10/14/2001 - Updated 10:39 PM ET
By Julie Appleby, USA TODAY
The nation's already crowded emergency rooms could face a tough winter, with the combined effects of the flu season and a public jittery over possible bioterrorism attacks.
Some hospitals in the Northeast are reporting people asking for anthrax tests, even though there's no indication they might have been exposed to the bacteria.
Crowding problems this winter could be exacerbated because:
* Symptoms of anthrax and other bioterrorism attacks mimic those of the flu, possibly scaring patients to seek help at emergency rooms when they otherwise might not ask for help.
* Production problems have delayed delivery of the flu vaccine, which could result in more illness if patients fail to get immunized.
* A shortage of nursing staff and specialist physicians willing to serve on-call in ERs continues.
A sharp increase in patients "could be devastating," says Joseph Waeckerle of the American College of Emergency Physicians.
He says emergency rooms "are already plagued with overcrowding problems and staffing issues, especially due to the severe nursing shortage."
Health departments, including those in New York and Massachusetts, say patients should not flock to emergency rooms with anthrax fears unless they were in known exposure areas, such as the NBC offices in New York that received a tainted letter or the newspaper facilities in Florida where one man died after contracting the disease.
The illness is not spread from person to person but instead by spores that can be inhaled or pass into the body through skin cuts.
Nasal swab tests have been requested by some patients in the wake of news reports about colleagues of the dead worker in Florida having them.
The swabs are not an accurate way to diagnose anthrax, however, health officials say. Blood tests are better.
But both tests "are unnecessary in the absence of a known anthrax exposure," the Massachusetts health department advised medical workers last week.
Even without anthrax fears, emergency room overcrowding has been an increasingly worrisome issue in parts of the nation.
In Los Angeles, Boston, Phoenix and other cities, ambulances are sometimes diverted from the closest hospitals to ones farther away because the hospitals or their emergency rooms are too full.
Adding to the problems are a shortage of nurses, hospital closings and decisions to reduce the number of beds to save money and a lack of after-hours clinics or doctor offices.
"Things have not improved," says Art Lathrop, emergency medical services director in California's Contra Costa County. "If anything, they're getting worse."