Flu tested hospitals’ mettle

Dr. Carl Urban works in New York Hospital of Queens' lab. The facility was used during last year's swine flu outbreak to try to find a treatment for the disease. Photo by Christina Santucci

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By Ivan Pereira
Thursday, May 20, 2010

When St. John’s, Mary Immaculate and Parkway Hospitals shut their doors last year, administrators at other medical centers in Queens said they knew they were going to have their hands, and more importantly emergency rooms, full of extra patients.

After the H1N1 virus broke out last spring, medical centers, such as New York Hospital of Queens, Elmhurst Hospital and Jamaica Hospital, were put to the real test and overloaded not only with people who had caught the new disease but also patients whose fear of contracting the flu drove them to get immediate help. Despite the extra load, physicians and other directors said with careful planning and patience they were able to ride out the crisis and serve the borough the best way possible.

With nearly 2.2 million residents living in the borough, the remaining hospitals had about 1.6 beds per 1,000 patients, according to the borough president’s office.

At first, administrators said they were worried about the outbreak, which started at St. Francis Prep in Fresh Meadows at the end of April 2009. The swine flu came on the heels of warnings by elected officials, such as Borough President Helen Marshall, that Queens would not be able to handle a major health crisis with fewer hospital beds.

Diane Sixsmith, chairwoman of the Emergency Department at New York Hospital of Queens, said what concerned her was not how to properly treat the new flu strain, but the 300 additional patients visiting her center daily after H1N1 struck.

“The challenge was not dealing with the sick people, it was dealing with people who thought they were sick,” she said.

Over the next month, hospitals such as NYHQ, Jamaica Hospital and Elmhurst Hospital, saw huge lines of patients young and old outside their centers. Mary Immaculate in Jamaica and St. John’s in Elmhurst had closed the month before following the shuttering of Forest Hills’ Parkway Hospital in November, and the administrators at the borough’s other medical centers braced for an influx of patients.

To handle the extra numbers, the centers developed their own systems to triage the flu cases and identify patients with other conditions.

Tents and trailers were set up outside Jamaica Hospital and Queens Hospital Center for the flu patients. At Elmhurst Hospital Center, which went from seeing an average of 350 patients a day to 800 a day during the peak of the outbreak, the staff had to get creative.

Chris Constantino, the hospital’s executive director, said a special decontamination trailer that was installed in the rear of the hospital had to be quickly converted into examination areas to help lighten the load in the already overcrowded hospital.

While administrators worked out how to treat the patients, Queens physicians scrambled to properly treat the swine flu. Dr. Farshad Bagheri, director of infectious diseases at Jamaica Hospital, said his center saw more patients because even though swine flu had been diagnosed in the past in other parts of the world, the virus that broke out last year had significant biological differences.

“A new virus like this, the community did not have immunity like this,” he said.

The medical centers had help from the city Department of Health and the U.S. Centers for Disease Control, which provided the hospitals with up-to-date information on how to treat patients. Many doctors prescribed Tamiflu and antibiotics to treat the nearly half-million patients in the city who had flu-like symptoms during the outbreak’s peak in May last year and the majority of those people made full recoveries, according to DOH.

Although there were some deaths in the borough from the disease, including Mitchell Weiner, an assistant principal at IS 238, which had an outbreak, doctors said that the best medicine for patients was to take a step back and remember their basic health precautions, such as covering their coughs and sneezes and washing their hands regularly.

“The reality is that the symptoms are the same. The flu is the flu,” Constantino said.

By July, the number of flu cases in the city had dropped to less than 50,000, according to the DOH, and the borough’s emergency rooms saw huge decreases in patients.

Nevertheless, Queens’ leaders said the swine flu episode was a case study of how the neighborhood’s medical centers need more help to answer the borough’s needs. Marshall said the least government agencies and private health organizations could do to combat similar outbreaks would be to fund smaller health centers in the most vulnerable neighborhoods, such as southeast Queens and Corona.

Centers like those would be better able to keep less serious cases away from the emergency rooms, according to Marshall.

“The closures of three hospitals in Queens continues to heighten fears today about a health care crisis and what would happen in the event of an outbreak of swine flu or another health emergency,” she said.

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