UC Davis Medical Center is bracing for a surge in flu patients as some hospitals in the Bay Area and Southern California suffer medication shortages and put tents outside their facilities to accommodate a deluge of patients in their emergency rooms.
So far, the flu season in Sacramento has been comparatively mild. But health officials say that could quickly change.
“We have identified and are creating a space that is adjacent to our emergency department where we will create a flu treatment center,” said Dr. J. Douglas Kirk, the chief medical officer at UCD Medical Center. “We will be prepared to open in the following week. We’ve set a target date of Jan. 24.”
The California Department of Public Health announced Friday that the number of flu-related fatalities rose to 74, up from 42 last Friday. Sacramento County has reported just three flu-related deaths; Yolo County, two; Placer County, one; and El Dorado County, none.
Officials at other Sacramento-area hospital systems say they are assessing their caseloads and will take appropriate action when needed. Kirk and Dr. Stuart Cohen, chief of the Division of Infectious Diseases at UCD, said they have been tracking the flu caseload in their system and monitoring the other UC medical centers around the state to get an understanding of when they can expect a surge of cases.
Cohen said Los Angeles and San Francisco may be suffering the brunt of the impact first because they have larger populations and residents there live in tighter quarters than residents of the Sacramento region. This year’s H3N2 flu strain is widespread in North America, said Dr. John Swartzberg, a clinical professor at the UC Berkeley School of Public Health and a hospital epidemiologist at the Alta Bates Medical Center in Berkeley.
In the East Bay, he said, hospitals are approaching capacity and the antiviral medication Tamiflu is in short supply.
“I’d hate to see people get complacent in Sacramento,” Swartzberg said. In comparison to swine flu, “H3N2 tends to be more virulent for humans. ... Since this is an H3N2 epidemic, it’s more serious.”
Cohen noted: “This year, the bell curve started going up a tiny bit earlier than we usually see in California, and it seems to be going up faster. In our lab-diagnosed cases – not including rapid flu tests and the tests we do in our emergency room – between Christmas and New Year’s – I think we had 18 positive tests. The week of Jan. 2-8, we had 38, and then last week, we had 49, so it’s going up, and we’re seeing a lot of people.”
During the swine flu (H1N1) pandemic in 2009-2010, 542 people died in California, most of them age 40 and older. Hundreds of schoolchildren fell ill, and whole districts shuttered. Religious leaders suspended the sharing of the chalice, and people stood in line for hours to get vaccines. Research by The Bee at that time found that residents of the Sacramento region’s poorest neighborhoods were eight times more likely to be hospitalized and more likely to die than those who lived in East Sacramento and Folsom.
Kirk said that mature adults can suffer from conditions such as hypertension, diabetes or other illnesses that put them at higher risk of complications resulting in death. Consequently, the screening process in the UCD emergency room focuses on identifying people with these conditions or respiratory illnesses.
Kirk recommended that everyone get the flu shot, but he said it’s particularly crucial to immunize the very young, mature adults and anyone with conditions that could result in complications. All medical professionals said vaccination is the best protection, and the H3N2 strain was included in this year’s vaccine. Because of the virulence of this type of influenza, doctors said, the vaccine is not always preventing all symptoms, but it can help to mitigate the severity of symptoms.
“Not only do we have an obligation to protect ourselves, but if I don’t get influenza, I can’t spread it to someone else. It’s a community obligation, Swartzberg said.
Once a surge begins, Kirk and Cohen said, it can last four to eight weeks. An infected person is most contagious in the day or two before their symptoms bring them down, he said, so it’s important that everyone practice good hygiene.
“In general, it’s transmitted by what we call droplets,” Cohen said. “If I cough and you’re within 3 to 5 feet, you can get hit with one of these droplets, and then it can be transmitted. It also can be transmitted by direct contact, so people can get the flu on their hands and either rub it in their eyes or put it up toward their mouths and transmit that way. There’s probably a period of time – I don’t know exactly how long that would be – when it’s still viable on surfaces, so that you could indirectly contract it by somebody touching a dirty surface.”
Wash hands or use hand sanitizer after contact, Cohen said. Regularly wipe down shared surfaces – phones, keyboards and the like – to prevent the spread of flu.
Parents should be aware that children can continue to spread the virus after they exhibit signs of being well, so to prevent spread of the disease, consider keeping children at home for a day or two after they appear well. If a mature relative cares for your child, protect both through immunization. Employers should consider getting more hand sanitizer within reach of workers.
“On average, 15,000 to 35,000 Americans die of flu in a typical year,” Swartzberg said. “It’s the only epidemic of infectious disease that happens every year, and because it happens every year, people are inured to it. It’s a deadly disease.”