When the Emergency Department at HHC's Queens Hospital Center saw more than 400 people in one day last May, hospital leaders knew they had to take emergency action. The new H1N1 flu virus first resulted in an overflow of worried-well patients, but quickly led to a surge of those with influenza-like-illness.

"It was difficult to anticipate how the virus was going to behave and how the public was going to react to the alarming (but ultimately inaccurate) reports from Mexico," said HHC President Alan Aviles. "We learned a lot last spring, not just about this virus, but also about the most effective strategies to deal with a cascade of patients seeking information, reassurance and treatment."

In preparation for what is expected to be a very challenging flu season, Mayor Michael R. Bloomberg, Aviles, New York City Department of Health Commissioner Thomas Farley, and officials from the Department of Education and the Office of Emergency Management held a high-profile flu summit on September 1 to unveil the plans for a strategic citywide response.

“There will be many efforts to keep New Yorkers informed about what we are doing to prepare for the return of the H1N1 and seasonal flu,” said Mayor Bloomberg. “We can't predict this year's flu season, but we can make sure that City government is fully prepared for whatever happens.”

The City's preparedness strategy was developed over the summer with the help of 15 workgroups and will focus on an aggressive public information effort, an open schools policy, providing access to vaccination and treatment, and alleviating hospital emergency room surge. The vaccination strategy will greatly depend on the arrival of the new vaccine, which is not expected to be available until at least mid-October.

City health officials said the H1N1 flu strain is not expected to cause unusually severe illness, but it is likely to lead to a broader spread of influenza this season. They estimate that approximately 800,000 New Yorkers came down with flu last season and 52 New Yorkers died from H1N1. This compares to the more than 1,000 New Yorkers who die each year from complications brought on by the seasonal flu.

Citywide readiness measures will include:

• Guiding patients to appropriate care. Few patients with flu symptoms require hospital care, but many go to emergency departments if they don't know about alternatives. An aggressive public information campaign will raise awareness about how to manage symptoms, when to seek care and where to find it.
• Developing alternate treatment sites. HHC will designate primary-care clinics to offer seasonal flu vaccinations as well as H1N1 vaccines to the public once they are available. Federally qualified health centers will also provide vaccinations and care. HHC emergency departments will also set up alternative sites near the EDs to treat patients with mild flu symptoms, if necessary, to alleviate overcrowding.
• Providing vaccines to school children. The City will offer free flu mist and flu shots for H1N1 on-site to all elementary school students whose parents want them to receive it. Free vaccinations will also be available on weekends at designated neighborhood schools for middle and high school students.
• A robust web site for information. The City Health Department created an online resource at nyc.gov/flu where visitors can find the nearest source of vaccinations and other non-emergency care.
• Flu consultation by telephone through 311. Any New Yorker can get flu-related information and educational materials by calling 311.

September 2009