Two More New Yorkers With Swine Flu Die
By ANEMONA HARTOCOLLIS
Published: May 26, 2009
A waiting area at Maimonides Medical Center in Brooklyn was converted to a flu clinic, which was filled with patients who were awaiting evaluation on Tuesday.
Evan Abramson for The New York Times
Two more New Yorkers have died with confirmed cases of swine flu, the city’s health commissioner said on Tuesday, bringing the city’s total number of deaths related to the virus to four. Emergency room visits and hospitalizations also continued to rise.
The commissioner, Dr. Thomas R. Frieden, said the two latest casualties, a 41-year-old woman in Queens and a 34-year-old man in Brooklyn, were linked to the H1N1 virus by lab tests completed on Monday and Tuesday. Both patients had underlying health conditions that put them more at risk, he said. He added that he could not say officially whether the flu had caused their deaths until autopsies were finished. Both died on Friday.
Officials have cited underlying conditions as a factor in all four deaths in the city, but they have not revealed those conditions, citing medical confidentiality.
Five more public schools were closed on Tuesday because of suspected swine flu cases, while more than a dozen that had been closed were reopened.
“It’s good that they’re back because they were missing a lot of school days, but in a way it’s frightening,” said Elizabeth Rosa, 33, a home attendant, after seeing off her daughter, Jasilyn, 11, and son, Kristian, 8, at the entrance of Public School 19 in Corona, Queens. “When I kissed them goodbye I thought, ‘Is it going to be O.K.? Is the school safe?’ ”
Dr. Frieden, speaking at a news conference at the health department, noted that both patients who died were relatively young. Health officials have said that there is some evidence that people born before 1957 may have been exposed to a similar virus and may have some immunity to the novel strain of flu that is circulating.
Hospitals that normally get about 200 visits to the emergency room each day are getting 2,000 per day, he said, and more than 25,000 people have gone to emergency rooms over the past month. The numbers are highest in Queens, but are increasing in Brooklyn and, to a lesser extent, in the Bronx and Manhattan.
Over the last five days, he said, 20 to 25 people a day have been hospitalized with the flu. Before the weekend, the city had recorded only 57 hospitalizations for flu during the entire preceding 30 days.
Dr. Frieden said the numbers of emergency room visits have been rising over the past week, perhaps driven by the publicity surrounding the deaths, but also by the pervasiveness of the virus through the general population.
To put the current situation in perspective, Dr. Frieden said that in a regular flu season, 400,000 to 1 million New Yorkers get the flu, and about a third of them never even realize it.
Of those who have gone to the emergency room, fewer than 1 in 50 needed to be admitted to the hospital, Dr. Frieden said. “The vast majority of people going to the hospital emergency department probably shouldn’t be going,” Dr. Frieden said. Similarly, he said, a spot check of schools with high absenteeism showed that two-thirds of the children who were kept home were not sick.
The pressure on emergency rooms could be seen on Tuesday at Maimonides Medical Center in Brooklyn, where many sick parents came in with sick children. The hospital created a flu clinic in an area that usually accommodates patients who have been admitted and are waiting for a bed. It was filled on Tuesday with people in masks being evaluated for flu.
Last year in May, the Maimonides emergency room saw an average of 263 patients a day. On Monday, emergency room doctors saw 480 patients.
“The consensus among these physicians,” said Dr. Steven J. Davidson, the chairman of the hospital’s emergency medicine department, “is that the influenza is mild but the patients are unusually scared.”
While the ailments that may have made the four New Yorkers who died more vulnerable to the flu have not been identified, federal and city health officials have released a list of conditions that increase the risk from flu. They include being older than 65 or younger than 2; respiratory ailments like asthma or emphysema; a weakened immune system because of pregnancy, diabetes or immune-suppressing drugs like steroids; tuberculosis; heart disease; kidney disease; and morbid obesity.
With reports of new flu cases tapering off around the country ― except in New York, New Jersey and New England ― federal health officials said on Tuesday that they would concentrate on tracking the swine flu’s progress in the Southern Hemisphere and preparing for a surge of cases in the fall.
Outside of the Northeast, reports of people with flu symptoms who visited doctors and hospitals dropped to normal levels for late May, said Dr. Anne Schuchat, director of immunization and respiratory disease for the Centers for Disease Control and Prevention.
Although Dr. Schuchat would not say that the flu had peaked for the season, she said the country was “at a transition point” and officials would look ahead to the next season, which usually begins in November.
Since the flu was identified in New York in late April, the city has closed 42 schools in 31 buildings, Dr. Frieden said. Schools have generally been closed for five days.
Since then, 25 have reopened, including about 20 on Tuesday. Most of the newly reopened schools had more than 85 percent attendance on Tuesday, although more than a quarter of the students at Public School 35 in Hollis, Queens, were absent. The handful of schools that reopened on Friday also appeared to have resumed normal routines, with more than 90 percent in attendance, according to the Department of Education’s Web site.
A spokeswoman for the department, Marge Feinberg, said that the overall attendance rate in the city was 82 percent on Tuesday, compared with 87 percent on May 4, before the flu had struck many students. The attendance rate in Queens was 82.6 percent on Tuesday, compared with 88.5 percent at the beginning of May.
Five additional schools are to be closed on Wednesday until Monday: Q811, a special education program at P.S. 822 in St. Albans, Queens; P.S. 231, a special education school inside P.S. 180 in Bensonhurst, Brooklyn (the rest of the building is open); P.S. 369 in Boerum Hill, Brooklyn (only the special education part of the building); P.S. 68 in Wakefield, the Bronx; and the Audubon School (P.S. 128) in Washington Heights.
Reporting was contributed by Ann Farmer, Donald G. McNeil Jr., Jennifer Medina and Mathew R. Warren.
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