COCOA BEACH, Fla. – The winter influx of snowbirds and other visitors to the Space Coast, combined with a relatively high incidence of flu, are creating a busy time for Brevard County hospitals and emergency medical crews.
“Flu cases are on the rise, and our region has the highest percentage of influenza-like illnesses at emergency departments and urgent-care centers statewide." said Matthew Gerrell, vice president of marketing & communications for Health First, which operates hospitals in Cocoa Beach, Melbourne, Palm Bay and Viera. He cited data from the Florida Department of Health.
Gerrell said the number of people experiencing respiratory issues also has increased recently, News 6 partner Florida Today reported.
The situation isn't limited to Health First hospitals. Every winter, hospitals around the state have to be prepared for an increase in patients, as snowbirds and visitors flood into the state. Outbreaks of flu or other communicable diseases can add the stress on health care providers.
"This isn't a Health First situation or a Brevard County situation," Gerrell said. "It is a statewide situation."
Other hospitals in the area noticed similar traffic:
"Seasonal fluctuations in patient census are common for all hospitals and planned for," said Natalie Sellers, vice president of communications, community and corporate services at Parrish Medical Center in Titusville. "This year has been an active flu season. However, the winter months are commonly busier for doctors’ offices, clinics and hospitals."
This is the height of flu season, and both Rockledge and Melbourne are seeing a surge of patients with flu and flu-like symptoms on top of the usual injuries and illness," said Eileen Bentley, marketing manager of Wuesthoff Health System, which has hospitals in Melbourne and Rockledge. "Nationwide, this is one of the strongest seasons on record for flu, stomach flu and other sinus-related issues. Within the first three weeks of February, we did see a higher number of patients, but numbers are slowly returning to more normal levels this past week."
Health First, the largest health system in Brevard, said its four hospitals combined averaged 83 percent capacity in February, with 722 out of 867 beds occupied, Gerrell said. That compares with an average of 689 out of 867 beds occupied, or 79 percent capacity, during February 2016.
A few weeks ago, Health First's flagship hospital, Holmes Regional Medical Center in Melbourne, exceeded 90 percent capacity.
As required by federal law, Gerrell said, "every single person who comes in our door gets seen" by medical staff.
"If you come in, we're going to help you out," Gerrell said.
That's true, even if the person's medical conditions might be more appropriately handled at an urgent-care clinic or a family physician, rather than a hospital.
The county also experiences increased demand for ambulance services during the winter months, said Orlando Dominguez, Brevard County Fire Rescue's assistant chief for emergency medical services operations,
"Sometimes, we do see a spike in volume," Dominguez said.
When there are a number of ambulance transports, combined with many walk-in visits to a hospital emergency room, "it's almost like the perfect storm."
The issue is exacerbated when Brevard ambulance crews transport patients to hospital emergency rooms, and the wait times get long.
A good turnaround time would be 15 to 20 minutes from the time when the two-person ambulance crew arrives with a patient and when the crew can leave after turning the patient over to hospital medical personnel.
But, when there are several ambulance crews at a hospital at the same time, and they each are waiting for 30 minutes to an hour, it becomes an issue, because the crews are off the road and unable to respond to another call.
"Then, the system gets a little bit strained," Dominguez said.
When that happens, Dominguez said, district fire chiefs contact hospital staff to ask whether the hospital wants Brevard County Fire Rescue to temporarily divert additional non-critical emergency patients away from the backed-up hospital emergency room, and instead transport patients to another nearby hospital whose emergency room may be less crowded.
Dominguez emphasized that the diversions do not affect critical calls, in which patients always are transported to the closest hospital.
The diversions could occur for patients with such less-critical medical conditions as having the flu or for a "slip-and-fall" incident with no major injuries, Dominguez said.
Dominguez said, as a result of the "tremendous job" local hospitals do in managing their patient flow, there have been only four diversions in the last six months involving local hospitals. And those, he said, were the result of medical equipment being down for maintenance or the emergency room not having certain specialized medical personnel on duty at a particular time, rather than because of patient volume.
Gerrell said there are times when patients come to a hospital emergency room when an urgent-care center might be more appropriate.
Examples Health First cites include such things as an eye irritation, a mild fever, a nosebleed, animal or bug bites, minor burns and rashes.
"Right or wrong, they are coming into the emergency room," Gerrell said. "We're able to handle it," although, for the patient, the wait time typically will be longer and the bill higher than at an urgent-care center or primary-care physician's office.
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Health First says the average emergency room wait time for a non-critical medical condition could be two to four hours, since patients with the more critical conditions like a gunshot wound or a heart attack will, in effect, move to the front of the line.
Gerrell said the wait time at Holmes for people with relatively minor conditions can be higher at times than at other Brevard hospitals, since Holmes is the county's only "Level 2 trauma center" to handle serious injuries.
Additionally, an average emergency room visit can cost an average of more than $1,000, significantly higher than an average urgent-care center visit.
But there can be extenuating circumstances when an emergency room visit may be appropriate — even for what might be considered a minor medical condition. Gerrell, for example, cites someone who experiences a mild headache, but who had a stroke a month earlier, or someone who is experiencing vomiting or diarrhea after having a gastrointestinal medical procedure.
Gerrell said Health First in the last few years has instituted new procedures to overcome issues related to high patient volume, including streamlining discharge of patients who are cleared to leave the hospital, so that beds can be opened up for incoming patients. It also adjust staff levels to accommodate the increased patient loads.