This year's flu season is busy, and it's being made even worse in some areas by a nationwide shortage of IV fluids.
Nearly every state in the country is experiencing widespread flu outbreaks, and Nebraska is no exception.
There have been more than twice as many positive influenza laboratory tests in Nebraska this flu season compared to last year, and Nebraska ranked fifth among states with the highest levels of flu activity in the most-recent weekly Walgreens Flu Index.
As of Dec. 30, there had been more than 2,000 lab-confirmed cases of the flu statewide.
More up-to-date data from Lancaster County showed 237 positive tests here as of Wednesday.
This year's most-active flu strain has been causing serious illnesses in some people, especially the very young and the very old.
Tim Timmons, supervisor for the Lincoln-Lancaster County Health Department's communicable disease program, said more than one-third of the confirmed cases in the county are in people 65 and older and more than half are in people 50 and older.
As of Dec. 30, there had been 306 flu-related hospitalizations statewide and eight flu-related deaths, with two of those occurring in Lancaster County. The average age of those people was 86. Those numbers will be updated Friday.
Bryan Health spokesman Edgar Bumanis said the hospital's two Lincoln campuses had 91 admissions of people with "influenza-like" illnesses last week, which is more than double the average of 35 per week that it typically sees when the flu season is in its early stages.
As of Wednesday, the hospital system had 18 in-patients at its two campuses with lab-confirmed cases of the flu.
"It seems higher than what we've had in recent years," he said.
CHI St. Elizabeth spokesman Evan Sheaff said the health system has seen an increase in flu patients across its several Nebraska hospital locations, and Lincoln is no exception.
At St. Elizabeth, "we have seen a significant increase in viral respiratory illnesses — this includes influenza," Sheaff said in an email.
However, he said, volumes have not been unusual or larger than expected.
Statewide, about 6 percent of all emergency room visits the last week of December were for influenza-like illnesses.
The numbers are higher in Lincoln and are increasing. As of Dec. 30, nearly 11 percent of local hospital admissions were for people with flu symptoms. As of Jan. 6, that jumped to 14 percent.
The increase in flu cases comes at a time when fluids used to deliver medicine and treat dehydrated patients are in short supply.
Supplies of saline and nutrient solutions were already tight before hurricanes pounded Puerto Rico last year and cut power to manufacturing plants that make much of the U.S. supply of fluid-filled bags used to deliver sterile solutions to patients.
Hospital officials, pharmacists and other staff have been devising alternatives and workarounds, training doctors and nurses on new procedures and options, and hitting the phones to try to secure fluids from secondary suppliers.
"If we can't support patients coming in emergency rooms who have the flu, more people are going to die," predicts Deborah Pasko, director of medication safety and quality at the American Society of Health System Pharmacists, a professional group. "I see it as a crisis."
Both Bryan and St. Elizabeth said they have been hit by the shortages but have been able to work around them so that patient care has not been affected.
Scott Persson, Bryan's pharmacy manager, called the shortages "very real and ongoing concerns."
But he said the organization's two hospitals have been able to meet their patients' medication and fluid needs.
"This is being done via adapting numerous methods of delivering therapy in order to conserve available resources, as well as engaging several vendors to maintain the most-stable supply line possible," Persson said in a statement.
Sheaff, the St. Elizabeth spokesman, said CHI hospitals across the country have been able to shift around supplies of IV solutions to hospitals with the most-critical needs.
St. Elizabeth and other CHI hospitals also have made changes to preserve fluids, such as administering some antibiotics through a syringe rather than an IV bag.
Because of those measures, "A patient will not have a different experience at St. Elizabeth, or any of our other facilities, due to this shortage."
Timmons said it's likely to be several weeks before flu cases start to decline.
"At this point the trend is up," he said. "We don't know when it will peak."
In the meantime, he recommended people who have not gotten a flu shot to do so. Also, he said those with flu-like symptoms should stay home from work or school.