UPDATED (See Bottom)
# 3706
This week, schools will be back in session across most of the United States, and the recent spike in H1N1 flu cases seen in the South-East (where many schools opened a week or 10 days ago) will probably be repeated across the nation.
Despite attempts to disinfect classrooms, teach flu hygiene to the students and staff, and separate sick students from the healthy – schools and parents are bracing for an increased round of infections.
This report from the Atlanta-Journal Constitution.
More swine flu at Georgia colleges
By Laura Diamond
The Atlanta Journal-Constitution
Officials at Georgia’s colleges are telling students and parents not to panic as the schools report hundreds of confirmed or suspected cases of swine flu.
Georgia’s colleges have the highest number of voluntarily reported swine flu cases in the nation, according to the American College Health Association. The organization is collecting weekly data on the illness, and colleges can choose to participate in the survey.
The U.S. Centers for Disease Control and Prevention has reported that Georgia and Alaska are the two states where swine flu has become widespread.
The number of cases is fluid, and local college leaders expect an uptick after activities that attract a lot of people, such as the first home football game and homecoming.
From a public health standpoint it makes sense to try to keep the schools open.
The novel H1N1 virus, for the overwhelming majority of people, produces mild-to-moderate symptoms. Only in a very small percentage does it produce serious, or life threatening illness.
Closing schools would create a hardship to many people, negatively affect the economy and society, and in the end would do little to stop the transmission of the virus in the community.
Schools are also the obvious venue from which to deliver the vaccine to kids.
From a population-level vantage point, tying to keep schools open this fall makes a lot of sense. But it is a bit of a gamble, and things may not go as smoothly as some officials hope.
The problem is, we are very likely to see a rising tide of media reports like this one:
Troy University student dies, flu may be factor
By Holli Keaton (Contact) | Troy Messenger
Published Saturday, September 5, 2009
A Troy University student died in a Dothan hospital Friday, after he had previously been diagnosed with the flu.
Andrew Salter, an 18-year-old freshman, died sometime Friday in Dothan’s Southeast Alabama Medical Center., Troy University Spokesman Andy Ellis confirmed.
Ellis said according to Salter’s father, he had previously been diagnosed with the flu. But, he was being treated in the hospital for pneumonia at the time.
Saying he died pneumonia would seem a bit of misdirection, since pneumonia often presents as a serious complication of influenza. Nevertheless, these sorts of reports . . . as they increase . . . are bound to resonate with the public.
Particularly with parents and students.
The question becomes, what should public health and school officials do?
There are those who would have them preemptively close the schools until all children could be vaccinated – something that could take well into the new year.
There are others who believe if more than a handful of students in any school come down with the flu, the school should be closed for a week.
But there is little evidence that a week’s closure would do much to stop the spread of the virus. And you could easily see schools cycle through repeated closings and openings under that plan.
On the other hand, for many, closing schools would have a huge negative impact.
Working parents would have to make other child care arrangements (or stay home from work, impacting the economy), students would fall behind in their studies, plus many children are reliant on the school’s nutrition program.
Many students wouldn’t stay at home if schools were closed, anyway, spreading the virus at the mall or at a friend’s house. Added to that, health officials would lose an important platform for delivering the vaccine to kids later this fall.
If this is beginning to sound like a no-win situation, you’re right.
I certainly understand why the decision has been made to open the schools normally this year. Even if events overtake policy later this fall, politically, they had to at least try.
And my sympathies go to those local officials who will have to check which way the wind blows each and every morning this fall, and decide what to do about schools that day. Theirs is going to be a difficult and thankless job.
But my guess is, if the virus delivers a heavy enough impact to schools this fall, parents are going to take the decision out of the hands of school officials. That they will begin to arbitrarily keep their kids home from school, whether they are sick or not.
While public health officials can (and should) remind the public of the relatively low risks that sending their kids to school presents, all it will take is one well publicized child’s death in the community to trump their argument.
When this happens, the big question will be how local school systems respond. If they take a heavy-handed approach, and try to force students back to class with penalties or truancy threats, it is likely to backfire badly.
Imagine the media circus that would surround the first child -coerced back to school by authorities - who ends up in the local ICU.
Believe me, it won’t be pretty.
Hopefully schools can find ways to accommodate students (and their parents) who are uncomfortable with their attending classes during a pandemic outbreak.
That can be done by preparing homework assignments that can be picked up/dropped off weekly, or by making lessons available online, or through the local PBS-TV station.
Over time, I expect a lot of students will return on their own accord, as long as it is apparent that the dangers are low.
While public officials may not always share the public’s level of concern over sending kids to school during a pandemic, they do need to accept that those concerns are very real and they need to be responsive to them.
(Note: A commenter took the original last paragraph in this piece as a condemnation of parents fears. It wasn’t intended to be, and so I’ve changed it.
Having raised my own kids, I understand the low tolerance for risk that most parents have when it comes to their own children. I share them.
My point is simply that while public officials have to think at a `population level’ when making policy decisions, families think at the individual level. Officials need to understand and accept that these two positions may not always be compatible.)
