ETMC, Mother Frances may need to 'divert' some emergency room patients

Published on Thursday, 9 January 2014 13:50 - Written by

By COSHANDRA DILLARD, cdillard@tylerpaper.com

The medical community is urging East Texans to get their flu vaccines as some medical providers see a steady flow of patients testing positive for the flu.

Medical officials today announced that they were experiencing extremely high volumes of patients in emergency departments most with upper respiratory problems such as the flu, pneumonia and severe colds.

Rebecca Berkley, a spokesperson at East Texas Medical Center said the hospital had been on “divert,” which means the facility had exhausted their resources and must turn away patients being transferred or transported to their facility.

“ETMC Tyler rarely goes on divert but recently both ETMC and Trinity Mother Frances have been on divert, which means both Tyler hospitals will balance the flow of patients between them based on patient request,” Mrs. Berkley said in a written statement.

During the month of December, 167 people who visited ETMC and its emergency clinic on Broadway Avenue tested positive for the flu.

On Thursday, ETMC officials reported that one person who had the flu in Smith County had died, however, it has not been confirmed that the flu was the cause of death yet. Two other deaths associated with the flu were confirmed in Gregg County last month.

According to the latest surveillance data reported by the Texas Department of State Health Services, there have been two pediatric deaths in the state. There have been dozens of adult deaths, including at least 21 in the Dallas area and possibly three in East Texas. Adult flu deaths are not tracked statewide, so there is no way to report an exact number of flu-related deaths.

According to DSHS data, the age group that seems to be most affected this season is 5-49. However, the flu typically affects seniors, people with compromised immune systems and/or those with chronic illnesses.

For the months of November and December, the Centers for Disease Control and Prevention had reported that young and middle-aged adults were experiencing severe respiratory illness, mostly due to the H1N1 strain of flu. The CDC advised that if the strain continued to circulate, it may disproportionality affect young and middle-aged people. Almost all cases reported in Texas, about 99 percent, have been the H1N1 strain, according to DSHS data.

“In 2009 we were worried that (H1N1) was affecting younger people,” said Dr. Jonathan MacClements, Smith County Health Authority. “We were encouraging young people to get vaccinated because we worried about the immunity and the sudden immune response — that they’d get a reaction that they would get sicker. It may be that we are looking at something similar but until we get some data out and the CDC says something, everybody is at risk.”

When people die from the flu, they usually succumb to a response to pneumonia. Some people also experience multi-organ failure. That’s what happened in the 1918 flu pandemic, when many young people died. It wasn’t because of the virus, but instead an immune response to the virus that overwhelmed their lungs. The lungs would fill up with fluid and they couldn’t breathe.

MacClements said there were no ventilators or advanced medical technology back then, which would have saved most people.

Health officials had predicted that last year would be a harsh flu season, but it turned out to be mild. The status of this season is still being considered.

“Last year didn’t seem to be as bad as we thought it was going to be,” MacClements said. “The virus didn’t seem to be as virulent. This particular year, the data is still being collected but at this time, this is a season that the CDC and the Texas Department State Health Services is watching extremely carefully.”

Whatever happens, MacClements said, the vaccines that is available covers three strains, including H1N1. He also noted that it is helpful for people who’ve had the flu already to still get the vaccine, as there are several subtypes.

TREATING FLU

The vaccine is for flu prevention. An antiviral is for the treatment of the flu. Only bacterial infections such as pneumonia would be treated with an antibiotic.

MacClements said doctors should be are that some of the rapid testing is coming up as false negative, so officials are encouraging them to treat patients with flu-like symptoms as if they have the flu.

In addition, he said the H1N1 strain circulating has some resistance to one of the medications.

“There seem to be a little bit of resistance—a very small resistance—to some of the medications right now, to Tamiflu,” he said. “We still have meds that do work and we still want encourage everyone to get their flu shots.”

MacClements advises people to stay at home if sick, see a physician, wash hands regularly and sneeze or cough into a sleeve or a handkerchief to reduce the spread. High fever, aches, pains, and especially chest pains are symptoms that warrant a trip to the doctor.

For more information about the 2013-14 flu season and preventive measures, see the Health & Fitness section in this Sunday’s Tyler Morning Telegraph.