Paul Goldfinger, MD, FACC
By now most of you have heard that influenza is spreading wildly across America and elsewhere. Here is a link to an article we posted in May, 2011, regarding preventing the flu. You will find this posting to be of great interest.
Blogfinger article on flu prevention
Influenza has been noticed ever since the pandemic of 1918. In 1908, the hospital where I worked, Dover General Medical Center, was founded in an old mansion. It had 25 beds and a small staff of doctors (not me) and nurses. When the 1918 pandemic hit, they were swamped and had to turn people away. They promised then that they would never refuse patients again. So the hospital grew to 360 beds, but when I was there, despite all those beds, each year at this time, the ER was overflowing, and there were beds in the hall. Sometimes the rescue squads would have to shop around for a hospital that had room, although usually, when one hospital was filled, so were the others. As hard as everyone worked, the degree of business would get chaotic, and the chance of errors would increase.
That pattern continues today at many hospitals where conditions get scary during flu season. Sometimes extra beds are added to rooms, and staffing shortages quickly develop. A hospital is not a good place to be at this time. If you have a friend or family member admitted with influenza or anything else, try to help the nurses (with their consent) whenever possible. But wear a mask and wash your hands frequently. Any patient who is admitted now with another condition, such as diverticulitis, is at risk for catching flu from a patient nearby or even the one who was last in your bed. Hospitals have to be meticulous when cleaning the rooms before admitting another case, despite the pressure coming from the ER to move patients to a regular bed.
Some of you may have heard of Tamiflu (oseltamivir,) an antiviral drug, which is given orally to patients who present within two days of the onset of symptoms. It is used all over the world, but there is some debate as to its effectiveness. In addition, Roche Labs is suspected of withholding research data. (See Forbes magazine Jan. 8,2013. )
Some individuals have stockpiled the drug in case a flu epidemic occurs. But you should know that the only proven results consist of shortening the duration of the illness by one day and perhaps reducing the severity of the attack. There is no proof that it prevents viral transmission or that it prevents the dreaded complications, particularly pneumonia.
You can still obtain benefit by getting a flu shot, but the flu shot may not be totally protective. It takes two weeks for a flu shot to kick in, and the elderly are weak producers of antibodies. So, by all means, get the vaccine if you haven’t done so already. Most of the drugstores have it.
Here is a NY Times link from today:
I went in to pick up just regular maintenance prescriptions and a few other things at the CVS at Jumping Brook Road and Asbury Avenue (I live outside the gates, remember) and people were going nuts over getting a flu shot. No CVS store in the area had them yesterday, though they were being overnighted to arrive today, the tech told me, and Walgreen’s, RiteAid, and most doctor’s offices were temporarily out of flu shots. I had heard on WCBS880 that 47 states had a flu outbreak, but since every drugstore chain has been advertising flu shots since August, silly me figured people had, you know, gotten them. There’s been flu shot campaigns at employers and fairs and festivals – why people wait until the flu actually breaks out is beyond me. (Since I’m immunosuppressed, I get flu and pneumonia vaccines every year – in August or September.) I just don’t understand why people put their health in the hands of Brian Williams, Bob Schieffer and Wolf Blitzer.
Thanks for the article
Well noted
Yes, I work with the state and an agency in Middlesex County. Basically any patient with flu symptoms gets a mask prior to entering the ambulance
Many of the patients we transport view the hospital as a more direct source of care then a primary. Many of the patients tell me they would have to wait a day or more to get an appointment, so a 5 hour wait may seem like a lot in an emergency, but it’s small potatoes to them.
Many I work with have aspirations of becoming a PA or MD, and none of them talk about private practice. Those that do not want to work in a hospital setting are looking at the R & D side
Bullets: I have been complaining about the primary physician situation for some time. That whole concept is in a shambles, and medical students are running away from that pathway as soon as they graduate. Obamacare is depending on that model, but they will have to take some drastic steps to deal with the situation.
Thank you for bringing us up to date on the current local situation. It sounds like you may be an EMS. Thank goodness for the EMS workers that serve tirelessly all over New Jersey. And let’s hope that the State isn’t so willing to allow hospital closures in the future as they have in the past.
We were at the Jersey Shore University Med Center ER room Tuesday night, but not because of influenza symptoms. Several staff members and the ER doctor told us that the ER had been inundated with flu sufferers, hence the five hour wait to see a doctor. After reading today’s NY Times article and this commentary from Dr. Goldfinger, I understand wny patients were brought in wearing masks.
Currently there are 4 ERs in NJ that are on full diversion, meaning they do not want ambulances to bring them patients as they can not handle them
Monday, Kimball, Ocean, Community, Centrastate and Monmouth were officially on diversion and JSUMC was at a 5-6 hour wait to see a nurse. The vast majority of those patients presented with flu-like symptoms. Basically they are getting hammered every day and the hospitals and local EMS cant keep up with the amount of patients who are presenting to the system.
If you go to this website: https://hippocrates.nj.gov/
This will show you every hospital that is on diversion and why. Normally that page is empty or has 1 facility. These past two weeks it was not unusual to see multiple hospitals and in some cases, every hospital in a given county directing patients away.
It seems that no one has a primary physician anymore