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The Patient Flow Team meets with nursing staff at Sunnybrook Health Sciences Centre Monday, November 25, 2013. The team is responsible for the movement of patients in, out and around the hospital, a task that’s a challenge on a good day but made especially difficult when there’s an influx of flu patients.

Kevin Van Paassen/The Globe and Mail

This is part of The Globe's months-long series on the challenges facing Canadian hospitals. All of our published material has been reported with permission from staff.

The idea of a SARS-like pandemic or the outbreak of a new virulent disease is enough to frighten anyone. But every year, hospitals have to contend with an infectious illness that takes over wards, kills patients and creates mayhem throughout the institution.

The illness? The flu.

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"It's a challenge every year," says Dr. Mary Vearncombe, medical director of infection prevention and control at Toronto's Sunnybrook Health Sciences Centre.

While there has been a spike in hospitalizations and deaths among young people this year, so far it has been an "absolutely normal" flu season, Vearncombe said.

But normal doesn't mean good. For hospitals such as Sunnybrook that don't have enough resources on a good day, the flu poses major challenges.

Sunnybrook operates at more than 100-per-cent capacity, which means many patients are waiting for beds on stretchers in the emergency department or in hallways.

Add to that an influx of patients with the flu and "it makes the flow of patients through the hospital even more difficult than normal," Vearncombe said.

One of the challenges hospitals face during flu season is preventing the spread of the disease. That means isolating some patients and encouraging visitors and staff to wash hands. But the biggest – and most contentious – challenge is convincing health-care workers to get immunized. They have direct contact with elderly, vulnerable patients who are at risk of becoming very sick or dying as a result of the flu virus.

This year, slightly more than half of the acute-care staff at Sunnybrook were immunized against the flu – a number that "is not good enough," Vearncombe said.

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To boost numbers, many parts of Canada are debating whether to introduce mandatory vaccinations for health-care workers. In British Columbia, workers must either get a flu shot or wear a mask while they are on the job. Many nursing unions say the move isn't fair and tramples their rights.

To Vearncombe, however, the answer is simple. "I think it should be a condition of service," she said.

"It's a privilege to work in health care in Ontario. With privilege comes responsibility."

Follow me on Twitter: @carlyweeks

We want to hear about health care in your community: What works, what doesn't, and what you think we should do about it. Share your experiences – and ideas for change. Follow @Globe_Health, tweet with #thehospital or email thehospital@globeandmail.com to join the conversation.

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