Hospital and public health officials who worry about being deluged this fall by sick and worried well patients fearing H1N1 now have comforting federal guidance on how to re-direct crowds without violating the law. First, jammed hospital emergency departments can set up alternate screening sites elsewhere on campus, with personnel stationed outside the emergency department to log in and redirect patients seeking care to that alternate site. This triage system is acceptable as long as the personnel are qualified physicians, RNs, physician’s assistants or nurses trained to perform such exams. Second, hospitals may set up screening at an off-campus site if it is controlled by the hospital. And hospital and community officials may encourage the public to go to these sites instead of the hospital for screening for influenza-like illness. Third, hospitals and community health officials may encourage the public to go to those sites instead of the hospital for influenza screening. And fourth, the required medical screening exam does not need to be an extensive work-up in every patient’s case. The guidance was issued in a fact sheet distributed to hospitals by the Centers for Medicare and Medicaid Services in response to hospital and agency concerns.

However, there are some important caveats.



•  Hong Kong reports 406 new cases of A/H1N1 flu (Link)
•  Pandemic risk of A/H1N1 flu in China increasing: Health minister (Link)

•  India: H1N1 toll continues to mount, reaches 69 (Link)

•  57 positive cases (translated) (Link)
•  Two patients H1N1 in Surabaya dies (translated) (Link)

•  Macao’s A/H1N1 confirmed cases climb to 658  (Link)

•  Sixteenth person succumbs to Swine Flu virus in Spain (Link)

•  Russian H1N1 seed virus for vaccine trials mutates (Link)

United Kingdom
•  Swine flu helplines to be scaled back (Link)
•  Swine flu: don’t coo over newborn babies, experts warn (Link)
•  Scotland: another death (Link)

United States
•  Report to the President on U.S. preparations for 2009-H1N1 Influenza (Link)
•  Flu outbreak could hit poor schools hardest (Link)
•  Speed up flu drugs, says White House panel (Link)
•  Driver Dies of H1N1 Flu on Heels of New Federal Guidelines (Link)
•  SC: 1 case of swine flu confirmed at school  (Link)
•  Sebelius: Closing schools wouldn’t ward off virus (Link)
•  There Could be Serious Social Disruption from H1N1 this Winter, New Federal Report Warns (Link)
•  Pressure to send kids to school sick  (Link)
•  Three Miami U students report flu symptoms  (Link)
•  CO: Fort Collins campus student may have H1N1 swine flu (Link)
•  H1N1 affects 47 at Kansas U (Link)

•  Vietnam’s A/H1N1 flu cases rise to 2,073 (Link)

•  CIDRAP – Studies: Novel H1N1 affects deep lung tissue, transmits fairly well (Link)

•  Flu Fighters Not Content with Calm (Link)