The worst flu season in nearly a decade has taken a toll on the nation's hospitals. The facilities have been on the front lines, dealing with a flood of patients that in some areas has reached crisis levels. In New Jersey and Alabama, some hospitals have needed triage tents just to process the surge of patients.
That hasn't been the case in Syracuse, but the rise in flu cases has swamped some local emergency departments, causing a ripple effect.
When patients seek refuge from the flu at the emergency department, it can crowd it to capacity. That forces ambulances to take patients to other hospitals. These so-called "diversion hours" spiked at several Syracuse hospitals in January, according to the Hospital Executive Council, a joint planning organization for Crouse, St. Joseph's and Upstate Medical University hospitals. The council's director Ron Lagoe says there were 163 diversion hours in January between the three hospitals. That's drastically higher from the same time last year, when there were only 33 diversion hours.
"The vast majority of influenza patients go home," Lagoe said. "They’re not admitted. If they were, we would need a whole lot more beds than we got now. But while they’re waiting to be treated - and being treated - that produces crowding."
Lagoe says emergency departments can sometimes reach capacity in January because of surgeries that were delayed from the holidays. But the total number of visitors, and their individual diagnoses, at the three hospitals also point to the virus.
"This was one of the two highest Januaries in the last five years and, I mean, we know from the trenches that part of this - not all of it - that part of this is people with the flu," Lagoe said.
Emergency department crowding at hospitals in larger cities like Syracuse presents a threat to the entire region that surrounds them because the facilities often act as a health care safety net since they offer more comprehensive care and services.
Upstate University Hospital is one of those facilities. It treats patients from about 20 counties in central New York, and is the only level one-trauma center between Utica and Rochester. But Dr. Jeremy Joslin, director of the adult emergency department at Upstate, doesn't think this year's flu season is making a significant impact on their operations.
"What I don’t see is I don’t see our emergency department being overrun with influenza patients," Joslin said. "It’s only during very small numbers of times where our ability to take care of patients is overrun, and that in my experience has been rarely due to the flu."
Joslin says Upstate's emergency department treats such a large volume of patients that the share of flu cases is very small in comparison. But one way the flu does impact the ED, Joslin says, is the additional time and manpower required to screen and then process the influx of patients.
"So when patients are being admitted to our hospital, we want to make sure that we don’t cause other patients in our hospital to get sick from the flu," Joslin said. "And so we test most patients who are being admitted who have any signs or symptoms of the flu. We want to make sure we don’t put patients together, one who has the flu and one who doesn’t, so that's something that we ramp up and ramp down every year."
More hospitalizations also means fewer beds for other patients. Many of those who are admitted have underlying conditions that make them more susceptible to the flu, and at greater risk of dying from it. These patients require more attentive care.
Onondaga County Health Department Medical Director Quoc Nguyen says the severity of the illnesses related to the flu, rather than the number, has actually been a bigger burden on Syracuse’s hospitals this year.
“The intensity of illness means the patient requires a higher level of care," Nguyen said. "It actually just stresses the whole system because you have more people who are more sicker, and you need to provide more support.”
Despite the additional stress this season’s flu has placed on the local health care system, Nguyen says Syracuse’s hospitals are resilient and have coped well with the increased volume of patients. He doesn’t discourage anyone from going to the emergency department if they need to. But Nguyen and other health officials recommend patients speak with their family doctor first so as not to unnecessarily burden the system.
“We just want to remind people there are several ways you can deal with the flu," Nguyen said. "And some of them may benefit both you and the health care system.”