In flu outbreak, authorities might use ‘pop-up’ centers

If a virulent form of the H1N1, or swine flu, virus spreads across the country this fall, you just might see triage centers open up in shopping center parking lots, where health care workers would decide who needs medical attention and who can recuperate at home.

“Drive-through” flu triage, where nurses perform quick assessments through an open car window, are also a possibility, said an Atlanta infectious disease control expert who was in Las Vegas on Thursday for a state-sponsored conference on health care-associated infections.

“At Emory we’ve realized you have to be open to all kinds of new ideas if we have a 1918 kind of flu epidemic,” said Betsy Hackman, who works for Emory Healthcare, an Atlanta group of hospitals and clinics affiliated with the Emory University School of Medicine.

“If we have a 1918, all bets are off,” she said.

The catastrophic swine flu outbreak of 1918 sickened an estimated third of the world’s population and killed more than 50 million people.

Hackman, who stressed such an outbreak today could overwhelm the nation’s traditional methods of dealing with sickness, said it’s too early to write off the current flu pandemic as benign, though the illness has been relatively mild.

In 1918, a spring wave of relatively mild illness was followed a few months later by a wave of the virulent flu after the virus mutated.

Emergency rooms, already overtaxed today, would have difficulty handling huge surges of sick people, and so would hospitals, she said.

“We might have to find a way to use churches and schools and ‘pop-up hospitals’ that are somewhat better than tents,” she said. “Hospital staffers may have to be put up in hotels where people are being treated, but then what do we do with their families and pets? There are still a lot of things we have to think through.”

Even if no testing or production problems occur with a new vaccine for the H1N1 virus, she said, there will not be enough doses for all Americans by this fall.

“We still have challenges ahead of us,” she said before giving a presentation at the Renaissance Hotel on Paradise Road. The session was held as part of a two-day conference on infection control that grew out of the hepatitis C crisis in Las Vegas last year.

She said authorities also have to decide how to deal with airplane passengers who appear to be sick, a challenge that Las Vegas could face because of its tourist market.

“We have an active quarantine station in Atlanta, and a number of people were pulled off international flights and we really didn’t know what to do with them,” she said.

There is only one way to handle the problems a 1918 type of crisis would present.

“Keep planning,” she said. “That’s why these kind of conferences are necessary. People need to exchange ideas.”

Contact reporter Paul Harasim at or 702-387-2908.

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