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Volume 14, Number 3—March 2008

Hospital Resources for Pandemic Influenza

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To the Editor: In their November 2007 article, Pandemic Influenza and Hospital Resources, Nap et al. evaluated hospital resources for pandemic influenza in the northern part of the Netherlands (1). Their results can be compared with those that I have described for the combined suburban communities of Roswell and Alpharetta, Georgia, USA (2). The Netherlands evaluation assumed that antiviral drugs will be available and will reduce hospitalizations by 50% and deaths by 30%. In view of the uncertainty of effective antiviral drugs and timeliness of vaccines, I did not estimate their effects. Nevertheless, several issues warrant comparison.

The plan for the Netherlands has no provisions for urgent care, i.e., parenteral fluids or antimicrobial drugs that are administered to ambulatory patients who are not hospitalized. Nap et al. may not perceive a need for enough beds to handle surge capacity. Allowing for 30% of beds to be used for patients with conditions other than influenza, they report a maximum availability of 232 beds per 100,000 population for pandemic influenza patients, and they estimate use of 72 beds per 100,000 in the pandemic model. In contrast, a maximum of 47 beds per 100,000 are available in Roswell/Alpharetta. Availability of beds in intensive care units, however, is identical for both regions, at 8 beds per 100,000 population.

The Netherlands plan calls for intensified treatment evaluation in 48 hours to withdraw care from patients who have little chance for recovery. Because most patients can be expected to have pneumonia and 2-organ failure (on average), a 50% mortality rate can be expected. In US hospitals, withdrawing care is difficult, even if mortality rates are expected to be 75% or 90% during acute illness with organ failure.

The pandemic influenza resource evaluation from the northern part of the Netherlands provides a useful contrast with at least 1 US hospital. The dramatic difference in bed availability highlights the potential challenges involved in local planning. The surge capacity limits in Roswell/Alpharetta led us to consider an alternative infusion center to provide care during an influenza pandemic.


Michael P. Dailey*Comments to Author 
Author affiliation: *North Fulton Regional Hospital, Roswell, Georgia, USA



  1. Nap  RE, Andriessen  MP, Meessen  NE, van der Werf  TS. Pandemic influenza and hospital resources. Emerg Infect Dis. 2007;13:17149.PubMedGoogle Scholar
  2. Dailey  MP. Pandemic influenza and community medical care. South Med J. In press.


Cite This Article

DOI: 10.3201/eid1403.071570

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Please use the form below to submit correspondence to the authors or contact them at the following address:

Michael P. Dailey, Infectious Disease Services of Georgia, 11660 Alpharetta Hwy, Suite 430, Roswell, GA 30076, USA;

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Page created: July 07, 2010
Page updated: July 07, 2010
Page reviewed: July 07, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.