A Reminder of What Midwest Winters Are About

“It’s a really big mess out there,” said David Beachler, a senior forecaster at the National Weather Service. “And it’s coming at a really inopportune time.”

At least seven traffic deaths across four states were reported in the blizzard, the first significant winter storm of the season for much of the Midwest. As the storm moved from the Plains into the Great Lakes by Thursday, more than a foot of wet, heavy snow fell in portions of Iowa and Wisconsin.

But the storm was notable less for how much snow it left behind than for how it left it. In some places, sudden bursts of snow fell at a rapid rate only to have winds, whistling and gusting at speeds as high as 55 miles per hour, sending sheets of it flying sideways.

“Because of the wind, combined with steady and heavy snowfall, what you have is not just a pain to plow through,” said Gov. Scott Walker of Wisconsin. “You really have those blizzard-type whiteout conditions, and that’s where people can get very quickly in a position where they get stranded.”

Mr. Walker declared a state of emergency, called in more than 100 members of the National Guard in heavy vehicles and snowmobiles, and closed state facilities in 22 counties.

In some places, major roads were closed and smaller ones were cluttered with motorists who had spun out, been blown off the road or had pulled over to wait out the storm. In Iowa, which issued a statewide “no travel” recommendation, drifting snow left some drivers unable to see even a single car length in front of them. About 80 Iowa National Guard members in Humvees helped rescue stranded motorists, including a family of five on Wednesday.

“I’ve lost count,” Annette Dunn, the winter operations administrator for the Iowa Department of Transportation, said of the number of wrecks across that state. “Many times, we’re just opening the road back up and we’ll get another accident.” In the largest single accident in Iowa, 25 cars were involved in a chain-reaction crash along Interstate 35 that left two people dead.

As holiday travelers were setting out for extended breaks, hundreds of flights were canceled or delayed here at O’Hare International Airport, as well as at smaller airports around the region. The problems appeared likely to create a backlog of travelers just as the real rush was soon to begin; about 266,000 passengers were expected to pass through Chicago’s airports on Friday, which was projected to be the holiday period’s busiest travel day.

School was canceled Thursday in parts of states including Minnesota, Iowa and Nebraska, where the storm arrived overnight on Wednesday. Multiple accidents, including overturned semitrailer trucks, led to the closing of nearly 400 miles of Interstate 80 from Lincoln, Neb., almost to the Wyoming border.

“Everything here was white,” said Mary Jo Oie, spokeswoman for the Nebraska Department of Roads. “You can’t see.”

Heavy snow and downed trees weighed on power lines across the Midwest, leaving some without power — and with the knowledge that temperatures, which had been relatively warm this season, were expected to continue sinking. Around Omaha, about 41,000 homes were without power on Thursday morning, and repair crews were slowed by the dismal conditions.

The storm was unlikely to have much effect on the drought that has troubled the Midwest for months. “Yes, the moisture is welcome, but it’s just not going to amount to a tremendous amount of moisture in the end,” said Brian Fuchs of the National Drought Mitigation Center.

In parts of the region, the blizzard ended what had been record stretches with no measurable snowfall. Last year’s entire winter was so remarkably mild and relatively snowless that numerous Midwestern towns used only a small fraction of their street salt supply.

In Chicago, a place that is accustomed to getting — and stoically coping with — more than its fair share of snow, on Thursday it had been 290 days since the last snow, the longest period on record. Some 200 city snowplows waited at the ready on Thursday afternoon, even before the falling temperatures were forecast to turn rain into snow.

Some here seemed unconcerned, even excited at the prospect.

“We’re supposed to have snow,” said Gina Walker, 42, who was visiting an outdoor holiday market downtown and said her two young sons had long been asking when snow would come. “We’re built for it.”

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About New York: One Boy’s Death Moves State to Action to Prevent Others

The action by New York has elated sepsis researchers and experts, including members of a national panel who this month formally recommended that the federal government adopt standards similar to what the state is planning.

Though little known, sepsis, an abnormal and self-destructive immune response to infection or illness, is a leading cause of death in hospitals. It often progresses to severely low blood pressure, shock and organ failure.

Over the last decade, a global consortium of doctors, researchers, hospitals and advocates has developed guidelines on early identification and treatment of sepsis that it says have led to significant drops in mortality rates. But first hints of the problem, like a high pulse rate and fever, often are hard for clinicians to tell apart from routine miseries that go along with the flu or cold.

“First and foremost, they need to suspect sepsis,” Dr. Mitchell M. Levy, a professor at Brown University School of Medicine and a lead author of a paper on the latest sepsis treatment guidelines to be published simultaneously next month in the United States in a journal, Critical Care Medicine, and in Europe in Intensive Care Medicine.

“It’s the most common killer in intensive care units,” Dr. Levy said. “It kills more people than breast cancer, lung cancer and stroke combined.”

If started early enough, the treatment, which includes antibiotics and fluids, can help people escape from the drastic vortex of sepsis, according to findings by researchers working with the Surviving Sepsis Campaign, the global consortium. The tactics led to a reduction of “relative risk mortality by 40 percent,” Dr. Levy said.

Although studies of 30,000 patients show that the guidelines save lives, “the problem is that many hospitals are not adhering to them,” said Dr. Clifford S. Deutschman, director of the sepsis research program at the Perelman School of Medicine at the University of Pennsylvania and the president of the Society of Critical Care Medicine.

About 300 hospitals participate in the study, and the consortium has a goal of having 10,000. “The case is irrefutable: if you take these sepsis measures, and you build a program to help clinicians and hospitals suspect sepsis and identify it early, that will mean more people will survive,” Dr. Levy said.

At a symposium in October, the New York health commissioner, Dr. Nirav R. Shah, said that he would require state hospitals to adopt best practices for early identification and treatment of sepsis. Gov. Andrew M. Cuomo intends to make it a major initiative in 2013, said Josh Vlasto, a spokesman for the governor. “The state is taking unprecedented measures to prevent and effectively treat sepsis in health care facilities across the state and is looking at a wide range of additional measures to better protect patients,” Mr. Vlasto said.

In April, Rory Staunton, a sixth grader from Queens, died of severe septic shock after he became infected, apparently through a cut he suffered while playing basketball. The severity of his illness was not recognized when he was treated in the emergency room at NYU Langone Medical Center. He was sent home with a diagnosis of an ordinary bellyache. Hours later, alarming laboratory results became available that suggested he was critically ill, but neither he nor his family was contacted. For an About New York column in The New York Times, Rory’s parents, Ciaran and Orlaith Staunton, publicly discussed their son’s final days. Their revelations prompted doctors and hospitals across the country to seek new approaches to heading off medical errors.

In addition, Commissioner Shah in New York convened a symposium on sepsis, which included presentations from medical experts and Rory’s parents.

At the end of the meeting, Dr. Shah said that he had listened to all the statistics on the prevalence of the illness, and that one had stuck in his memory: “Twenty-five percent,” he said — the portion of the Staunton family lost to sepsis.

He said he would issue new regulations requiring hospitals to use best practices in identifying and treating sepsis, actions that, he said, he was taking “in honor of Rory Staunton.”

The governor’s spokesman, Mr. Vlasto, said that “the Staunton family’s advocacy has been essential to creating a strong public will for action.”

Dr. Levy said New York’s actions were “bold, pioneering and grounded in good scientific evidence,” adding, “The commissioner has taken the first step even before the federal government.”

Dr. Deutschman said that initiatives like those in New York were needed to overcome resistance among doctors. “You’re talking about a profession that has always prided itself on its autonomy,” he said. “They don’t like to be told that they’re wrong about something.”

The availability of proven therapies should move treatment of sepsis into a new era, experts say, comparing it to how heart attacks were handled not long ago. People arriving in emergency rooms with chest pains were basically put to bed because not much could be done for them, said Dr. Kevin J. Tracey, the president of the Feinstein Institute for Medical Research at North Shore-Long Island Jewish Health System. Dr. Tracey, a neurosurgeon, has made major discoveries about the relationship between the nervous system and the runaway immune responses of sepsis.

If physicians and nurses were trained to watch for sepsis, as they now routinely do for heart attacks, many of its most dire problems could be headed off before they got out of control, he said. The Stauntons have awakened doctors and nurses to the possibility of danger camouflaged as a stomach bug.

“We are with sepsis where we were with heart attack in the early 1980s,” Dr. Tracey said.

“If you don’t think of it as a possibility, this story can happen again and again. This case could change the world.”

E-mail: dwyer@nytimes.com

Twitter: @jimdwyernyt

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