Columbus Regional makes plans for handling crisis

By FULLER ROYAL

As the avian flu continues to manifest itself in humans around the world, hospitals in the United States are evaluating their ability to cope with a possible pandemic.

Columbus Regional Healthcare joins a growing list of hospitals rethinking their plans for a potentially deadly influenza outbreak like the one that killed millions worldwide after World War I.

Health organizations around the globe, including the World Health Organization and the Centers for Disease Control, are keeping healthcare workers and hospitals like CRH abreast of the latest incidents as avian influenza as well as updates on potential vaccines for the threat.

E-mails and newsletters keep the medical community informed on how to be ready.

But just how is “ready” defined?

That’s one question that CRH Infection Control Nurse Miranda DuFour tries to answer, even when the answer changes from month to month.

“We’re taking steps to make sure our hospital does have a plan for an influenza pandemic,” DuFour said. “We’re using a template provided by the North Carolina Department of Health and Human Services and it’s still in draft form.”

No hospital in the country has the capability to handle a true pandemic – too many patients with limited manpower and resources. There are only so many beds and so many nurses.

Two years ago, when SARS broke out, DuFour said CRH implemented a “respiratory etiquette” policy.

That policy included signage throughout the hospital asking visitors to wash their hands before visiting the floors and to wear a mask if they had a cold or cough.

In the winter, the hospital provides visitors with a package that contains a mask, tissues and hand sanitizer.

Should there be an influenza outbreak, more serious steps would have to be made.

“We are meeting with our local public health officials and with county emergency medical services to establish links and develop a network,” DuFour said.

The problems that would arise during a pandemic include the potential for thousands of critically ill patients and several thousand deaths.

Any plan that CRH puts together must be made in conjunction with local and state governments. Laws concerning mandatory quarantine would need to be looked at.

A pandemic would tax not only the hospital but private practitioners, home health providers and the health department.

Other problems that would surface would be the rate of illness among healthcare workers from doctors to nurses to support staff.

DuFour said that ethical questions would have to be answered. Who would get to use the limited number of respirators? Who would get the hospital beds? Who would receive whatever limited medicines are available?

No healthcare system in the United States would be able to handle the load by itself.

DuFour said that while CRH has contracts with other area hospitals to handle patient overloads, there would be little chance that those hospitals would not also be affected by their own outbreaks.

For now, planning and prevention is the best option.

DuFour said at the local level, CRH participates with the Local Emergency Planning Committee – county leaders in discussions about contingency plans for pandemics as well as natural disasters and terrorism.

CRH is also a member of the Southeastern Regional Advisory Council or SERAC.

Through membership in SERAC, representatives of CRH learn what other hospitals are doing and how they are preparing for disasters.

DuFour said she monitors the Centers for Disease Control and subscribes to the Health Alert Network or HAN as well as the Statewide Program for Infection Control and Epidemiology.

“Using HAN, if CRH had a case of SARS I could enter it on the Web and it would go out across the nation,” she said. “We were alerted about two months ago of the mumps in Charlotte.”

In January, CRH participated in a regional pandemic drill. SERAC ran the drill that involved CRH as well as EMS and the health department.

“That was a good experience,” she said. “They unfolded a scenario where they noticed an increase in animal die-offs in Thailand.”

A “pretend virus” was discovered and it arrived in Southeastern North Carolina at the airport in Wilmington. CRH experienced a play-by-play of what it could experience as the number of patients grew.

“Are we ready?” DuFour asked. “No one is 100 percent ready.”

She said that every time something happens like a hurricane, it strengthens the local medical team.

“I do monitor the CDC material and forward it to the staff here to keep them aware,” she said.