As of Jan. 5, the CDC estimated that 24 states and New York City are reporting high levels of influenza-like illness activity, 16 states are showing moderate levels of activity, five states are reporting low levels and five others are reporting minimal levels.
CDC Director Dr. Thomas Frieden said in a media call that while some areas of the country may be over the peak, other regions, particularly in the West, may see rising numbers of cases. “It's likely that influenza will continue for several more weeks,” he said.
However, CDC officials say there are measures of improvement in some areas of the country, such as the South and Southeast. Across the country, outpatient visits to healthcare providers for influenza-like illness declined week-over-week to 4.3% for the week ended Jan. 5, but still above the baseline level of 2.2%.
What it all means is unclear. “Trends are hard to predict,” Frieden said. “Only time will tell us how long this will last.”
The increase in patients could help hospitals' bottom lines, says one for-profit industry analyst. Frank Morgan, an analyst at RBC Capital Markets, noted that a strong flu season would be a positive for patient volume as well as cash flow. Yet he cautioned that the increased flu activity won't necessarily translate into higher margins, as the flu not only puts a strain on hospital resources but also tends to see lower reimbursement than other conditions.
Hospitals and physicians across the country are taking a variety of steps to handle the influx of patients.
At 2,264-bed New York-Presbyterian, which operates the teaching hospitals of Columbia and Cornell universities, volume in the emergency department was already strained following superstorm Sandy, which severely limited the operations of two downtown medical centers, 806-bed NYU-Langone and 828-bed Bellevue.
Kelly, president of the hospital system, said New York-Presbyterian has seen a 10% to 15% increase in emergency room visits related to the flu outbreak and has admitted 110 to 120 patients. The hospital has ramped up its staffing levels considerably in the ER as well as set up an overflow area in the lobby for increased volume, he said. It is sequestering patients who come in with flu-like symptoms to prevent the spread of the viruses within the hospital. On its inpatient floors, single rooms are now serving as double rooms to meet the need for increased capacity.
Lehigh Valley Hospital-Cedar Crest in Allentown, Pa., set up a tent with six beds outside its emergency room to accommodate the increase in patients and segregate the ones who have the flu.
At 547-bed St. John Medical Center in Tulsa, Okla., officials are considering implementing its emergency management plan after weeks of working essentially at capacity, said Pam Kiser, chief nurse executive and vice president of nursing. “Everybody has a room. It may not be your traditional room,” Kiser said. St. John has taken actions such as converting an ER patient holding room into an intensive-care unit, she said.
The Tulsa medical center has been able to avoid turning patients away by expanding its daily bed management program, but executives appeared likely to implement its plan to try to ease the stress of the patients, Kiser said.
St. John has also been hit with an increase in patients with illnesses that aren't the flu, but are causing flu-like respiratory infections, she said.
The same is true at other hospitals. Whooping cough and a gastrointestinal virus are going around, said Dr. Christine Laine, a practicing physician, editor-in-chief of the Annals of Internal Medicine and senior vice president at the American College of Physicians. “A lot of people are sick, whether it's the flu or something worse,” Laine said.
At WellStar Health System, Marietta, Ga., the system's own employees are feeling the effects of the increased flu activity, spokesman Keith Bowermaster said. His own department has seen three of 25 staffers fall victim, he said.
The system saw three times as many flu cases in ambulatory settings in November and December as it did during the same period the previous year, with higher flu-related admissions as well.
He added that the number of cases is already above the number seen during that period in 2007-08, which is the worst flu season on record at WellStar. That season peaked in February, and with this year's peak still an open question, the flu season could well be the system's worst.
At 580-bed WellStar Kennestone Hospital, one of the busiest emergency departments in Georgia, 826 more patients flooded the ER last month than in December 2011—a 28% increase—largely driven by flu-like illness. The hospital in Marietta admitted 316 more patients than in December 2011, a 27% spike.
As a result, Kennestone has seen backups in its waiting room as patients wait in the ER for a bed to open up on a busy inpatient floor.