Obama’s swine-flu declaration allows off-site ERs

President Barack Obama's national-emergency declaration to deal with H1N1 influenza will allow Virginia hospitals to respond rapidly if the pandemic worsens here, Gov. Timothy M. Kaine said yesterday.

But it won't lead to the production of any more vaccine against the disease known as swine flu.

Obama's declaration of a national emergency -- signed Friday night and announced yesterday -- means that hospitals can set up emergency rooms off-site if needed to treat influenza cases and protect other patients from infection.

The outbreak in Virginia is not serious enough at this point to implement such changes, Kaine said in a statement. State health officials said Friday that the H1N1 flu may be peaking in Virginia and could start to decline.

Kaine noted that the state is moving forward on vaccination, treatment and public education.

"In the meantime, I encourage Virginians to keep up preventive measures like hand-washing, covering one's cough or sneeze, and other similar steps."

Mark Levine, deputy commissioner for emergency preparedness for the Virginia Department of Health, said the national-emergency declaration is a precaution.

"If we get to a point of needing to set up alternate care facilities or take other unusual efforts to take care of a lot of patients, all of the legal aspects are in place to allow us to have waivers," he said.

"In planning for pandemic influenza, we identified the potential for a huge surge of patients where hospitals have used up all their spaces and need other facilities."

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Karen Nelson, a spokeswoman for the HCA Virginia Health System, said the hospital system expects to work closely with the state Health Department "as things evolve."

Vaccine supplies are a separate issue, said Levine, who noted that "vaccine is totally dependent on the producers." Not only are they producing it as fast as they can, but also the state is distributing vaccine as fast as it can, he added.

Obama's national declaration comes with the disease more prevalent than ever in the country and with production delays undercutting the government's initial estimates that as many as 120 million doses of the vaccine could be available by mid-October.

Health authorities say more than 1,000 people in the United States, including almost 100 children, have died from the H1N1 strain of flu, and 46 states have widespread flu activity.

The swine-flu death of 6-year-old Heaven Wilson of Amelia County on Wednesday "certainly heightens the level of concern," Levine said.

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So far, only 11 million doses have gone out to health departments, doctor's offices and other providers, according to the Centers for Disease Control and Prevention.

The federal government now hopes to have about 50 million doses of swine-flu vaccine out by the middle of next month and 150 million in December.

In the Richmond area, vaccine shortages have led to cancellations of some immunization clinics at schools. The Richmond City Health District is saving its few remaining doses for pregnant women and front-line health-care workers.

Levine encouraged people to take influenza symptoms seriously, but not to flood emergency rooms needlessly.

"Between private health-care providers, the state hot line and Web-based resources, there are means to help you figure out the best action at the time. The important thing is not to deny, not to ignore what's going on, but to seek out help."

The national declaration means U.S. Health and Human Services Secretary Kathleen Sebelius now has authority to bypass federal rules when opening alternate care sites, such as off-site hospital centers at schools or community centers if hospitals seek permission.

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Some U.S. hospitals have opened drive-throughs and drive-up tent clinics to screen and treat swine-flu patients. The idea is to keep infectious people out of regular emergency rooms and away from other sick patients.

Hospitals could modify patient rules -- for example, requiring them to give less information during a hectic time -- to quicken access to treatment, with government approval, under the declaration.

The national-emergency declaration was the second of two steps needed to give Sebelius extraordinary powers during a crisis.

On April 26, the administration declared swine flu a public-health emergency, allowing the shipment of roughly 12 million doses of flu-fighting medications from a federal stockpile to states in case they eventually need them. At the time, there were 20 confirmed cases in the U.S. of people recovering easily. There was no vaccine against swine flu, but the CDC had taken the initial step necessary for producing one.

"As a nation, we have prepared at all levels of government, and as individuals and communities, taking unprecedented steps to counter the emerging pandemic," Obama wrote in the declaration.

He said the pandemic keeps evolving, the rates of illness are rising rapidly in many areas, and that there's a potential "to overburden health-care resources."

Contact Katherine Calos at (804) 649-6433 or .

The Associated Press contributed to this report.