University of Michigan and St. Joseph Mercy health systems prepare for possible swine flu pandemic

Still, swine flu appears to be the first real test of that preparation, and health experts said they were surprised by what they encountered in the spring.

“We were expecting to see fairly large numbers of sick patients,” said Carol Chenoweth, an infectious disease expert at U-M.

The health system prepared for the influx and designated certain units for the sickest of those patients.

Instead, Chenoweth said, much smaller numbers of people had acute problems. They saw about 1,000 outpatient visits related to the flu, about 100 people were admitted and only 20 were among the very sick who ended up in the hospital’s intensive care unit.

Many of those 20 were transported to the hospital via Survival Flight helicopter with acute respiratory problems that kept them in the ICU for three weeks. 

“Those were some of the sickest patients we’ve seen,” said Shon Dwyer, who's been leading U-M's logistics planning for H1N1.

Using the lessons learned in Washtenaw County and stories from hospitals worldwide, Dwyer said health officials have been trying to think of every scenario and contingency plan.

That’s included the potential creation of a pandemic urgent care center in U-M’s Taubman center, possible creation of off-site operating rooms and added backup staff to prepare for the possibility that 30 percent to 40 percent of U-M's health care workers could be out due to illness themselves.

If the ICU - which generally doesn’t run at full capacity - fills up, the hospital would consider postponing elective surgeries, Dwyer said.

U-M has a number of devices called extracorporeal membrane oxygenation machines, or ECMOs, which became important in other hospitals around the world to treat the sickest patients. The health system also has extra ventilators, including some destined for retirement that are being kept in storage in case they're needed.

"We are preparing for the worst and hoping for the best," Dwyer said, echoing the statements of other local health officials.

St. Joseph Mercy Health System, based in Ann Arbor, also has been looking at lessons learned this spring. For instance, patients were initially showing symptoms at outpatient clinics, and the health system is working to put procedures in place to quickly identify, isolate and treat those patients if appropriate.

Hospitals are being more proactive in tracking patients and reporting cases to the state, said Russ Olmsted, epidemiologist in infection control services at Saint Joseph Mercy Health System.

They're also increasing protective equipment for health care workers and pushing patients and health care workers to cover their coughs and wash their hands regularly.

"We had good cooperation generally," Olmsted said.

Health experts are urging health care employees and anyone who’s been identified as a higher risk to get vaccinated. Vaccinations are especially important among pregnant women, who make up about 1 percent of the U.S. population and about 6 percent of deaths from the virus.

Washtenaw County officials say up to 80 percent of the county's nearly 350,000 residents should be eligible for the vaccine. Officials say they expect enough vaccine for the highest risk individuals and plan to work with schools, university and health care providers to provide venues to distribute it.

Local hospitals say they've been working together and with public health officials to raise awareness and education. It's been especially difficult because new, and sometimes, conflicting information is being passed down from the CDC on a regular basis, officials said.

“I think we need to do a lot of education. We get flu shots every year, and I think people feel like this is somehow new,” Chenoweth said. “People need to follow the respiratory etiquette our patents taught us, you should wash your hands. It’s those close contacts that are where it’s really going to spread.”

Tina Reed can be reached at tinareed@annarbor.com or find her on Twitter at www.twitter.com/treedinaa.