Fear of Pandemic Flu Clogs EDs Even When Disease is Not Present

A study of emergency department (ED) activity before and during the H1N1 influenza pandemic highlights the role public fear can play in unnecessarily straining medical facilities and will aid in ongoing preparations for public health emergencies, according to the authors.

When EDs experience surges in patient volumes and become overcrowded during a pandemic, the quality and timeliness of medical care suffers, noted William M. McDonnell, MD, JD, who will present study findings May 4 at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

To determine how public fear over H1N1 influenza and presence of the disease in the community affected use of a pediatric ED, McDonnell and his colleagues compared usage rates during three one-week periods. Fear week was a period of heightened public concern before the disease was present in the community. Flu week was a period of active pandemic disease. Control week was a period prior to the onset of concern.

Results showed that parents brought their children to the ED in increased numbers during fear week. Compared to the control week, the number of patients was up by 16.3 percent, and children ages 1-4 years comprised 54 percent of the increase.

When H1N1 later arrived in the community (flu week), the ED saw a second surge in patient volumes. The number of patients increased 22.4 percent compared to the control week, and children ages 5-18 years accounted for 91.7 percent of the increase.

"Our study shows that public fear of disease, even when actual disease is not present, can bring about the problems of emergency department overcrowding," said McDonnell, assistant professor of pediatrics in the Division of Pediatric Emergency Medicine and adjunct professor of law at S.J. Quinney College of Law, University of Utah. "As we continue developing our public health emergency planning programs, we must ensure that responsible news media coverage of public health issues provides the benefits of a free and vigorous press, without unnecessarily harming the public health."