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Part Two
Over the weekend, local news mentions that A/California really seems to be torquing through town. A few short interviews with an official from the local school board & some major employers mention increasing absence rates. No surprise there, A/California has been having a major impact in some parts of the US - especially among children. A dozen or so children are brought to emergency by their worried parents as they have very high fevers, ferocious coughing & absolutely no energy.
The initial lab tests come back Monday & H5N1 is confirmed in the 2 patients tested late last week. Several others who had been tested prove to have A/California. A hastily convened meeting of several doctors involved in caring for these patients at the hospital makes the problem clear - initially A/California & H5N1 - now known as A/MyTho; present almost identically. Like most A strain flu patients develop symptoms very rapidly, progressing rapidly from feeling a little off to fevers, generalized muscle soreness & significant fatigue. Those that have so far been hospitalized, (6 by now), rapidly progressed to even higher fevers, prolonged & non-productive coughing & much difficulty breathing. Of the 6 admitted, only 2 had previously existing medical conditions.
An increasing number of patients are coming in to emergency with serious flu like symptoms but with the hospital being full & as many gurneys in hallways as can easily be accommodated right now, the hospital is in a quandary. A number of staff are already out with what is presumed to be A/California. The Chief Medical Officer & other senior hospital staff meet to develop contingency plans. They have some on file but current conditions must be factored in.
Late Monday afternoon, the mayor convenes a meeting of senior medical persons from the hospitals & major long term care facilities. Chiefs of emergency & law enforcement departments, the head of local public health & the base commander from the local communications training base are also in attendance.
The Public Health Chief, Dr. Gemmel begins by stating what is known about A/MyTho & passes on what Asia is experiencing & what national officials project will occur in Canada. The pandemic is still spreading throughout Asia & officials there are hoping the wave peaks soon. In the meantime, case loads are doubling roughly every week. It's getting hold in Europe & Africa is reporting cases. Kingston can expect a few hundred presumed cases by the end of the week & possibly close to 1000 within 2 weeks of that. It's possible 200 of these cases may require hospitalization.
The Director of Medical Operations at the hospital explains how the hospital is strained at the best of times & this late in the winter, surge capacity is essentially non-existent. The hospital is full. His staff estimates they may be able to discharge up to 13 patients by noon tomorrow but 9 people are already in temporary beds in hallways & alcoves. Today's snowfall has meant a stream of ambulances to the emergency with broken limbs, several suspected heart attacks from shovelling & 3 serious car accidents brought in 5 patients. He's hoping only 2 of the latter will require admission.
Emergency services are reporting higher than normal levels of staff calling in sick & are already running at low manning. Added coverage is going to have to mean changes in shifts for line staff. In short, the system is already running at maximum capacity & this is only beginning. Dr. Gemmel strongly recommends the immediate closure of all non-essential public venues - bars, restaurants, pool & bingo halls, gyms, swimming pools & sports clubs.. the also urges the city to close all schools as of Monday. The mayor says he'll discuss it with city council.
The reserve units in the area include a military medical company & the base commander reminds the mayor that a 'call up' is rather more complicated than picking up the phone & ordering the CO to bring everybody in. He intends to try to set the wheels in motion immediately but explains it will take at least a week because of various legalities & procedures which must be followed. The hospitals & long term care facilities will cancel all planned staff holidays & look to those recently retired - maybe they can be brought back in on a temporary basis. Where the funding for any of this is going to come from is anyone's guess.
By Friday, the strain on health care is obvious & several more meetings have been held involving some or all of the parties mentioned above. cases are popping up across the country with rapid spread in the larger cities. Governments have been working on an emergency footing, hurriedly enacting various pre-written legislation to deal with the pandemic. The military has essentially dropped all normal training & deployment schedules & there is word that troops deployed overseas are coming home. All members of the military on reserve status are to presume they are called up & are to report to their reserve units - if they're members of the regular reserve - paperwork may or may not catch up with them soon. Supplementary reserve - those retired within the last several years, (I forget exactly how many), are to plan on receiving orders soon & should prepare personal affairs accordingly.
Health care workers, first responders & their dispatchers have been declared essential personnel by the province. Unfortunately, a percentage of these have already 'disappeared' not reporting for their latest shifts, not answering the phone... it can only be assumed they're too frightened of the outbreak to work it or too concerned about their own families. Staff are continuing to go down with what appears to be A/California but that means a minimum of a week off work & Dr. Gemmel would prefer they stay off duty a week AFTER their last symptoms. That's a luxury we may not be able to afford however.
Wednesday night, the 9 year old girl dies & an 11 year old with no pre-existing conditions dies early the next morning. The school boards announces all schools will be closed as of Friday - an increasing number of cases seem to be coming out of the schools. Parents are very upset but are not complaining as much as they probably would have been had they not heard of the 2 deaths & by now 5 other children in very poor condition in hospital. The major concern with the school closures is... what to do with the kids? The city has a high percentage of single parent families & those with a parent working & young children have few options. They scramble to arrange care with neighbours & relatives. Most manage something & those who can't are forced to take holiday time.
Local media has been covering this solidly with lists of symptoms given in every newspaper edition & on every newscast. Public health has set up hot lines for people to call if they're concerned their or their family members' symptoms mean they should go to hospital. Right now, the hospital emergency is closed to all save those who come in by ambulance or who are told to go by either their own doctor or staff at the hotlines. Their names are given to emergency 'front door' staff & with the exception of a few unfortunate delays, most enter the facility for screening immediately.
The local medical association is working on a plan to most efficiently make use of their skills & a great deal is furiously being worked on behind the scenes... the weekend, essentially becomes two more working days...
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