Longer waits, higher admission rates and a very busy staff. This is what a flu pandemic looks like to Dr. Kevin Garrett, the chief medical officer at Christus St. Vincent Regional Medical Center.

Likewise, other health providers in Santa Fe say they are slammed as the swine flu (H1N1) outbreak has infected patients at a steeper and earlier rate than anticipated.

"We're seeing an incredible surge in patient loads," said Dr. Richard Lieberman, a physician who manages Santa Fe Urgent Care on Rodeo Road as well as clinics in Los Alamos and Española.

The surge isn't only in adult patients. Garrett said the pediatric clinics owned by Christus — Arroyo Chamiso and Camino Entrada — are each seeing up to 50 children a day just with H1N1 flu or its symptoms.

Still, health providers say years of planning have helped them prepare, and they are ready if it gets worse — a definite possibility, since some estimates are that the virus will hit 40 percent of the U.S. population.

Medical staff and bed space can be expanded quickly, and there are stockpiles of essential supplies such as masks, gowns and respirator kits. The state has enough antiviral for the more vulnerable patients, said Dr. C. Mack Sewell, the state epidemiologist who has been part of pandemic planning, noting, "Everyone is very busy, but we can cope." Christus has antiviral available for indigent patients as well.

"Were seeing hundreds of patients on the weekends, double from a year ago," added Lieberman. "I have brought in more providers to cut the wait times."

Dr. Eric Kraska, who heads up the physician group at the Christus St. Vincent emergency room, said he has a doctor on 24-hour call to come in if needed, and other physicians are extending their shifts. He said 25 percent of the ER caseload is flu-related.

While big-city hospitals can divert patients to other emergency rooms if they fill up, "We are the only hospital in the community" with an ER, Kraska pointed out. "We can't go on divert. Flu season changes the resources."

Other Christus departments have already added staff to be ready, sometimes hiring temporary workers or upping available hours for part-timers. The hospital has also limited the number of visitors, including young children, to curb infection, Garrett said.

Christus is planning a separate compound near the emergency room for a "flu fast-track area" with staff and supplies so it won't impact the regular Emergency Room, which serves as the regional trauma center.

They also have contingencies to expand bed space, if needed, at nearby offices, including Physicians Plaza.

Sewell said most facilities in the New Mexico have enough physical space for a mass pandemic, or can acquire it. "It's not a matter of the physical bed space, but having the staff to attend patients," Sewell said.

"It does test our resources, but we have a sufficient number of people in place," said Todd Sandman of Presbyterian Health Services, which manages 35 clinics and hospitals across New Mexico, including Española Hospital.

Still, the question of preparedness came up last week as pharmacies and health offices throughout Santa Fe ran out of the seasonal flu vaccine. Even Christus St. Vincent received just a portion of its order as manufacturers shifted production to the H1N1 vaccine, Garrett said. He expects that to change, and more seasonal vaccine to become available, as the flu season progresses and then peaks in February.

So far there have been very few cases of seasonal flu, said Sewell. Not true with H1N1, which surfaced early in 2009 and took off with the start of school.

"It never went away, it stayed through the summer and we've been monitoring it," said Martin Vigil, emergency management director for Santa Fe County.

Most H1N1 patients get typical flu treatments, stay home and are just fine. Neither the hospital nor clinics are even testing most patients, unless there are complications. "Those that are not high-risk and have normal symptoms are just fine after a few days," said Lieberman.

He added, though, that there have been a handful of healthy children and young adults with no chronic health complications (such as asthma, diabetes or respiratory problems) who have died. "In New Mexico, some of those were not predictable. That is the tragedy of this virus," said Lieberman.

H1N1 vaccine

The state is starting to receive its H1N1 vaccine. Some 4,800 doses are expected in Santa Fe County, though shipments have already been delayed. Christus is already vaccinating nurses and medical staff — front-line medical providers need the protection — and shipments will continue throughout the winter, Sewell said.

Vigil said the public can help by respecting the priority order set for the vaccine, which includes those who are pregnant, infants, and health-care workers. The priority is set by federal health officials.

"Now is the time for social responsibility and calm," said Vigil. "Follow the guidelines and allow those priority groups to acquire the dosages first."

Kraska added that patients should take stock of their symptoms and only seek emergency help if they are high-risk, have a high fever, chest pains, shortness of breath, and/or severe vomiting. (For more information Google "Flu Decision Chart" on the Internet).

And there may be some good news to the steep curve of infection in New Mexico. It may mean the H1N1 virus will go away sooner.

"There are a lot of unknowns with this; we may see a peak really soon," said Sewell. "Or maybe a peak, followed by a lull followed by another peak. We don't really know what we're in for."

Contact Bruce Krasnow at brucek@sfnewmexican.com.