Image: Inauguration rehearsal
Paul J. Richards  /  AFP - Getty Images file
Sparse crowds at this inauguration rehearsal will be replaced by expected record throngs on for Barack Obama's swearing-in ceremony on Tuesday, Jan. 20. Regional hospital expect an influx of emergency room patients, mostly because of crowds and cold. Officials say most illnesses and injuries can be prevented by preparation.
By JoNel Aleccia Health writer
msnbc.com
updated 1/16/2009 4:45:23 PM ET 2009-01-16T21:45:23

Packed crowds and winter cold could put a damper on history for spectators at Barack Obama’s presidential inauguration Tuesday, especially if out-of-towners don’t keep their health in mind.

Hospital officials in and around the nation’s capital say they’re braced for illnesses and injuries ranging from twisted ankles to trauma as expected record numbers of visitors flock to Washington, D.C., for the ceremony. Some medical centers are increasing staffing or cancelling elective surgeries in anticipation and medical aid stations are being set up near the ceremony.

“What we are preparing for are crowd-related injuries, crush injuries,” said Dr. Janis M. Orlowski, chief medical officer for Washington Hospital Center, in the heart of the city. “People can step off a curb and break their ankle, they may fall, they may faint within a crowd.”

Preliminary tourism reports indicate that many elderly and disabled people will be among those who want to witness Obama’s swearing-in as the nation’s 44th president, said Cindy Notobartolo, who heads emergency preparedness efforts for Suburban Hospital in Bethesda, Md.

“You can expect they will need medical care,” said Notobartolo.

There may be problems with medication, especially if visitors don’t bring adequate supplies, or with heart and breathing conditions worsened by spending hours outdoors in frigid weather. Even people in good health might find themselves surprised by temperatures expected to barely top freezing. “It will be things like hypothermia,” Notobartolo said. “People coming from Hawaii certainly don’t know what 20 degrees feels like.

Hypothermia occurs when body temperature drops below 95°F and the heart, kidney or central nervous systems are affected. The condition can be fatal if the nervous system becomes depressed or heart rhythm is altered.

Even the strong feelings associated with witnessing the first African-American to assume the presidency could result in physical symptoms such as fainting or hyperventilating, Orlowski said.

“There will be those people who will be overcome emotionally because they will see a sight they never thought they’d see,” she said.

2 million — or more?
Estimates of the size of the crowds expected to jam the National Mall and the area surrounding the inaugural platform on the Capitol steps have varied wildly, from initial projections of 3 million to 5 million to revised figures of 1 million to 2 million.

Orlowski said she’s now relying on estimates from D.C.-area government, police and emergency services officials, who put the number at about 2 million people.

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“But we’ve heard as high as 4 million and [we] could accommodate that number,” she noted.

That compares with 400,000 who reportedly showed up for George W. Bush's 2005 inauguration, and a record 1.2 million estimated for Lyndon Johnson's ceremony in 1965.

The potential impact of such crowds on emergency departments of local and regional hospitals also has varied widely. On a typical Tuesday, Orlowski said her emergency department sees between 175 and 220 people. On Jan. 20, the number might range from 50 to 100 higher than that, she said.

But Notobartolo said local hospitals have been told to expect between 200 and 1,000 patients a day above their normal levels.

Dr. Bruno Petinaux, emergency department director at the George Washington University Hospital in D.C., said his hospital has canceled all elective surgeries on Monday and Tuesday to leave room for inauguration visitors.

Health officials said all employees have been pressed into service, with mandates to leave early for work or bunk with colleagues who live near the hospital.

"We have told our staff there are no non-essential people here," said Notobartolo. "If you work in accounting, we might find we need you to help register people."

Many potential health problems might be treated before they ever get to the hospital. Nearly 50 medical aid stations staffed by crews of volunteer doctors, nurses and other professionals will be set up on the Mall, near the Capitol steps and the Lincoln Memorial, according to Dr. Pierre Vigilance, director of the District of Columbia Department of Health.

Visitors should prepare themselves
And many more issues could be averted if visitors prepare to manage their own health, Petinaux said.

“I think the key in the messaging is that preparedness is on the side of the attendees,” he said. “The crowds will need to dress appropriately and hydrate appropriately and have their medical needs met before they arrive here.”

That’s a message that Melissa Waldrop, 37, of Section, Ala., is taking to heart. She’s traveling nearly 700 miles by car and train with her 9-year-old son, Andy, who became captivated by politics — and Barack Obama — as a second-grader.

“We’re bundling up just like he would to go hunting with his dad,” said Waldrop, who is planning to carry food and water and to watch out for pushy mobs.

“I kind of dread the crowd part to a certain extent,” she said. “But my son was just all excited."

Andy thinks he might want to be a politician, Waldrop said. So if standing for hours in the snow will help him get a glimpse of his future, she’ll do it.

“More power to him,” Waldrop said.

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