Saturday, December 01, 2007

Going Their Way

 

# 1307

 

 

Thanks to one of my loyal readers for sending me this article which appeared yesterday in Catholic Online.

 

It is important for all school systems to have a pandemic plan. Kids are particularly at risk during a pandemic, and schools are notoriously good petri dishes for infection.  

 

Unfortunately, this plan has a serious shortcoming.

 

 

First the article, then a discussion.

 

 

 

San Francisco archdiocese develops preparedness plan in case of a flu pandemic

By Michael Vick
11/30/2007

Catholic San Francisco (www.catholic-sf.org)

SAN FRANCISCO, Calif. (Catholic San Francisco) - The Department of Catholic Schools for the Archdiocese of San Francisco has released a preparedness plan for pandemic influenza in response to concerns and recommendations of local health departments and the Centers for Disease Control. The plan is the culmination of work that began last school year, said Superintendent Maureen Huntington.

 

 

In the event of a serious flu outbreak, the plan calls on principals and teachers to practice safe hygiene techniques including frequent hand washing and to encourage students to do the same. Phones, door handles, hall passes and other surfaces are to be cleaned regularly.

 


The directives further call for strict monitoring of students for symptoms of the flu prior to an outbreak. In the event of an outbreak or pandemic, schools are to implement more intense surveillance, with findings reported to the local health department.

 

At all levels of infection, infected children and staff are to stay home. If the level of infection rises above 30 percent of a school’s population, the plan calls on principals to close the school and cancel all non-academic events.

(Cont.)

 

Where to begin?

 

First, I will stipulate that there are basically two camps when it comes to the issue of school closures during a pandemic.  One camp, the one that I firmly belong to, believes schools should be closed at the first sign of a pandemic, and kept closed until the threat passes. 

 

We believe schools, along with child care centers, are basically a convenient place to gather large groups of kids in close quarters to better facilitate the transmission of the virus.

 

But that opinion isn't universally held. 

 

There are many who believe that schools are too important to close, even during a pandemic.  They argue that closing schools would be a hardship, particularly on working parents, and the ripple effect would cause many to miss work to stay home with their kids. They also point out the school lunch program provides, for many kids, their best meal of the day. 

 

And, they argue, if you close the schools kids will just congregate elsewhere, and spread the flu amongst themselves.  At least at school, they can be monitored for signs of influenza, and sent home if they appear ill.

 

While I'll grant that the schools provide a valuable service, and that closing them would be a terrible inconvenience to many families, I have to ask, how many memorial services for dead kids is all of that worth?

 

Harsh rhetoric, I know.  But school officials need to stop thinking of pandemic flu as if it was just another nasty seasonal influenza. 

 

It isn't.

 

Pandemic flu is a killer.  It stems from a novel virus, one that we humans  have little or no immunity to, and historically novel viruses have exacted a heavy toll in lives, particularly among the young.

 

Until a vaccine is available (six months or more into a pandemic) the use of NPI's (Non pharmaceutical Interventions) are our best hope to limit the spread of the virus. 

 

That means, among other things, social distancing.  Avoiding crowds.

 

And you simply can't get enough separation in a school to allow for proper distancing.   

 

Classrooms are often crowded, with desks only a foot or two apart.  For many students, once an hour a bell rings and they then migrate, en mass, to their next class through crowded hallways filled with other students.   And of course, students share bathroom facilities, and most congregate in a lunchroom once a day.

 

You couldn't ask for a better environment to spread a virus.

 

The idea that teachers will be taught to watch for signs of influenza in their students is nice, but it ignores the fact that people with influenza may shed the virus for 24 to 48 hours before showing clinical signs of infection.   By the time a fever or a cough has appeared, a student or teacher may have spread the infection to several others.


And they, in turn, will take it home to their families.

 

By the time 30% of a school's population has called in sick, it is too late to close the schools.   By that time, nearly everyone will have been exposed.

 

The idea behind NPI's is to flatten the curve, and to slow the spread of the virus in a community.  Closing schools early, no matter how inconvenient that might be, is an imperative first step to accomplishing that.

 

Hopefully school officials everywhere will take a hard look at the Interim Pre-Pandemic Planning Guidance provided by the CDC, and move towards early school closures.

 

Of course, parents will need to find ways to keep kids home during a pandemic.  They can't be allowed to mingle with friends, hang out on the street corner, or go to the mall (assuming it's even open).  

 

Social distancing won't be easy, but it can be lifesaving.

 

The reality is, I doubt many parents will send their kids to school once a pandemic begins, regardless of school policy.  They would be risking not only their kids lives, but their own, by exposing them to large groups of people some of whom could be infected.

 

One can only hope that the point is moot. 

 

That parents will exercise better judgment than to send their kids to a school where 25% of the students are already out with a potentially deadly flu.

 

At least I hope so.