HEALTH experts fear the
state's swine flu death toll could soar with six young, healthy people
in Sydney fighting for their lives on last resort cardiac bypass
machines because their lungs are too damaged or diseased for regular
mechanical ventilation.
The surge in the number of
people with swine flu needing life-saving treatment has forced NSW
Health to consider closing elective surgery at some big hospitals to
allow staff to redirect resources.
Four people have
now died in NSW since the pandemic hit on May 9, a woman, 61, being the
latest victim. Her death on Saturday at Lismore Base Hospital was
followed by two more suspected swine flu deaths, of men aged between 30
and 50, at Royal North Shore Hospital. Their deaths have been referred
to the coroner.
More than 350 people have been
admitted to hospital with swine flu since the pandemic began. Fifty
have been treated in intensive care, but doctors say the surge in
patients needing cardiac bypass treatment is putting a huge strain on
intensive care units and on staff and resources across the state.
All
six of the victims on cardiac bypass are at Royal Prince Alfred
Hospital, where staff have been forced to borrow three machines to
treat 10 patients in the past two weeks. The hospital usually treated
about five patients a year using the machines, the head of intensive
care services, Robert Herkes, said yesterday.
"This
is not an ordinary winter. Swine flu is hitting young, otherwise
healthy people … they start with a sore throat, develop shortness of
breath and within 12 to 24 hours have rapidly developed respiratory
failure and are being ventilated."
Dr Herkes said
extracorporeal membrane oxygenation, or ECMO, was considered a last
resort treatment, but staff were "throwing everything" at the patients
because they were young and relatively healthy.
Patients
in respiratory distress are administered anticoagulants by machine, and
their blood is drained through tubing in their femoral or jugular
veins. It is oxygenated outside the body, allowing the lungs to recover.
Three
patients with swine flu had been taken off the treatment at Royal
Prince Alfred in the past few days. One was "sitting up talking on a
ward", but two were still critical and were being mechanically
ventilated, Dr Herkes said.
Brad Frankum, a general
physician and immunologist at Campbelltown Hospital, said he had heard
anecdotal reports that "more people than ever before" were being
treated with ECMO this winter. "This is of great concern because it
would suggest that the number of serious cases [of acute respiratory
distress] are threatening the capacity of the system," he said.
The
deputy director-general of NSW Health, Tim Smyth said yesterday five
big hospitals in Sydney had now been designated to treat swine flu
victims with ECMO, up from two a fortnight ago. He said about a third
of swine flu patients in intensive care were needing this treatment,
but there was still capacity to deal with the pandemic.
He
said the department had stockpiled 130 new standard ventilators two
years ago as part of the state's disaster plan and would open more
intensive care beds on high dependency units if the number of patients
continued to surge.
But Peter Collignon, a
professor in infectious diseases at the Australian National University,
played down the use of the machines, saying "this happens every winter
- it just doesn't get publicity".
A spokesman for
the State Government said elective surgery could be cancelled at Royal
North Shore, Royal Prince Alfred and St Vincent's hospitals, and
patients due for surgery would be moved to less affected hospitals.
"There's
no move at this stage to move to a different [status] in our pandemic
plan," a spokesman for the Health Minister, John Della Bosca, said.
There
are many hundreds of flu deaths every year, but a senior health source
said swine flu was likely to hit harder as there was no vaccine and no
immunity.
THE STORY SO FAR
- 2029 people have tested positive in NSW.
- 346 have been admitted to hospital (255 in Sydney's west and south-west).
- Four have died, with two more deaths awaiting coroner's confirmation.
- Five major Sydney hospitals now treating victims with cardiac bypass machines.
- One-third of the population expected to get swine flu.
http://www.smh.com.au/national/swine-flu-warning-as-deaths-increase-20090713-diti.html