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Swine flu: Hospitals weigh continuing ban on children over concerns about spread of H1N1
Efforts to stop H1N1 spread have family consequences
By Dahleen Glanton and Lisa Black Tribune reporters
December 13, 2009
At the height of the fall's swine flu surge, hospitals across the Chicago area adopted one emergency measure that was crucial to protecting patients but painful in its own right for some families. They banned children from entering.
The new rules -- prohibiting anyone under 16 or 18 from in-patient areas -- were implemented because children are prolific carriers of the H1N1 virus and posed a threat to patients, particularly those in high-risk categories like pregnant women, newborns and those with chronic illness.
Now, as H1N1 cases wane but experts warn of another possible spike, some hospitals are wrestling with the question of whether -- and when -- to lift the restrictions. For hospital staff, it presents a delicate balancing act -- weighing the health concerns against a patient's need to be comforted by a son, daughter, niece or nephew, and a family's desire to spend time with a sick relative.
With the holidays approaching, the ban raised the disconcerting scenario of a hospitalized cancer patient not being able to see his or her children for days or even weeks.
"It is the topic of conversation among our planning teams, as to what is the trigger (to relax the ban)," said JoAnn Foley, chief emergency preparedness officer at Sherman Hospital in Elgin, which restricts those under the age of 16. "It isn't going to be date-driven. It needs to be driven by the flu."
Among those who have voiced displeasure are Laurent Pernot and Jennifer Solomon, both public affairs consultants from Chicago. Their son, Gabriel, 8, was not allowed to make the trip to meet his new brother Luca after Solomon delivered him at Prentice Women's Hospital on Thanksgiving Day.
"We are conscious of the (infection) issue, but at the same time, it seemed a little bit of an overreach to go so far as banning children," said Pernot, 39, pointing out that he, his wife and Gabriel had waited in line five hours to get the H1N1 vaccine.
The child prohibition is not the only flu precaution being enforced at hospitals.
At Northwestern Memorial Hospital and its affiliate, Prentice, security guards and nurses screen visitors for flulike symptoms, turning away anyone who is coughing, sneezing or has a fever. Some hospitals allow only one guest at a time in a room, forcing families to choose whether a parent or a spouse gets to visit first.
"The reason we elected to (prohibit children) is to protect the safety of our patients and staff," said Dr. Gary Noskin, chief of staff at Northwestern. "One of the features of influenza is that people can start transmitting the infection 24 hours before they have symptoms. ...We felt that restricting (children) was the most effective way to control the spread of the virus."
Most hospitals, however, make exceptions on a case-by-case basis, making allowances for those who are in end of life situations, when there is a particular hardship or when a young sibling is hospitalized.
Deciding when to ease the restrictions will not be easy. Some staffs have been meeting weekly or daily to monitor the rise and fall of cases.
Though swine flu is believed to have peaked in Illinois and the Chicago area, public health officials have urged health care workers and the public not to let down their guard. H1N1 is still circulating, officials said, and there are more cases of flu around than normal for this time of year.
Many Chicago-area hospitals are taking a wait-and-see approach before they return to their usual visiting policies.
Health officials also fear they could lift the restrictions too soon, leaving them unprepared for a possible surge in January when children go back to school and college students return to campus after the holiday break.
"We are trying to be very responsive throughout, on the way up and on the way down," said Dr. Stephen Weber, medical director for infection control and clinical quality at the University of Chicago Medical Center.
"There is a real possibility of seeing a spike in the next few weeks, and we want to be responsible. We don't want to seem like we're changing the rules day to day or hour to hour."
At Loyola University Medical Center in Maywood, officials plan to extend a prohibition on children through the seasonal flu season, which generally runs through early spring. Several oncology nurses at Loyola said last week that they had patients hospitalized for a month who were struggling with the restrictions because their children couldn't visit them.
According to Dr. Jorge Parada, medical director of Loyola's infection control program, some medical experts believe such policies should be enforced year-round, regardless of the flu, because of children's higher tendency to transmit illness. He said there are documented cases at Loyola where visitors spread the flu to patients and staff.
Still, hospital administrators can't help but be aware of hardships due to the policy.
Pernot and Solomon, also 39, were disappointed that the birth of their son could not be a family affair, at least immediately. They said Gabriel had looked forward to meeting his brother at the hospital and tracked his weekly development in his stepmother's belly on the ultrasound.
As it turned out, he greeted Luca a few days later outside the hospital after Solomon came down with the baby.
"It was like Romeo and Juliet, with kids," Pernot said. "Gabriel and I were on the sidewalk with the car seat waving at Jen and the baby up in the room."
http://www.chicagotribune.com/health/chi-hospital-kid-ban_glantonblacdec13,0,4029126.story
Efforts to stop H1N1 spread have family consequences
By Dahleen Glanton and Lisa Black Tribune reporters
December 13, 2009
At the height of the fall's swine flu surge, hospitals across the Chicago area adopted one emergency measure that was crucial to protecting patients but painful in its own right for some families. They banned children from entering.
The new rules -- prohibiting anyone under 16 or 18 from in-patient areas -- were implemented because children are prolific carriers of the H1N1 virus and posed a threat to patients, particularly those in high-risk categories like pregnant women, newborns and those with chronic illness.
Now, as H1N1 cases wane but experts warn of another possible spike, some hospitals are wrestling with the question of whether -- and when -- to lift the restrictions. For hospital staff, it presents a delicate balancing act -- weighing the health concerns against a patient's need to be comforted by a son, daughter, niece or nephew, and a family's desire to spend time with a sick relative.
With the holidays approaching, the ban raised the disconcerting scenario of a hospitalized cancer patient not being able to see his or her children for days or even weeks.
"It is the topic of conversation among our planning teams, as to what is the trigger (to relax the ban)," said JoAnn Foley, chief emergency preparedness officer at Sherman Hospital in Elgin, which restricts those under the age of 16. "It isn't going to be date-driven. It needs to be driven by the flu."
Among those who have voiced displeasure are Laurent Pernot and Jennifer Solomon, both public affairs consultants from Chicago. Their son, Gabriel, 8, was not allowed to make the trip to meet his new brother Luca after Solomon delivered him at Prentice Women's Hospital on Thanksgiving Day.
"We are conscious of the (infection) issue, but at the same time, it seemed a little bit of an overreach to go so far as banning children," said Pernot, 39, pointing out that he, his wife and Gabriel had waited in line five hours to get the H1N1 vaccine.
The child prohibition is not the only flu precaution being enforced at hospitals.
At Northwestern Memorial Hospital and its affiliate, Prentice, security guards and nurses screen visitors for flulike symptoms, turning away anyone who is coughing, sneezing or has a fever. Some hospitals allow only one guest at a time in a room, forcing families to choose whether a parent or a spouse gets to visit first.
"The reason we elected to (prohibit children) is to protect the safety of our patients and staff," said Dr. Gary Noskin, chief of staff at Northwestern. "One of the features of influenza is that people can start transmitting the infection 24 hours before they have symptoms. ...We felt that restricting (children) was the most effective way to control the spread of the virus."
Most hospitals, however, make exceptions on a case-by-case basis, making allowances for those who are in end of life situations, when there is a particular hardship or when a young sibling is hospitalized.
Deciding when to ease the restrictions will not be easy. Some staffs have been meeting weekly or daily to monitor the rise and fall of cases.
Though swine flu is believed to have peaked in Illinois and the Chicago area, public health officials have urged health care workers and the public not to let down their guard. H1N1 is still circulating, officials said, and there are more cases of flu around than normal for this time of year.
Many Chicago-area hospitals are taking a wait-and-see approach before they return to their usual visiting policies.
Health officials also fear they could lift the restrictions too soon, leaving them unprepared for a possible surge in January when children go back to school and college students return to campus after the holiday break.
"We are trying to be very responsive throughout, on the way up and on the way down," said Dr. Stephen Weber, medical director for infection control and clinical quality at the University of Chicago Medical Center.
"There is a real possibility of seeing a spike in the next few weeks, and we want to be responsible. We don't want to seem like we're changing the rules day to day or hour to hour."
At Loyola University Medical Center in Maywood, officials plan to extend a prohibition on children through the seasonal flu season, which generally runs through early spring. Several oncology nurses at Loyola said last week that they had patients hospitalized for a month who were struggling with the restrictions because their children couldn't visit them.
According to Dr. Jorge Parada, medical director of Loyola's infection control program, some medical experts believe such policies should be enforced year-round, regardless of the flu, because of children's higher tendency to transmit illness. He said there are documented cases at Loyola where visitors spread the flu to patients and staff.
Still, hospital administrators can't help but be aware of hardships due to the policy.
Pernot and Solomon, also 39, were disappointed that the birth of their son could not be a family affair, at least immediately. They said Gabriel had looked forward to meeting his brother at the hospital and tracked his weekly development in his stepmother's belly on the ultrasound.
As it turned out, he greeted Luca a few days later outside the hospital after Solomon came down with the baby.
"It was like Romeo and Juliet, with kids," Pernot said. "Gabriel and I were on the sidewalk with the car seat waving at Jen and the baby up in the room."
http://www.chicagotribune.com/health/chi-hospital-kid-ban_glantonblacdec13,0,4029126.story