Articles, Blog

Update on Recent Flu Virus Surge

February 8, 2020


Good morning, everybody Everybody ready to get going? I think we’re trying to get the music turned down You know let’s uh, we’ll get the music off if we can but let’s go ahead get started now Good morning. My name is Phil Pitchford. I’m the communications officer for the City of Riverside on behalf of the City of Riverside the Riverside City Fire Department Our partners with Riverside County and our local healthcare providers where we want to thank you for being here today We’re here to provide some information about a surge in the last week of Influenza cases not just in the city of Riverside, but also in Riverside County Our format today is I’ll do a short introduction I’ll bring up our Mayor Pro Tem Jim Perry from the city of Riverside, and then we’ll move into our speakers from Riverside University health systems and we recite Community Hospital so and each speaker will come up, and they’ll give their name right before they speak so With that I’ll bring a Mayor Pro Tem Jim Perry. Thank you Hello how is everyone my name is Jim Perry I’m a city council member and the current Mayor Pro Tem We’re here because of the flu epidemic We’re very concerned for all of our businesses and our residents and people who live and play within the city and county of Riverside We here at the City of Riverside are going to take some very active steps to make sure that all of our residents and personnel Throughout the city and region know and have resources to fight this epidemic We will be active we will have information going out on social media. We will have information on our city website That’s Riverside, CA.gov and We also have our 3-1-1 system. We use it for many many reasons throughout the city of Riverside But if you need help if you need resources if you need some direction and where to go Help is simply by just picking up a phone and calling 3-1-1 We also want to assure everyone that our fire department and our emergency medical technicians are fully aware of Everything that is going on with this epidemic. They’re fully trained and ready to assist at a moment’s notice So thank you very much for coming out today Hello my name is Dr. Steven Kim I am the medical director of the emergency department at Riverside Community Hospital And I’d like to thank everyone for this opportunity to address the public concerns regarding the recent outbreak of the influenza virus What the public knows as the flu over the past several weeks we have seen a significant rise in patients presenting to the emergency department with flu-like symptoms these symptoms are most commonly fever body aches fatigue and Then you develop cough runny nose and sore throat fortunately most of these patients that we’ve been evaluating in our emergency department Have what we guess physicians call “uncomplicated flu” or “uncomplicated influenza.” what that means is that the majority of these patients Will get better on their own without any significant treatment other than just rest Getting a lot of sleep Plenty of fluids drinking a lot of fluids and also taking tylenol for fevers or body aches However we have to be cognizant that there are people that do develop serious complications from the flu The most serious complication is pneumonia respiratory distress and There are some populations in our community that are at higher risk for developing this complication those include the elderly patients in nursing homes our young children especially those under two years old and Also, those who have asthma or COPD chronic lung disease heart disease and people with weakened immune systems These people all of us need to be Mindful that if they do get the flu they can develop complications that can lead to serious problems We are able to take care of any of these Complications that come to our Hospital and provide the our community the best medical care. That’s available As of this morning we have had about 75 confirmed cases of the flu that required hospitalization several of the patients are in our ICU Most of them fortunately are on our regular medical and telemetry units and they’re getting excellent care from our nurses and our physicians at our facility How can we protect ourselves from the flu obviously Everyone needs to get their flu shot. I can’t stress this enough I know there has been some questions about the efficacy of the flu vaccine this year Even if it’s only 30 or 40 percent effective it is still going to reduce the number of flu cases that will be presenting and Also, it can decrease the severity of the disease and also the duration so everyone please get your flu shot if you have not already secondly at Riverside if If you feel that you are sick and have the flu and are considering coming to our emergency department keep in mind this over the past two weeks we have seen an increase of about 40% in our normal ED patient volume and That has created Some difficulty for us to be able to handle all the patients that are coming in simultaneously We are doing our best we pride ourself in seeing our patients as quickly as possible in providing efficient Excellent care however because of the influx of patients that are coming in that are concerned about having the flu It’s hampered our ability to do that effectively our wait times have have increased because of this and Most of the volume that has come in is due to patients that have uncomplicated flu so these patients could truly stay home and Take care of themselves there and seek medical attention with their primary care physician instead of rushing to the emergency department What that will do is allow resources to be available for us to take care of patients who have more life threatening injuries and serious traumatic injuries and serious problems so I would like to ask the public for their help to use judgment and Do their best when it comes to making this decision about coming to the emergency department? Obviously of course if you’re having significant trouble breathing or chest pains that could be a sign of having complicated pneumonia so please Seek medical attention under those circumstances One final thing because the wait times are very important I do want to highlight that Riverside Community Hospital does have a Our wait time text program where you can text a number and find out the average wait time So please use that resource as well when making a decision when to come to our emergency department. Thank you Good morning my name is Barbara Kohl. I’m a public health nurse and the director for Disease Control For Riverside University Health System Public Health and as was just stated Influenza certainly could be a serious illness to people It was listed what risk factors exist. What we do as public health is monitor What’s happening in our communities throughout Riverside County. So there are several ways we monitor disease activity. One is what we call Sentinel sites, so we have clinics as well as physician offices who report patients Presenting to them for care with influenza like illness We also monitor visits to emergency departments for individuals with influenza like illness so for the week ending December 30th 2017 All of these locations had increased levels of influenza like illness so above normal What we would expect for this time of year, so that’s one avenue that we monitor the other thing we monitor are individuals aged 0 to 64 years of age who are hospitalized and require intensive care unit To be in an intensive care unit is reportable to public health. We do see an increase in those cases so far a week ago we had five reported. Now we’re up to 19 including those five so we are seeing more acute illness Flu associated deaths are also reportable to public health and thus far this year We’ve had a flu associated death in an individual under ten years of age So again it highlights how important it is for individuals to get their influenza shots and again Even if it’s not a hundred percent match the idea is that it will reduce Severity of illness hopefully keep people well from from getting ill so we really promote influenza vaccination there’s still time to Obtain a shot and be protected From Riverside County we find that usually we start seeing our highest activity mid January early February By March it tends to wane. Now no season is exactly the same It’s difficult to predict and we’re up in an upswing at the moment But there’s still time for people get their vaccine it takes about two weeks after getting vaccinated to have Protection in terms of antibodies being built for that person. we definitely encourage the other preventive measures effective hand-washing frequently People properly covering their cough if they’re coughing if individuals have respiratory illness fever cough We encourage adults not to go to work if possible and for children. You know not to send children to school sick Influenza is spread through Droplets but also direct contact so someone Coughs in their hand shakes your hand you touch your mouth you touch your eyes That allows a portal of entry for the virus to enter your body So preventive measures besides getting the shot. It’s really using social distancing if you’re around someone That’s ill Trying to stay some distance So you’re not real close. if someone does need to go in to see their healthcare provider we’re also reminding people of the importance of having a Surgical mask to contain those droplets, so they don’t get into the air and potentially expose others And I think the majority of health care facilities are Having masks like in the waiting room where people can put them on if they don’t have them so influenza the majority of people have it recover can have serious complications for those very young they’re elderly and Those were under health conditions. We really appreciate You as the media sharing this message out to the public so we can help keep our communities safe Thank you Good morning everybody my name is Jeffrey Liang and I serve as the ambulatory medical director at Riverside University Health System I’m also a family physician And I just want to underscore a few of the messages you’ve already heard this morning The first thing is the flu season is just starting Where you see it picking up and probably everybody knows someone with the flu right now There are actually many things that you can all do to help us with this flu epidemic. The first Which you’ve heard already is if you have not gotten the vaccine for the flu we encourage you to do that We encourage you to talk with your friends and family and encourage anybody who has not received the vaccine to get that Some people have been concerned that the flu vaccine may not be as effective this year But it is still the best way that we can either prevent the flu or reduce the symptoms The other thing is there are certain groups of people that we’ve already mentioned Who are at higher risk for complications if they get the flu that includes young children, the elderly, people who are pregnant, people with chronic conditions And if you have any family members like that the best way that you can take care of them is actually making sure that they get flu shots if they’re eligible and Make sure that everybody around them gets flu shots as well That’s called cocooning for instance children less than six months of age Actually are not able to get the flu shot and the only way that we can protect them is by making sure all of their Family members and caregivers have received the flu vaccine so in some cases You may feel like I’m young I’m healthy, do I really need the flu vaccine. You know, I if I get it It’s not too bad. Well it may not just help you, but it will help everybody around you, so that’s the first message Now anybody who has not received the flu vaccine we encourage you to contact your primary care Providers office and and get your vaccine as quickly as possible at Riverside University Health System we offer free flu Vaccinations at all of our clinic sites both within the community as well as at the our RUHS Medical Center and you can look that up at www.RUHealth.org If you think you are sick with the flu Most people can stay at home This is something that that we often forget and many times when we don’t feel well We want to go see the doctor we wanted to go to the emergency room, and we want to feel better immediately the flu is one of those things that can take up to two weeks to get better from and Unfortunately does not respond to regular antibiotics. For most people with the flu Which includes things like sore throat, runny nose, cough, headache, feeling bad having body aches Feeling like you don’t have enough energy most people can rest at home And that’s actually a great tip because that will decrease your chances for Spreading the flu at work or to other people so we encourage you to take care of yourself to rest at home to drink plenty of liquids, and if you are not sick also make sure that you’re getting enough rest so that you keep your immune system strong if You are sick, and you feel like these symptoms are worse than normal or if you’re having trouble breathing or or other symptoms that you feel like you need help from a doctor we encourage you first to reach out to your clinic or your primary providers office The emergency room is really meant for people with Life-threatening illnesses that means people with trouble breathing, people where we feel like we have something dangerous And for most people with the flu Most people are not having Life-threatening illnesses. So number one, we encourage you to stay at home if you feel like you do need extra care Then we encourage you to reach out to your clinic with your primary care provider And if you feel like you absolutely might have a life-threatening illness Then then we encourage you to reach out to your emergency room or hospital We want everybody to seek the right care at the right place at the right time So please make sure that you’re talking to all of your friends and family To get the vaccine one last tip is that the flu vaccine that you get this year Could actually help decrease your risk for getting the flu next year And many people don’t realize that the flu vaccine has what we call a stacking effect So if you receive the flu vaccine last year it will help you a little bit this coming year and this season So that’s another reason to get the flu vaccine Thank you very much Thank you that concludes our prepared remarks right now We would like to offer you an opportunity to ask questions of some of the speakers If some of the speakers could maybe come over to my left in case you get a question You’ll be close to the podium if you have a question. Maybe you could say if you have it specifically for a person… Rob? Well first question how bad is it? Most jurisdictions in Southern California are reporting increased activity the California Department of Public Health actually will be having a call with local jurisdictions to see where we are throughout the state so it’s not just Riverside County. In terms of how bad we’re up from where we’ve been historically this Point in time and past years and we were discussing Internally when was the last time it was this severe this early, and it was actually around 15 years ago Where we felt the activity increased substantially. To this point in time. In terms of do we have an epidemic? I think we are looking at where are the cases? Are they linked? So you can have increased Activity and totally not have the epidemic. We’re gathering information We’re communicating with our hospitals I think we would say at this point we have Significant increase in activity and it’s ongoing and we haven’t quite defined it as an epidemic yet Well in terms of an epidemic we look at the connections between cases we look at being above baseline I would say we are approaching that level and we will continue to monitor to see how many more cases that we get. Now part of the discussion when we talk about the surveillance in terms of the Sentinel sites its Influenza-like illness right some of them haven’t actually had testing so they they’re presenting with symptoms consistent what we’re monitoring in addition is what stream of flu are circulating in Riverside County. so right now the predominant strain that we’re seeing is influenza A and the subtype is called h3 so it’s seasonal influenza we’re seeing some B Not a lot. So we haven’t declared it an epidemic, but definitely we have increased activity Now each flu influenza season varies and I don’t have a clear-cut reason for right now Is it that fewer people got vaccinated? Is it a more [inaudible] strain at this point We don’t have really a definitive “This is why it’s up.” Flu is very cyclic, it’s sometimes unpredictable in terms of the severity So it’s difficult to to predict that but what we know for sure is more people are presenting to emergency departments With influenza like illness our sentinel sites the clinics that physicians are seeing increased activity what we know is that our? Hospitals are indeed being impacted so definitely up, and we’re trying to review all the variables contributing to that All right, so I don’t have numbers for San Bernardino County To restate for what’s reportable to public health as individual cases. It’s individuals ages 0 to 64 Who end up in ICU or is a fatal case. so as of last Friday our Count was 19, the week before that it was 5, and the 19 includes the 5. we’ve had the 1 flu-associated death Well it’s a percent, so I don’t have the individual number by facility. What we do is the information comes into our Epidemiology Department and they calculate percentages How many people presented with influenza like illness one place I can direct you on our website which is www.publichealth.org At that site there are graphs and it graphs out the percent of people presenting to ED Physician sites it gives you a percent. so doing week 51, seven point one percent of visits to physicians sentinel sites were Consistent with influenza like illness, and this is above our historical level, and if you want that this type of graph it’s in the media kit So I do have that for you Guess it’s hard to see this All right Well CDC has reported an increase in multiple states over recent weeks, so it’s not just California. For Southern California seems to have a higher rate, but it is fairly widespread So when you look at data from the California Department of Public Health influenza activity is Characterized as statewide. So there’s a lot of activity throughout, California as well as in other states Okay, thank you Right Yeah, all I can tell you is that for example on a normal day We may see about 300 patients a day in our ER, this past week from Christmas till yesterday. We’ve been averaging 450 patients so almost about 40 to 50 percent increase I would say in patients and the majority of those cases because I’ve literally been called in almost every day to work extra to help cover and most of the patients that I’m seeing are just Families that are concerned about their either their loved ones your children that have flu like symptoms and they’re you know they’ve heard a lot of horror stories about Patients that have the flu that get really sick and die and so they want to come in and most of it is reassurance I think part of it was the fact that it was the holidays and a lot of the doctors offices were closed I have my fingers crossed that that’s the reason why our volume went up But I don’t think so I think patients are looking for timely care and their doctors are being inundated And so they want to come to our ER and most of the time all I’m telling is your your child or your loved one looks great and You just you got a rest and stay home and stay well hydrated and hopefully this will pass Yeah, I think the biggest symptom is if you’re having a lot of trouble breathing Okay, because that could indicate that that this has progressed into the lungs and that’s the most dangerous complication Sir. I’m Doug Key, I’m with American Medical Response We’ve had a 30% increase in the number of ambulance transports that we’re doing in the county We’ve hit historic numbers in terms of our transports We both brought in extra resources to take care of the transportation, so I don’t think we’ve had any adverse outcomes but Significant delays at the hospitals for offloading because the hospitals are all impacted with the same kinds of issues So I think we’re all working together in concert to take care of the demand, but it’s up across the board including in 911 Our transport numbers have never been higher We don’t go hospital to hospital But we will have offload delays at the hospital and so we’ve sent personnel there in order to relieve our crews to bring them back Out onto the street, so they’re ready for the next 911 call. “Is this City-wide or County-wide?” Its countywide All right Any additional questions? Alright, thanks everybody for coming appreciate it

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