North Carolina's state lab is so overwhelmed with testing that it asked only those who end up in intensive care be tested. The good news is most of the cases have been mild.
The emphasis now is doing everything possible to slow the spread.
Walk into WakeMed Children's emergency department and you're greeted by a sanitation station before you get to the front desk. Hand sanitizer, tissues and masks are available for anyone showing flu-like symptoms. They're asked to keep the mask on until a doctor tells them otherwise. Each case is suspected swine flu. They're seeing an average of 60 children a day system-wide. Only 2-5 each day are being admitted.
"Often it is either the child has very high fevers that can't be controlled or they have respiratory distress and or at times it's children who have other diseases and illnesses and so this flu just complicates those illnesses," said Barb Bisset of the Emergency Services Institute.
Bissett says WakeMed is staying on top of swine flu and the CDC's recommended response.
Extra rooms in the hospital can be turned into flu clinics if need be. They have the equipment to set up triage tents like hospitals in Austin and Memphis have. Those facilities are seeing hundreds of possible swine flu patients each day.
They're directing sick children through these makeshift clinics as a way to quarantine them while they're being treated.
Federal officials have told emergency departments that if swine flu is widespread in the community, they can expect the number of patients to double every two days.
"If we see 200 patients today that means in two days we may see 400 patients, in four days we may see 800, and the numbers go very quickly. Fortunately we are not seeing that as of yet but from a planning perspective we are always taught to prepare for the worst," said Bissett.
WakeMed is coordinating with other hospitals preparing for the worst. They do want to stress that if you or your children feel like you have the flu you should just stay home unless the high fever won't break or if they or you are having trouble breathing.