Having lived through Beijing's 2003
SARS epidemic and experienced China's secretive response, it is refreshing to see the U.S. debating how to divvy up
scarce medical resources should hospitals be overwhelmed with pandemic patients.
But I haven't seen much discussion on how to try to prevent medical facilities being deluged with patients who shouldn't be there in the first place.
A doctor at a ground zero hospital in Flushing, NY, told me when the 2009 H1N1 virus first hit the headlines last spring, less than 1 percent who came in for testing were infected. The flood of potential patients not only taxed the hospital, but could have put some of the test-seekers at greater risk of infection.
Let me share a cautionary tale of friends' experience during China's SARS epidemic, and ponder some lessons for the U.S. as it grapples with 2009 H1N1.
My friend writes about his wife's roommates, I'll call them "Mr. A" and his girlfriend "Ms.B":
"Mr. A went on a business trip by train and when he came back, he had the symptoms of a cold. He went to the hospital. It was crowded. He had to wait in the hallway. That was the time when SARS was spread in this hospital and many people contacted the virus this way. He was diagnosed as SARS and was hospitalized.
A few days later, Ms. B had symptoms of a cold too. She went to the hospital, and was diagnosed with SARS, too. Both were given large amounts of steroids.
It is not clear whether they really had SARS, or were (incorrectly) diagnosed with SARS. If they did have it, it is unclear whether the boy contacted SARS in the hospital or on his business trip. There was no report of other SARS patients on the train he took."
My friend's wife had the same symptoms. She worried she would be forcibly hospitalized, regardless of whether she had SARS. So she isolated herself and nursed herself back to health.
Mr. A and Ms. B are reportedly suffering life-long consequences from the steroids, which were administered with the aim of reducing inflammation of the lungs. (According to
this research it was not possible to determine whether such treatments benefited patients during the SARS outbreak. Of 29 studies on steroid use, 25 were inconclusive and four found that the treatment caused possible harm.)
My take-away: The U.S. should improve public education about when to seek medical help for H1N1, the risks of going to crowded hospitals, and the pros and cons of self-imposed isolation. This should be an important component in reducing the burden on overwhelmed health systems.