August 19, 2018
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Maine braces for worsening of flu season

Allen J. Schaben | TNS
Allen J. Schaben | TNS
Stephanie Scott, RN, charge nurse, keeps an eye on patients in the emergency department at St. Joseph's Hospital in Orange, Calif., on Friday, Jan. 5, 2018. (Allen J. Schaben/Los Angeles Times/TNS)
By Meg Haskell, BDN Staff
Updated:

The worst could still be ahead for flu season in Maine, with swamped emergency rooms in Portland sending patients elsewhere and health officials striving to take advantage of the illness’ typically late arrival to the state.

At Maine Medical Center in Portland, epidemiologist Dr. August Valenti said the emergency department was forced on several recent occasions to divert incoming flu patients to different hospitals.

“We have been slammed in the emergency room,” he said.

Inpatients with flu are sometimes paired up in double rooms instead of in private rooms, and some beds in specialty areas, such as outpatient surgery, have been called into use to handle the overload, he said.

Other steps are under consideration, Valenti said, including canceling elective surgeries to keep acute-care beds open and using a heated tent designed for disaster management to triage emergency patients. Toward the beginning of the month, the hospital “came pretty close” to instituting such measures, he said.

“We’re doing okay, but I don’t think we’re out of the woods yet,” Valenti said.

Dramatic scenes from other regions of the country showing crowds of flu patients being cared for in tents or languishing without access to intravenous fluids or medicines have not played out here. But flu season isn’t over yet.

The season generally extends into April or later.

In Maine, the flu season typically crests later in the year than in more southern states. Flu surveillance maps from the U.S. Centers for Disease Control and Prevention show Maine lagging several weeks behind western and southern states in both the geographic spread of the flu and the intensity of the illness it causes, a phenomenon often attributed to both cooler weather and a sparse population.

The latest flu data in Maine show that it has so far caused 34 deaths, 667 hospitalizations and outbreaks in 77 nursing homes, schools and other institutions this season. That’s considerably more serious than the 2009 H1N1 outbreak, one of the worst flu seasons in recent memory. During that outbreak, 21 adults died from the illness and about 250 Mainers were hospitalized.

Nationally, the 2017-2018 influenza season is now being called the worst since that H1N1 pandemic.

While Maine has yet to feel the dire impacts experienced in some other states, hospitals here are revisiting the plans they developed after the 2009 pandemic, which challenged the nation’s health care system as it swept the country and the globe, said Kathy Knight, director of the North East Regional Resource Center in Brewer, a public health emergency preparedness program affiliated with the Maine Center for Disease Control and Prevention.

Examples include using temporary structures, including tents, to care for contagious patients, tapping into emergency stockpiles of antiviral drugs and other supplies, mandating additional staff and extending hours of outpatient services.

“Hospitals [in other states] are using their emergency management plans in order to see all the patients who need care. We’re not at that point in Maine, because the severity hasn’t peaked out yet here,” Knight said.

Flu is widespread in Maine, but has not yet become a full-blown outbreak, said Patty Hamilton, director of the Bangor Department of Public Health and Community Services.

“We have a unique opportunity here to get ahead of the game,” she said.

Hamilton is working with area health care providers, emergency planners, schools and local staff from the Maine CDC to spread the word through school visits, public service announcements and social media that a worsening flu season in Maine calls for heightened vigilance.

Eastern Maine Medical Center in Bangor has seen more patients with influenza-like illness — fever, coughs, body aches — but nothing out of the ordinary yet, Senior Vice President Dr. James Jarvis said.

While the hospital has taken no extraordinary measures yet, if conditions worsen significantly, EMMC is prepared to open overflow beds in non-medical facilities, such as area hotels or the Cross Insurance Center, and to access supplies held in emergency stockpiles, he said. Local supplies of intravenous fluids and antivirals are stable, he said.

While hospitals adapt, or prepare to adapt, to meet demands of the flu season, Hamilton said the best strategy is to limit the number of Mainers who get sick in the first place.

First, she said, anyone who still hasn’t gotten a vaccine should get one. The annual flu shot is recommended for everybody over the age of 6 months, with rare exception. Although it’s not a great match for this year’s dominant and virulent H3N2 virus, it’s not too late to benefit from the limited protection the vaccine offers, Hamilton said, and there’s plenty available from area pharmacies and care providers.

Anyone who already got a flu shot earlier in the season does not need another one, she said.

Her group is also handing out free containers of hand sanitizer and information about the flu at this month’s Northern Maine Principals Association Basketball Tournament in Bangor.

“That’s 40,000 people coming and going at the Cross Center, ” Hamilton said. Athletes, family members, coaches and others who get a vaccine now will benefit by tourney time, Hamilton said, although maximum protection takes about two weeks to fully develop.

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