H1N1 influenza activity continues to increase steadily in the United States and flu activity is now widespread in 46 states (FluView, October 2009). Nationwide, visits to doctors for suspected H1N1 influenza are higher now than what is usually seen at the peak of regular flu seasons. In addition, flu-related hospitalizations and deaths continue to go up nationwide. Health authorities have confirmed that more than 1,000 people in the United States, including more than 90 children, have died from complications of the H1N1 influenza.

In response to these daunting statistics, President Obama took additional steps to deal with this pandemic. On October 23rd, 2009 he declared the H1N1 influenza outbreak a national emergency. Administration officials said this emergency declaration was a pre-emptive move designed to make decisions easier when they need to be made. Officials said the move was not in response to any single development. Health and Human Services Secretary Kathleen Sebelius now has authority to bypass federal rules when opening alternative care sites, such as offsite hospital centers at schools or community centers if hospitals seek permission.

So what does that mean for us? Although this declaration seems to be largely a preemptive administrative move, it will give emergency rooms and hospitals more flexibility that they need to be proactive in dealing with this pandemic. By having the flexibility to move emergency rooms offsite and establish additional remote treatment facilities, hospital personnel can speed up the provision of care and treatment and simultaneously protect non-infected patients. To date, some hospitals have already opened drive-thru’s and drive-up tent clinics to screen and treat influenza patients. This has worked well thus far, and definitely helps to lessen the burden on emergency room staff.

In addition, under this declaration, and with government approval, hospitals can modify patient rules to quicken access to treatment. An example of this would be a lessening of required administrative paperwork that needs to be completed prior to a patient with suspected H1N1 influenza being seen during busy times in the ER.

This declaration also addresses a financial question for hospitals, and may allow for hospital reimbursement when treating people at sites not typically approved. This effectively allows hospitals to establish remote treatment centers that can claim federal reimbursement.

This has been a positive move forward by the administration to deal more effectively with the pandemic, but healthcare professionals also need to play their part as well. It is imperative that we recognize that our best defenses in this war against H1N1 are effective handwashing and immunization.