| Oct 19 @ 12:43 PM |
Florida hospitals to restrict care in case of flu pandemic
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Bj864
Posts: 3,958
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I thought it would be interesting to find out peoples reaction to this.
Florida health officials are drawing up guidelines that recommend barring patients with incurable cancer, end-stage multiple sclerosis and other conditions from being admitted to hospitals if the state is overwhelmed by flu cases.
http://www.sun-sentinel.com/news/nationworld/sfl-swine-flu-crisis-propublica-sboct18,0,2336680.story
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| Oct 19 @ 1:53 PM |
Florida hospitals to restrict care in case of flu pandemic |
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Nightowl001
Posts: 7,492
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In mass casuality situations, triage is inevitable. Guidelines are essential.
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| Oct 19 @ 1:57 PM |
Florida hospitals to restrict care in case of flu pandemic
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eastham
Posts: 7,902
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Several years ago, a friend of mine who suffered from complications from a sea snake bite was admitted into Bethesda Naval Hospital. When a TB patient was admitted down the hall, she was temporarily discharged and moved to Bachelor Enlisted housing at the hospital. Moving chronically ill patients, especially those who would be compromised by someone with an infectious disease, happens all the time.
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| Oct 19 @ 3:00 PM |
Florida hospitals to restrict care in case of flu pandemic |
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redhairNfreckles
Posts: 4,664
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Having gone to nursing school and being initially licensed in the state of FL (1966), I can remember the day when no one was turned away. If we had a full census (no more available rooms), then they were admitted into the hallway.
Many a day we would have one side of the hallway lined with several beds awaiting the next available room and using portable screens for privacy until then.  No way would the fire codes of today allow that! 
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| Oct 20 @ 5:09 AM |
Florida hospitals to restrict care in case of flu pandemic
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SensualGemini
Posts: 6,858
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BJ: Florida health officials are drawing up guidelines that recommend barring patients with incurable cancer, end-stage multiple sclerosis and other conditions from being admitted to hospitals if the state is overwhelmed by flu cases.
...They are just getting ready for the new social health program. 
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| Oct 20 @ 4:35 PM |
Florida hospitals to restrict care in case of flu pandemic |
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lacyvsq
Posts: 6,161
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Given that iatrogenesis is the second leading cause of death, this may be a health card for those people denied medical care. Maybe they can actually get some health care instead.
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| Oct 20 @ 4:44 PM |
Florida hospitals to restrict care in case of flu pandemic
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Jankia
Posts: 11,881
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My reaction is...get ready for more of the same regardless if we have a flu epidemic or not.
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| Oct 20 @ 6:49 PM |
Florida hospitals to restrict care in case of flu pandemic |
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kattsmeow
Posts: 22,624
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http://latimesblogs.latimes.com/lanow/2009/10/{email address removed}
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| Oct 20 @ 8:03 PM |
Florida hospitals to restrict care in case of flu pandemic
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SensualGemini
Posts: 6,858
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Lacy: Given that iatrogenesis is the second leading cause of death, this may be a health card for those people denied medical care. Maybe they can actually get some health care instead.
...Although a serious issue, are they any facts to prove that statistically, alternative medicine is any better in savings lives?
In addition, with the release of the Institute of Medicine (IOM) report "To Err Is Human,"2 millions of Americans learned, for the first time, that an estimated 44,000 to 98,000 among them die each year as a result of medical errors. JAMA
vs.
Number of deaths for leading causes of death: * Heart disease: 631,636 * Cancer: 559,888 * Stroke (cerebrovascular diseases): 137,119 * Chronic lower respiratory diseases: 124,583 * Accidents (unintentional injuries): 121,599 * Diabetes: 72,449 * Alzheimer's disease: 72,432 * Influenza and Pneumonia: 56,326 * Nephritis, nephrotic syndrome, and nephrosis: 45,344 * Septicemia: 34,234 CDC
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| Oct 21 @ 10:14 AM |
Florida hospitals to restrict care in case of flu pandemic |
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Bj864
Posts: 3,958
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After giving this a lot of thought, I have to agree that this is probably the only fair way it could be handled.
I reached this conclusion, knowing that I would not be admitted to a hospital, because of my health condition and would face certain death.
Knowing that, I would still prefer that someone younger and healthier with a lot of normal life left to live be saved.
To be totally honest, I doubt I would go to the hospital anyway. I tend to avoid them.
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| Oct 21 @ 3:57 PM |
Florida hospitals to restrict care in case of flu pandemic
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SensualGemini
Posts: 6,858
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BJ: After giving this a lot of thought, I have to agree that this is probably the only fair way it could be handled.
...I would not worry about what government health officials come up with, as most any doctor will treat you by obligation of oath, while leadership grows more ignorant.
...Apparently, incompetent leadership cannot define a plan that is more realized as a civilized society.
...There are many, many empty facilities around this nation, capable of holding millions of people, that could be utilized and mobilized in a short amount of time by a Federal readiness program that is scalable and utilizing all resources, including all facets of the military, which is taxpayer funded and even world wide health care staff.
...In the past, hospitals were known to use neighboring houses as facilities.
...There is plenty of argument for self insured, rather than government insured, as government insured can then decide who lives and who does not, while they are drawing up these guidelines as we type.
...Social health care under the guise of the conservative estimate of 9 million that want health care and do not, will define the health care or not, for the remaining 300 million or so and thus far, remains totally incompetent.
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| Oct 21 @ 4:30 PM |
Florida hospitals to restrict care in case of flu pandemic |
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lacyvsq
Posts: 6,161
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The flu season has passed in the southern hemisphere without hospitals being flooded and without mutation to a more deadly strain. I and many others have already had the swine flu without complications. In fact, it appears that most people born before 1950 are immune to the swine flu by virtue of it being related to the Spanish flu.
That said, if I had a chronic disease or a close friend with one, I would line up a secondary line of care -- perhaps a retired medical practitioner who would respond out of the goodness of his heart or out of a sense of charity or guilt or whatever.
There is a certain sense in that we feel the life of younger people are more valuable, but on the other hand, some do not treasure their lives in the way we may expect. Look at those who commit suicide or experiment with dangerous drugs or sports or lifestyles, or those who consistently numb out. Perhaps wisdom acquired by age can have a value equal or greater.
Don't consider that merely because of age, you life is more expendable than that of another. Don't just lie down and die (bj). Think creatively and even perhaps with the love you would show for your best friend or your own child. There are alternatives.
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| Oct 22 @ 10:22 AM |
Florida hospitals to restrict care in case of flu pandemic
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Paralegal_at_Law
Posts: 5,868
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The death panels are alive and well.
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| Oct 22 @ 9:23 PM |
Florida hospitals to restrict care in case of flu pandemic |
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SensualGemini
Posts: 6,858
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.
...Plan all they want to, because when it comes time for mass casualty, mass chaos will take place and it will be the law of the jungle... the old, the weak and the young will not stand a chance.
...In the closed thread, Feeding Time!, which was over a few hundred dollars and if these actual images, here and here, are not an indication of what people will do in mass chaos, then click your heels twice and be prepared to be trampled.
...Sure, government has built many prisons in preparation, but they could not even handle the small riots, not even one city after a hurricane, let alone mass chaos across the nation. Like New Orleans, where officials never even showed up for work, as their families came first, expect the same.
...In conclusion, an incompetent, self serving government is not preparing to help as many as possible, while you are responsible for you and whomever you accept as your responsibility... while those that expect "entitlements" will be at your door if you have what they want. Any lack of preparation will be met with devastating consequences and that includes health care.
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| Oct 23 @ 10:59 AM |
Florida hospitals to restrict care in case of flu pandemic
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Bj864
Posts: 3,958
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...I would not worry about what government health officials come up with, as most any doctor will treat you by obligation of oath, while leadership grows more ignorant.
The question is not about whether the government set the guidelines, but about whether you agree with the methods that will be used.
They would only come into play if the hospitals were totally overloaded.
I doubt that will happen, but you never know. If it does, how do you feel about the methods mentioned?
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| Oct 24 @ 11:31 AM |
Florida hospitals to restrict care in case of flu pandemic |
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Gallows_Humor
Posts: 13,626
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just skimmed here..
you all realize that if a true flu pandemic hit... a hospital is the last place you would want to be...??
interesting dilemma ..If you were a healthy health worker.. would you expose yourself to a deadly virus to save" a few" people while the rest died??
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| Oct 26 @ 12:07 AM |
Florida hospitals to restrict care in case of flu pandemic
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katydid438
Posts: 8,019
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CTV.ca News Staff
A pre-teen girl is believed to have died from swine flu in an Ottawa hospital, in an area officials say is now a "hotspot" for the virus.
"At this point, we urge certain individuals to understand that currently in the Eastern Ontario region we are in a second wave of H1N1," said Dr. Paul Roumeliotis, the unit's Medical Officer of Health.
"We have seen an increase in influenza-like-illnesses in Ottawa hospitals in the last few weeks," he said.
"(Ontario's) Eastern counties, as well as the Kingston area are considered hotspots for H1N1," Roumeliotis said.
At this point, the girl tested positive for influenza A, and all recent cases of influenza A have died been identified as H1N1 influenza A. Officials are waiting for lab tests to confirm the girl did have the swine flu virus.
The Eastern Ontario Health Unit said it could not release much information on the girl due to confidentiality reasons. She was slightly under 11 years of age, had siblings, and lived somewhere in Eastern Ontario.
The girl died sometime this weekend. Officials are not sure whether she had any underlying medical conditions.
She may be the first child in the area to die from the virus and the second person since the virus began circulating. She went to a school that had not previously been identified as having a swine flu outbreak. So far, 7 out of 25 schools have tested are positive for the H1N1 virus.
Children who are sick at home are randomly tested for the virus. An outbreak at a school is declared whenever 10 per cent of children are absent.
Officials are not sure how the girl got the flu and say that it is hard to track because the virus now is now circulating in the general population.
Roumeliotis said there are a number of patients suffering from the virus in hospital, including some recovering in intensive care units.
The area has seen 15 new cases so far in this second wave of H1N1 flu, which began a few weeks ago.
During the first wave in the summer, one person died and 28 people tested positive in the area.
High risk groups
Roumeliotis urged the public to practice hand washing and to be vaccinated against the virus, as clinics in Ontario roll out the vaccine starting Monday to people in high risk groups:
seniors over 65
people with chronic health conditions
pregnant women
children under five years old
health care workers
people in remote communities.
The virus seems to particularly attack young people. The average age of those hospitalized in the province has been 18.
More than 700,000 doses have already arrived at clinics with a second shipment scheduled for this week. That amount is enough for 75 per cent of the province's 12 million residents.
"I would presume that any tragic situation like this will help people make up their minds in a positive way" about getting vaccinated, Roumeliotis said.
"Unfortunately I think that now people will understand a bit more the severity of the infection and not call it a hoax or an overestimation or an exaggeration."
On Friday, Ontario health officials said the province has an increasing number of confirmed cases and that more and more people are visiting doctors with complications of flu.
There number of deaths had been stable since April at 24, but in recent weeks four more people have died. They said 439 people have been hospitalized with confirmed swine flu.
Officials in the province say there is enough vaccine for everyone that wants it and clinics will continue until December.
 pretty sure it's a true pandemic.
As a nurse it's my duty to get the flu shot and look after the patients....also wear personal protective equipment !
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| Oct 26 @ 5:47 PM |
Florida hospitals to restrict care in case of flu pandemic |
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Gallows_Humor
Posts: 13,626
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maybe this will help you understand where I am coming from... 
[QUOTE]
By LAWRENCE K. ALTMAN, M.D.
Published: June 8, 2009
After decades of warnings about the inevitability of another pandemic of influenza, it is astonishing that health officials have failed to make clear to the public, even to many colleagues, what they mean by the word pandemic.
Generations of people have used the term to describe widespread epidemics of influenza, cholera and other diseases. But as the new H1N1 swine influenza virus spreads from continent to continent, it is clear that a useful definition is far more complicated and elusive than officials had thought.
And what is at stake is far more than an exercise in semantics. A clear understanding of the term is central to the World Health Organization’s six-level staging system for declaring a pandemic, which in turn informs countries when to set their control efforts in motion.
Dictionaries and medical journals offer little guidance. Their definitions can be too vague or too narrow, contradictory and clouded by jargon.
“There is a lot of misinformation in the medical literature, and it is really quite hard to figure out what is and what is not a pandemic,” said Dr. David M. Morens, an epidemiologist at the National Institute of Allergy and Infectious Diseases who has been studying the history of pandemics.
The word implies the rapid spread of an infectious disease to many countries in different regions, hitting each with more or less the same severity. But in fact, severity varies — not all people are infected at the same time, and not every country need be affected.
And there can be many other factors, including the numbers and percentages of people falling ill and dying; a population’s vulnerability to the disease, based on previous rates of infection; and the quality of health care facilities and disease monitoring systems.
Not least is that scientists do not know precisely how pandemics arise, what fuels them, why they vary in their lethality, why some occur in waves and why they stop.
Health officials have long preached that with influenza, the only sure bet is to expect the unexpected. The new swine influenza virus, which appeared suddenly after years of warning about a potential pandemic of avian influenza, upset the W.H.O.’s assumptions that most people have the same understanding of the word pandemic.
For years, the organization’s Web site defined an influenza pandemic as causing “enormous numbers of deaths and illness.” But the agency recently pulled the definition, apologizing for causing confusion and anxiety.
One of the biggest problems in public health is communicating risk assessment.
United States and W.H.O. officials say their preparedness plans are intended for governments, not people in the street. Officials bristle at criticism that their messages and plans have led the public to equate the word pandemic with the Spanish influenza of 1918-19, the worst recorded pandemic in history, killing 20 million to 100 million people.
In preparing for the worst, officials have considered milder pandemics, said Dr. Nancy J. Cox, chief of the influenza division at the Centers for Disease Control and Prevention in Atlanta.
But Dr. William Schaffner, the chairman of preventive medicine at Vanderbilt University, said that “we, the public health community, deserve to be chided” about the confusion.
“We ought to be able to do a better job in communicating in an understandable way,” he said in an interview.
Scientists like to assert that theirs is an exact discipline. But like the terms “evidence -based medicine” and “peer review,” pandemic turns out to be another example of imprecise vocabulary that doctors use every day, assuming everyone understands their meaning.
Journals, textbooks and reference works use pandemic in discussing certain diseases, but rarely define the word.
For example, the definition section of the Control of Communicable Diseases Manual, a standard reference work, includes “endemic” (said of a disease that is usually present in an area or a population group) and “epidemic” (more cases of an illness than would normally be expected) but not “pandemic.”
The disease manual’s editor, Dr. David L. Heymann, a retired assistant director-general of the W.H.O., said the term had not caused confusion in the past, but assured me in an interview that “pandemic will be defined in the next edition.”
Even the indexes of most major medical textbooks do not list pandemic. One is Harrison’s Principles of Internal Medicine, of which Dr. Anthony S. Fauci, who directs the National Institute of Allergy and Infectious Diseases, is a main editor.
“It’s a mistake, and I’m surprised it’s not there because it should have been,” Dr. Fauci said in an interview.
Government agencies do not have official lists of pandemics. Textbooks cite many recent and old ones, including these:
¶AIDS. Many experts have called H.I.V. a pandemic. Others disagree, saying the virus is pandemic only in Africa.
¶Cholera. Since 1817, most experts agree, the world has had seven pandemics of this bacterial illness, which causes severe diarrhea and dehydration. ¶Acute hemorrhagic conjunctivitis. Beginning in 1969, an enterovirus has caused tens of millions of cases of a highly contagious, acute, painful, but rarely blinding, form of hemorrhagic eye inflammation.
¶Dengue. Since World War II, this mosquito-borne viral
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| Oct 26 @ 5:48 PM |
Florida hospitals to restrict care in case of flu pandemic
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Gallows_Humor
Posts: 13,626
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¶Dengue. Since World War II, this mosquito-borne viral disease has spread widely in Asia and Latin America.
¶Syphilis. A pandemic of the bacterial disease raced through Europe and Asia after Columbus’s return from America and during mass movements of armies in Europe.
Although pandemics have been classically limited to infectious diseases, the term has spread to noninfectious, chronic ones. For example, many health officials now speak of pandemics of obesity and heart disease.
Knowledge about past pandemics is necessarily incomplete; historical accounts cannot make up for the absence of modern disease monitoring and laboratory tests.
About 14 pandemics of influenza have been described since the 16th century, with the first indisputable one occurring in 1889.
In 1580, an influenza pandemic swept through Asia into Europe within six weeks, and at least 10 percent of Rome’s 81,000 residents died in the first week, said Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Some Spanish cities were almost totally depopulated.
Dr. Morens, of the infectious diseases institute, said his studies of influenza pandemics left a confusing track record and “are rewiring our brains about thinking about influenza.”
“The medical literature will tell you there were three pandemics in the 1830s,” he said — “one from 1830 to 1832, a second in 1833 to 1834 and a third in 1836 to 1837. But I am beginning to think they were all one pandemic.”
Dr. Morens said he was puzzled as to why no influenza pandemics were recorded for nearly 150 years after the one in 1580, although there were some severe localized epidemics.
“A period of pandemic stability makes us wonder whether a pandemic comes at any time by chance,” he said, “or whether something about epidemic situations prevents pandemics,” or at least delays them.
The W.H.O.’s staging system has long been part of its plan for an influenza pandemic. Deep concern about a potential pandemic of the H5N1 avian influenza virus led the organization to convene a large meeting of experts in 2005. Among other things, the experts recommended simplifying the staging system.
A number of doctors ask why health agencies do not declare seasonal influenza a pandemic when it spreads around the world.
But Dr. Osterholm, the Minnesota expert, said that “you can’t use the terminology for just worldwide transmission, because if you did that, you would say every seasonal flu year is a pandemic.”
“To me,” he continued, “a pandemic is basically a new or novel agent emerging with worldwide transmission.”
Dr. Keiji Fukuda, an influenza expert who is an assistant director-general at the W.H.O., said in an interview that “as difficult as things are right now,” the problem of defining a pandemic and communicating risk “would be magnitudes worse and more confusing” if the agency had not dealt with AIDS, SARS and avian influenza.
Those experiences prompted new international health regulations and pandemic plans, and allowed critical scientific information to be disseminated quickly, he said.
The process was “painful, sure,” he said. “But you can’t really do anything like this without having some amount of pain.”[/QUOTE]
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| Oct 26 @ 11:39 PM |
Florida hospitals to restrict care in case of flu pandemic |
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katydid438
Posts: 8,019
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I hear what you are saying. HIV in Africa should probably should be called epidemic because of the unbelievable number of those infected. There is no where near the number of infected anywhere else in the world in such a concentrated population. As with Cholera, the same could apply because that particular disease is predominent in tropical/sub tropical regions.
As far as I understand, the word/term pandemic is reserved to a disease that can spread to any country irregardless of their climate conditions. The most common virus is influenza which does not recognize boundaries,can be contracted by anyone and is not dependant on human risk behaviours.
Although H1N1 is not the pandemic virus expected, the Avian virus is still being tracked. H1N1 although referred to as a swine virus still has it's origin from an "avian" virus, so those that track flu viruses were really half right.
The word pandemic can be tossed about, but to my knowledge, Influenza is the only virus that can be spread worldwide quickly. We are all used to hearing about seasonal flu,,but this is an entirely new flu,,,which will only become more infectious unles it is contolled by vaccination of the population. 
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