Xinzhi Zhang, MD PhD, NCID/OD/OS, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS # D-59, Atlanta, GA 30333, 404-371-5364, XZhang4@cdc.gov, Martin I. Meltzer, PhD, Office of Surveillance, Office of the Director, Centers for Disease Control and Prevention, National Center for Infectious Diseases, Mailstop D-59, 1600 Clifton Rd., Atlanta, GA 30333, and Pascale M. Wortley, MD, MPH, NIP, CDC, 1600 Clifton Rd. NE, MS-E52, Atlanta, GA 30333.

BACKGROUND: During the next influenza pandemic up to 35% of the population may become ill, resulting in a large surge in demand for hospital-based services. We designed a simple Table Top Exercise (TTX) tool to aid public health officials and hospital administrators to plan for such a surge in demand. METHOD: TTX tool users provide estimates of their local population in three age groups (0-17, 18-64, 65+) and their available hospital resources (staffed beds, ICU beds, mechanical ventilators). Users select duration of pandemic (6, 8, 12 weeks) and gross clinical attack rates (15%, 25%, 35%). TTX tool then provides estimates of hospital admissions, bed capacity needed, ICU capacity needed, and ventilator usage. We used metro Atlanta as an example to illustrate the impact of an 8 week influenza pandemic, with a 25% attack rate. RESULTS: For metro Atlanta, the demand on hospital resources peaked in week 5, with a maximum of 287 hospital admissions/day. During this week, 1938 persons would be hospitalized, 407 persons would require ICU care, and 203 persons would require mechanical ventilation (27% of all hospital beds, 54% of total ICU capacity, and 29% of all ventilators). Reductions in hospital capacity due to illnesses among health care workers were not taken into account. CONCLUSIONS: Sample results from TTX tool illustrate how the next influenza pandemic may overwhelm existing hospital resources given that hospitals increasingly operate at full capacity. Public health officials and hospital administrators must plan for surges in demand for hospital services during the next pandemic.

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