Health pros try to outsmart flu
BY LAURAN NEERGAARD Associated Press
Tuesday, August 11, 2009
8/11/09 at 4:44 AM
WASHINGTON — Sit for hours amid the sneezing in an emergency room this fall, and if you didn't arrive with swine flu you just might leave with it.
Fearing swamped ERs, the government is working with worried doctors to develop hot lines or interactive Web sites to help the flu-riddled decide when they really need a hospital — and when to stay home.
With flu season rapidly approaching, the plans aren't finished yet, and it's too soon to know how many people could access such programs.
But, "we are working on triage systems so people will have good information about, 'What will I need to do?'" Dr. Anne Schuchat of the Centers for Disease Control and Prevention told state health officials last week.
Every winter, crowded emergency rooms are flooded with hacking sufferers of the regular flu. When swine flu appeared last spring, ERs in New York and other hard-hit areas had a similar surge — and most visits were by the mildly ill, not those in real danger. More ominous, both types of flu are expected to spread widely this fall and winter.
"There's a clear sense that we can't afford a repetition of the spring experience all over the country," says the ER specialist Dr. Arthur Kellermann of Atlanta's Emory University, who has pushed the government planning and praises what he calls "an unprecedented partnership" to create the tools in time.
"You can't drop millions, much less tens of millions of Americans, into that system willy-nilly because they want to play it safe and get checked," Kellermann said. "The play-it-safe strategy may be to stay home."
The goal is one-on-one interactions, either with nurses or with sophisticated technology, for a customized assessment of whether someone's symptoms and medical history put him or her at low or high risk for flu complications.
At low risk? The advice is to stay home, rest and stay hydrated. Doctors don't want you sneezing on the guy with chest pain or the kid with the broken arm or the immune-weakened chemotherapy patient while you wait to hear that in person.
"You could wait 18 hours to see me and I'll tell you, 'Please go home and go to bed,'" Kellermann warns.
Conversely, call centers could give families the info they need to, in Kellermann's words, "drag Grandpa out of the bed and take him to the emergency room."
Schuchat cautions that officials haven't decided exactly how call centers may work or even how many will be needed. In the meantime, the CDC has given states and hospitals guidelines on how to open their own — using existing phone banks such as poison-control centers plus the agency's latest information on flu risk and treatment — while exploring whether the government can create a more comprehensive system. Emory and Georgia's health department developed a prototype that Kellermann says is being refined for potential national use.
Dallas' Health Department opened a call center to help doctors decide whether and how to treat sneezy patients, to blunt ER visits, and is planning an expanded fall program.