Even a relatively mild outbreak of swine flu this season could hit 35 percent of Connecticut's population and overtax the number of available hospital beds, according to a report issued Thursday.
The Trust for America's Health, using data from the federal Centers for Disease Control and Prevention, found that 15 states, including Connecticut, could run out of hospital beds in this fall's "second wave" outbreak of the H1N1 flu. The swine flu became a worldwide pandemic this spring.
"Health departments and communities around the country are racing against the clock as the pandemic unfolds," said Jeff Levi, executive director of the trust, in a conference call.
"The country's much more prepared than we were a few short years ago for a pandemic, but there are some long-term, underlying problems which complicate response efforts," including the ability to accommodate a "surge" of flu outbreaks, communicate information to the public and monitor the pandemic.
The H1N1 outbreak would be in addition to seasonal flu, which kills 36,000 people nationally each year; separate vaccinations will be needed for each strain. While the elderly are considered at high risk for seasonal flu, they are not for swine flu. People 6 months to 24 years old, 25- to 64-year-olds with other medical conditions, pregnant women, caregivers for children under 6 months and health-care workers are most susceptible to H1N1.
According to the TFAH report, Connecticut would need half again as many hospital beds as it now has available, or 148 percent of available beds. Also, the state has enough antiviral medication, such as Tamiflu, to cover only 15.6 percent of its population, the report said. It is one of 15 states in danger of a hospital bed shortage and one of 13 that can cover less than 20 percent of their population with antiviral medications, TFAH said.
Levi said other issues highlighted in the TFAH report are the low number of people who get flu shots. "Last year, only 36 percent of U.S. adults were vaccinated for the seasonal flu -- and only 24 percent of young adults were vaccinated," he said.
"Minorities have sometimes been hardest hit by this virus -- partly because of higher rates of underlying chronic conditions," he added. "Special outreach will be required to assure that we achieve higher rates of vaccination in minority groups."
Also, Levi said the country faces a challenge in its basic public health structure. "It is important to note that we are creating this emergency response at a time when the core strength of our public health system is weakened -- from years of cutbacks in federal funding for emergency preparedness and, more importantly, state and local government budget crises that (have) resulted in cutbacks in staff that greatly undermine the capacity of local health departments to ramp up in response to this pandemic."
William Quinn, New Haven health director, said that assessment doesn't apply to his department. "I think we're in very good shape," he said. "We've been planning (since) even before what happened in the spring."
The H1N1 vaccine is expected to start arriving from the CDC in the next two weeks, said Ken Rubano, assistant director of environmental health and emergency response for the city Health Department.
"The first shipments of vaccine that are coming in are what is called FluMist (nasal spray) and there will be 37,000 doses delivered to the state of Connecticut in the next week or so," Rubano said.
Rubano said the city has been monitoring public and private schools, colleges, hospitals and day-care centers and sent out 60,000 informational pieces. So far, cases have been light, he said.
He said the city will decide whether to add H1N1 vaccine clinics to its seasonal flu clinics depending on the number of cases, but the Health Department will have the vaccine available. "For the high-risk population, it is encouraged ... that they go to their private doctors," Rubano said.
While the vaccine will be provided free, doctors may charge for the office visit, the state Department of Public Health said.
Dr. Louise Dembry, a Yale-New Haven Hospital epidemiologist, said since the H1N1 virus has brought on mild symptoms in most patients, there may not be a need for the number of hospital beds the TFAH report cites. Besides, she said, "We've got the new Smilow Cancer Hospital that will be opening up, and that will create more bed capacity in the short term."
Dembry said hospital staff will look at emergency room capacity as well as room for those who need to be admitted. In spring, the ER was hit harder at first, she said. The key, she said, will be determining "how can we be flexible and fluid in times when we don't know" how large the outbreak will be.
The report recommended federal, state and local health departments develop long-term plans for dealing with severe health emergencies, using the swine flu pandemic as a test case. To see more of New Haven Register, or to subscribe to the newspaper, go to http://www.nhregister.com. Copyright (c) 2009, New Haven Register, Conn. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.
Copyright (C) 2009, New Haven Register, Conn.