Sources at Middlemore Hospital have expressed concern that two patients may have died after catching the flu when being admitted. 

As flu season applies pressure to hospital resources around the country, there are concerns two patients may have died after catching influenza at Middlemore Hospital, according to two sources spoken to by the Spinoff.

When the two patients came into the hospital’s Emergency Department around a fortnight ago, they were not presenting with flu symptoms, but later died of flu-related complications, said the hospital employees, whom the Spinoff has agreed not to name. “It’s difficult to prove they caught the flu there, but it’s highly likely,” said a nurse.

Through a spokesperson, Middlemore Hospital rejected the claim.

Middlemore, located in South Auckland, is home to the busiest mixed emergency department in Australasia. Triage is long and complicated, flu shots are thin on the ground, and the seating is almost as limited as the bed space, said the sources. With midwinter bringing “flu season,” the wait to be seen at ED grows longer and more dangerous.

Last year, Middlemore added a 30-bed winter ward to cope with the colder months’ increase in flu and flu-related illnesses, said the sources, but the hospital was still struggling to cope. Because ED sees the majority of incoming patients, those with the flu risk coming into contact with other patients as soon as they arrive at the hospital.

Middlemore declined an interview, but responded to questions via email.

Any patient recognised as having influenza was cared for in droplet isolation, said a spokesperson. “Once recognised as having influenza, patients are cared for in droplet isolation. This means masks are worn by health care workers within 1 metre of the patient. Patients only need to be separated from other patients by a minimum of 1 metre to 1.5 metres as this is the maximum droplet spread.”

Asked whether it is true that two people contracted the flu in the Emergency Department last week, and that it developed fatally, the spokesperson replied simply, “No.”

It is estimated that around 500 people die every year from influenza, but there is reason to believe the number may be higher.

“Mortality is not the best indicator of flu severity because so few lethal cases are recorded or identified,” said Michael Baker, professor of public health at the University of Otago, Wellington.

“Most people who die from flu have an underlying illness, and that becomes the reported cause of death.”

If you have an already established condition, that will be what goes on your death certificate; not influenza. “It may be our single biggest infectious disease killer.”

On admissions of people with flu-related symptoms to ED, the spokesperson said: “Some people have been admitted. Most people with the flu are discharged. Those admitted are those at risk, e.g. the elderly, which is why we recommend vaccination.”

When asked what could be done to prevent the flu from developing fatally, Middlemore’s spokesperson said that in select cases antivirals may be used. “At risk people should be or have been vaccinated,” said the spokesperson.

Unfortunately, some sections of the population aren’t always identified as “at risk”.

Baker said that the flu kills not only people over 65, but also some in their 50s and 60s. There’s an intense immune response to influenza that can be damaging to lungs and the lining of blood vessels, leading to premature heart attacks and strokes. Then, there’s secondary pneumonia. Some cases of death from bacterial pneumonia occur following influenza infection, which creates the susceptibility to secondary pneumonia by damaging lung tissue.

“Instead of living for another five or ten years, some people have their lives ended prematurely by flu,” said Baker. 

Well over a million doses of the flu vaccine have been administered so far this year, but have become harder to find. Most communities have been asked by the Ministry of Health to manage and prioritise their remaining stock, suggesting that those who don’t meet high needs criteria wash their hands and practise “safe sneezing”.

Flu season is known to peak in August.