Ferris Labban is now out of intensive care. But his plans for going home hit a snag when he started suffering severe stomach pain.

"Ferris had a little setback last night. We were hoping to go home finally today since a week of being here, but his temperature rose to about 101 last night and he was in a lot of pain with his stomach and his side," his mother said.

Last week, the big day to return home finally arrived for Benjamin Oback.

"I'm very excited," he told "Nightline." "I finally get to go home and play."

But there was a hitch in his case, too. Benjamin has an inflamed pancreas and stomach pain, which postponed his release from the hospital.

"Benjamin was really sad and he cried because he couldn't come home today," Benjamin's father Eric Oback said.

But last Friday, when Benjamin's ultrasound looked normal, doctors finally were able to send him home.

"I'm feeling fantastic. I have a lot to look forward to," he said.

But for Hufford, and the medical team at UC Davis, it's just another difficult day in a battle that shows no signs of letting up.

"I have four other children with H1N1 yet to see today," she said.

It's a battle that shows no signs of letting up. Benjamin's hospital bed is already filled with another patient.

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