Though fears of a flu epidemic have so far gone unrealized, emergency rooms throughout Maryland have been taxed to capacity - and in some cases beyond - by an influx of patients complaining of seasonal illnesses.
Dr. Richard L. Alcorta, medical director of the Maryland Institute for Emergency Medical Services Systems, said hospitals across the state called in extra staff, put up temporary beds in some areas and postponed elective surgeries to deal with the increase in patients with winter ailments.
He attributed the heavy patient load - which happens almost every winter - to seasonal occurrences of influenza, as well as a gastrointestinal virus generically referred to as "stomach flu." Pneumonia and bronchitis have also been common.
"Essentially all of our hospital beds, in a lot of our hospitals, are full," Alcorta said. But, he added, "Each year we see some of this."
As of 5 p.m. yesterday, 18 Maryland hospitals were operating under "red" or "yellow" alerts. A yellow alert means the hospital is asking that noncritical patients be sent to the next-nearest facility.
A red alert means the hospital's critical-care beds are full, so people requiring inpatient critical-care treatment should be sent elsewhere, if possible.
Hospitals are not turning away patients with life-threatening injuries or illnesses. Even hospitals that have experienced a large increase in admissions said they have been able to handle the load.
"Winter is busier," said Dr. Dick Kuo, medical director of the adult emergency room at the University of Maryland Medical Center. "We've been very crowded but not overwhelmed."
During his Thursday night shift at Northwest Hospital Center in Randallstown, emergency room physician Dr. Frederick Burke said some patients were being placed on extra beds in the hallways. Although this winter seems busier than the last, he said, it's not uncommon for hospitals to experience yellow and red alerts this time of year.
"It happens all the time," he said. "Patient care is not compromised as a result of it."
Alcorta said that 18 of 22 hospitals in Central Maryland had posted a yellow alert Tuesday. Although requests to divert patients are common, that number was "actually pretty high," Alcorta said.
One problem, he said, is that economic pressures have forced hospitals to reduce the size of their staffs, giving them less flexibility to handle patient loads during heavy periods.
"They've been decreasing their surge capability," Alcorta said. He said people who are sick should seek medical care, but he encouraged those with mild symptoms to either monitor their health for a few days or see their primary-care doctor.
Dr. Michael Pipkin, emergency room director at Franklin Square Hospital Center, said patient volume there has been predictably very high. But many people showing up in the ER didn't need emergency treatment and wound up clogging the system.
"Patients with flu occasionally need to come to the ER, but that's rare," he said. "Those who can't manage at home are typically the very young and the very old."
Dr. Lisa Maragakis, associate epidemiologist at Johns Hopkins Hospital, said flu arrived later this winter than last, when it peaked in mid-December. Hopkins' ER staff has been busy treating flu patients, she said, as well as those with other viral symptoms.
"They're typical wintertime pathogens," she said. "It's not unexpected."
At Anne Arundel Medical Center, the number of emergency patients jumped from an average of 200 to 240 on Sunday, said Margot Mohsberg, a hospital spokeswoman. The number of patients admitted increased from about 25 to 40. She attributed the jump to influenza, stomach flu and a variety of other ailments.
"We are definitely seeing more patients, but we are definitely not overwhelmed," she said.
St. Joseph Medical Center in Towson treated a record number of emergency patients, 183, on Monday. Many were elderly men and women with pneumonia, said hospital spokeswoman Vivienne Stearns-Elliott. Flu did not account for the majority of cases.
As of Thursday, more than halfway through the flu season, the Maryland Department of Health and Mental Hygiene had reported 1,030 laboratory-confirmed cases of influenza. The state recorded nearly 2,200 during all of last flu season.
Federal health officials called for a rationing of vaccine in the fall after factory contamination kept half the nation's supply from reaching the market. But a few million doses are still available, and officials said it's not too late to be immunized.
Meanwhile, area hospital officials said they have tried to cope with longer-than-usual waiting times in emergency rooms by bringing in additional staff.
"You bring in nurses, you bring in techs to help the emergency room," said Michael Schwartzberg, a spokesman for Greater Baltimore Medical Center, which had posted both yellow and red alerts yesterday afternoon. "We've done what we can do to get patients moving through the system."
Sun staff writers David Kohn, Dennis O'Brien and Michael Stroh contributed to this article.