Fighting the flu with tents and tweets

Pat Crocker and his crew got creative in coping with an H1N1 flu surge last fall.

Pat Crocker, D.O.’80

Most medical centers expected the H1N1 flu virus would increase their patient counts this year, but last fall Pat Crocker, D.O.’80, and his colleagues found themselves in an especially hot spot for the flu and in the media.

“Austin turned out to be one of the early epicenters of H1N1,” says Crocker, emergency medical director at Dell Children’s Medical Center of Central Texas. “We started seeing flu patients in early September and got up to 400 a day, 70 percent with the flu or influenza-type illnesses.”

Fortunately, Crocker and the Dell team were ready. They expanded their “surge capacity” plan made after the terrorist attacks on Sept. 11, 2001, and used during Hurricanes Katrina and Rita. The plan mapped out a pandemic care area that provided immediate, delayed and overnight care capacity, with pre-packaged and palleted supplies ready for rapid deployment. The plan also featured three Western Shelter tents, erected on the medical center’s parking lot, that could be assembled in two hours and provided a weather-secure environment.

How did patients feel about being treated in a tent?

“They were really happy,” Crocker says. “They would drive up and see a swarm of patients and think they would have a long wait, but it was very efficient. From intake to dismissal, a patient would be in and out typically under 30 minutes. And the kids and families thought the tents were kind of cool.”

The tents relieved the load on the medical center’s emergency room and kept the highly contagious from other patients, he says. The well-organized process likely kept people from getting sicker, too.

“Before the tents were up, 8 to 10 percent of our patients were leaving the hospital without being seen” because they didn’t want to wait, he notes. “That fell to less than 1 percent after the tents were erected.”

The tents also drew a surge in media attention. ABC’s “Good Morning America” and CBS’s “The Early Show” both broadcast from Dell, and almost 80 other television and radio stations covered the hospital.

“Our 15 seconds of fame lasted a little too long,” Crocker laughs.

Dell and its parent organization, Seton Family of Hospitals, used the social media website Twitter as well as tents to tackle the flu surge. Crocker and a fellow emergency medical physician, Tate Ehrlinger, posted daily and sometimes hourly reports – “tweets” – about H1N1, physician recommendations and other helpful tips (

While the number of flu patients at Dell has declined to about 200 per day, Crocker and his colleagues continue to watch for signs of the H1N1 making an antigenic shift. That occurs when two or more different strains of a virus or different viruses form a new subtype that could be more virulent or resistant to the vaccination.

“I think we were really lucky that we didn’t see that. Most patients seemed like they had a bad cold,” Crocker says. “In the months ahead, we will see if the H1N1 virus recombines with the bird flu or other virus.”

He’s also concerned by the virus’s high incidence among people under age 18, and the fact it’s “clearly active” in summer months. “That’s really unusual for the flu,” he says. “You have to wonder what’s in the future – seeing the flu year-round?”

Worried whether your child has the flu?

Pat Crocker, D.O.’80, chief of emergency medicine at Dell Children’s Medical Center in Austin, TX, advises parents to call or see a doctor if a child has flu-like symptoms and

  • is younger than a year old
  • is more ill than you would expect
  • has a fever for more than three days
  • is lethargic and symptoms do not improve after taking Tylenol
  • has an existing chronic illness or some other risk factor.

He advises a trip to the emergency room if symptoms include shortness of breath, chest pain, trouble breathing, persistent vomiting, seizures or confusion.


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