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Surge plan in place for Zika crisis at Florida hospital

Crisis is at a level 3 alert for Baptist Health South Florida, which is the lowest level, but could rise if virus spreads.

Susan Morse, Senior Editor

Baptist Health South Florida is among several health systems in southern states that are at the epicenter of growing concern over the spread of the Zika virus.

In its weekly update, the Florida Department of Health reported three new non-travel related cases of Zika in Miami-Dade County, where Baptist Health South Florida has hospitals and primary care facilities. Florida's health department on Friday also reported 10 new travel-related cases in the state, with one involving a pregnant woman. 

In June, Florida was the first state to report a case of local transmission of the Zika virus. It has since spread to Texas, as a resident of Texas caught Zika after travelling to Florida and brought the virus home, health officials said. Zika has also been linked to an infant's death in Texas.

Pregnant women are at greatest risk because the virus can cause the birth defect microcephaly and other neurological disorders.

Florida authorities said they still believe active transmissions are only taking place within a less than one-square mile neighborhood called Wynwood in Miami-Dade County.

The crisis is at a level 3 alert for Baptist Health South Florida, which is the lowest level, according to Jack Ziffer, MD, chief medical officer for the health system. Should Zika spread beyond the Wynwood area, the alert level could be raised, he said.

[Also: Researchers identify a key weapon of Zika virus]

The situation is updated daily within the health system, which has a plan in place for testing those who have symptoms of the virus; those without symptoms who want to be tested; pregnant women; and those concerned they may be reservoirs for infecting others.

The provider's plan follows protocols by the state, which so far has conducted testing on 3,340 people for the Zika virus.

While specific testing figures for Baptist Health South Florida were not available, what Ziffer and others want to avoid is having the emergency rooms of the system's half-dozen hospitals overwhelmed by people seeking to know whether they are infected.

What's needed is the right care, at the right level, Ziffer said.

"People want to be tested in an ER (who are) without symptoms," he said. "We need to figure out communications should we be overwhelmed in the ER. For people who are symptomatic, they need to be seen by a healthcare provider."

The Obama administration this month shifted $81 million from the Department of Health and Human Services to research to develop a Zika vaccine.

[Also: Zika: Cases rise in Miami, Clinton tells Congress to come back]

Baptist Health South Florida is working to get those without symptoms to its urgent care centers and low acuity destinations.

"Every patient needs a doctor, needs counseling," Ziffer said. However, he added, "The less we have that disrupt our existing emergency operations, the better off for all patients served."

Communication will especially be needed during flu season, as Zika symptoms can mirror those of the flu.

"To date, this has not been a work flow impediment to the normal care, to the high level of care we give patients," Ziffer said.

To warrant testing for Zika, which is a blood test, the state lab requires that the patient have symptoms or meet other conditions.

"It can't be on demand testing," Ziffer said. And, "It may or may not be paid by insurance."

To be tested, the patient needs a document from the state health department, and physician approval, in the form of a prescription for the testing.

[Also: HHS shifts $42 million to Zika fight, money previously set aside for Ebola response]

There is currently a lag time of about a week between testing and the results.

"All of us are concerned about ... we've got a very mobile society, the ease with which it took root in Wynwood, presumably by a mosquito," Ziffer said. "It bit someone in the home and bit someone else in the home and (spread through) person-to-person transmission."

Another concern is what will happen when children go back to school.

"Kids would be a straight-forward pathway to the spread of the virus," Ziffer said. "They are in outside play areas, go home to parents, parents of general child-bearing age. I think all of us have concerns. The health system is anticipating the surge if this goes county-wide, what might the guidelines be. We've worked on surge plans. Our hope is we won't need to implement them."

Twitter: @SusanJMorse

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