Saudi Schools Prepare For MERS

 

# 8542

 

Perhaps since it has been primarily perceived as a disease that affects older men, the Ministry of Education In Saudi Arabia has done little except proclaim that their schools are free of MERS, and that parents need not worry (see Director of Education Riyadh: Riyadh schools free from Corona).

While it is true that young people make up a small minority of symptomatic MERS cases, we are seeing an increasing number of pediatric cases reported of late, including the infection of a 16 year-old, and the death of a 9-month old, yesterday (cite).

 

Parents (and others) - worried and upset over the government’s initial slow response to this virus - have taken to twitter and other social media platforms demanding that schools either close or steps be taken to reduce the risks to their children.

 

Today, Arabic media is carrying reports indicating that the Ministry of Education is about to order schools to take specific steps to address the expanding MERS outbreak. Steps that include an isolation room, masks, gloves, and thermometers for every school.

 

This from Al Hasa Today.

 

 

Room "temporary detention" of suspects "Corona" school

April 28, 2014 

Sources revealed that the plan of the Ministry of Education for the prevention of HIV Corona include the allocation of a room in each school to wait for conditions until transported to their homes or to the hospital by the patient's condition.

The room will provide the expected processed in about 34 thousand schools all means of prevention and their gloves and masks while providing high detection device for the patient's temperature to detect suspected cases, according to the "economic".

The plan to be implemented by the ministry for HIV prevention training sessions aimed at schools, to provide them with the necessary information about the disease and its symptoms and how it is transmitted and detection, reporting, and prevention in cooperation with the Ministry of Health.

The sources said that the ministry will allocate a central operations room to answer questions employees of schools, students and parents.

The number of school administrators in some areas and cities raised letters to the departments of education, so as to cancel the program lineup morning (queue), and the abolition of the establishment of the noon prayer in schools for poor ventilation and protect against HIV infection.

The following is a statement from the Saudi Minister of Education – posted yesterday on the MOE website – that states that an `action plan’ is being readied for schools in the Kingdom.

 

Faisal directs an action plan for the prevention and awareness of disease Coruna

HRH Prince Khalid Al-Faisal, Minister of Education to work to take the necessary measures for the prevention of Corona virus in schools, and through the development of an action plan for the prevention of the disease in schools And put in place mechanisms to clear methodology implemented in coordination and integration with the Ministry of Health.

This came during a meeting today which was attended by His Excellency Acanutorhalld Sabti, Deputy Minister of Education, HE Sheikh Al Acanutorahmd Deputy Minister for the education of boys, and Acanutorslaman Monthly General Manager of School Health.

He also asserted the need to disseminate health education for employees of schools, students and the provision of supplies and the use of all available means, including social media, and work to improve the cleanliness and maintenance in schools and providing supplies to schools time and provide antiseptics  and disinfectants in all schools, and equip school clinics Bmstelzmadtha medical office.

And accept the conferees state of health of students and teachers and the level of preventive measures of infectious diseases in schools, and discussed the measures taken to maintain the health of students and employees of schools, has also asserted the importance of coordination with the Ministry of Health as a ministry of the National Committee for Infectious Diseases Dr / Solomon Monthly, general manager of school health , everyone has contoured note that there are no cases of school and thankfully which bodes reassured on the health situation in schools at the moment

Hong Kong Braces For Back-To-School Flu Surge

 

 

 

# 4838

 

 

Although this report is from Hong Kong, the same concerns are likely to emerge in other parts of the northern hemisphere as students return to school for the fall session.

 

Not only do we have the remnants of the 2009 H1N1 pandemic virus still in circulation - we’re seeing reports in some parts of the world of a resurgence of H3N2 – a new strain to which community immunity may be low.

 

Trying to predict how the upcoming flu season will play out usually only serves to underscore the total unpredictability of the virus and our longstanding inability to prognosticate such events.

 

So I’ll not even bother.  

 

What I will say is this year’s trivalent seasonal flu vaccine contains antigens for the former pandemic H1N1 virus, the newly emerging H3N2 Perth virus, along with a B influenza virus. 

 

Which makes it your best bet for reducing your odds of getting the flu this year.   

 

But of course, that only works if you get the shot before you are exposed (keeping in mind it takes a couple of weeks to build immunity).

 

This report from news.gov.hk.

 

 

August 27, 2010

Public Health

Flu outbreaks in new school term expected

Centre for Health Protection Controller Dr Thomas Tsang warns a significant number of flu outbreaks are expected when the new school term begins next week, and the public should also stay vigilant against any possible outbreak of hand, foot and mouth disease later this year.

 

Dr Tsang told the media today Hong Kong is remains in the summer influenza peak season, and the centre has recorded at least 300 isolates of flu virus a week showing the viruses are quite active in the community.

 

He also expects the number of hand, foot and mouth disease cases will rise next month with the peak season starting in October or November.

 

He urged schools, institutions and parents to stay alert and take precautions to prevent outbreak. Schools and institutions should report outbreaks immediately to the centre.

 

Dr Tsang said the pneumococcal vaccination programme for children will start in October at the Department of Health's Maternal & Child Health Centres, using a new vaccine which can prevent the 10 most common types of the disease.

Study: Student Behavior During Pandemic School Closings

 

 

 

# 4555

 

 

One of the commonly cited concerns over closing schools during a pandemic has been the assertion that students would simply find other places to congregate, such as the mall.  

 

Gains in reducing transmission of the virus due to `social distancing’, many have felt, were over-estimated due to non-compliance to advice to stay home.

 

We’ve a study today that appears in PLoS One, which looks at the self-reported behavior of students at private girls' school in Boston that closed for a week towards the end of the school year. 

 

Grades 9-12 and grades 5-8 were sampled.   This was a small study, and subject to a number of limitations (which are enumerated in the article).  

 

Also, the severity of novel H1N1 wasn’t generally perceived by the public as a `deadly flu’.   Behaviors observed during this last pandemic may not accurately reflect behavior in future, potentially more virulent, outbreaks.

 

 

That said, here is the abstract, followed by a couple of excerpts from the discussion area of the study. 

 

The results, as you will see, are a mixed bag.

 

Social contacts continued, albeit at a lower level, once schools closed and disturbingly, many students failed to follow the advice to stay home if sick in the days leading up to the school’s closure.

 

 

Student Behavior during a School Closure Caused by Pandemic Influenza A/H1N1

 

 

Joel C. Miller, Leon Danon, Justin J. O'Hagan, Edward Goldstein, Martin Lajous, Marc Lipsitch

Abstract

Background

Many schools were temporarily closed in response to outbreaks of the recently emerged pandemic influenza A/H1N1 virus. The effectiveness of closing schools to reduce transmission depends largely on student/family behavior during the closure. We sought to improve our understanding of these behaviors.

Methodology/Principal Findings

To characterize this behavior, we surveyed students in grades 9–12 and parents of students in grades 5–8 about student activities during a weeklong closure of a school during the first months after the disease emerged. We found significant interaction with the community and other students–though less interaction with other students than during school–with the level of interaction increasing with grade.

Conclusions

Our results are useful for the future design of social distancing policies and to improving the ability of modeling studies to accurately predict their impact.

 

 

Discussion (Excerpts)

Surprisingly, interaction with other students was lower at the end of the closure than at the beginning, particularly in grades 9–11. We had anticipated that there would be an initial period of fear-based isolation followed by increased contacts as complacency grew. An explanation for the actual observations could be that families were initially unprepared for the closure and students had little to do except visit friends, but as the week progressed families planned additional activities. Alternately, the low level of contacts could represent studying at home for exams that occurred soon after returning to school.

 

The data suggest students did not closely adhere to advice from the school about behavior to control the spread of infection. Prior to the closure, students were advised to remain home for one week following onset of fever with respiratory symptoms. This was not followed, and some students attended school the day after symptom onset.

 

During the closure, students were advised to avoid contacts with other students and with the community, but our surveys show that they remained active, unless they became symptomatic. Whether it is important for apparently healthy students to avoid social contact for the entire closure is unclear: although direct evidence for or against significant presymptomatic transmission of influenza is weak [11], it is frequently assumed that a significant fraction of infections happen in the presymptomatic stage [12].

Study: Effect Of School Closures On Viral Transmission

 

 

# 4087

 

 

You don’t have to be an epidemiologist to know that schools are hotbeds of respiratory illness each winter, and that kids are very efficient spreaders of viruses. 

 

It was for that reason that in early pandemic planning – particularly when considering a high mortality virus such as H5N1 – school closures for up to 12 weeks were prominently featured.

 

Once it was established that the novel H1N1 virus was nowhere near as virulent as bird flu, social policy in most countries was to try to keep schools open as much as possible.

While it has been assumed that closing schools would help curb the spread of a pandemic virus, until now there has been very little research that quantifies the benefit. 

 

Something that we really ought to know before the next pandemic virus emerges.

 

Today we get a study, published in the open access journal BMC Infectious Diseases, that finds that forced school closures can reduce secondary infections by roughly 20%.

 

This study makes the assumption that social mixing and interaction during a pandemic induced school closure would mimic social contacts currently seen during routine weekend and holiday school closures.  

 

Their estimates, therefore, are probably conservative.  Social distancing beyond just the closure of schools would likely be taking place, and large social gatherings probably discouraged. 

 

School closings have costs, both economic and social, and those have to be taken into account as well.  Forced school closings are not something to be done lightly.

 

During a severe pandemic wave, however, this study makes a pretty good case for the closing of schools to significantly lower the attack rate.

 

 

Estimating the impact of school closure on social mixing behaviour and the transmission of close contact infections in eight European countries

 

Niel Hens , Girma Minalu Ayele , Nele Goeyvaerts , Marc Aerts , Joel Mossong , John W Edmunds  and Philippe Beutels

 

BMC Infectious Diseases 2009, 9:187doi:10.1186/1471-2334-9-187

Published:
27 November 2009

Background

Mathematical modelling of infectious disease is increasingly used to help guide public health policy. As directly transmitted infections, such as influenza and tuberculosis, require contact between individuals, knowledge about contact patterns is a necessary pre-requisite of accurate model predictions. Of particular interest is the potential impact of school closure as a means of controlling pandemic influenza (and potentially other pathogens).

Methods

This paper uses a population-based prospective survey of mixing patterns in eight European countries to study the relative change in the basic reproduction number (R0 - the average number of secondary cases from a typical primary case in a fully susceptible population) on weekdays versus weekends and during regular versus holiday periods. The relative change in R0 during holiday periods and weekends gives an indication of the impact collective school closures (and prophylactic absenteeism) may have during a pandemic.

Results

Social contact patterns differ substantially when comparing weekdays to the weekend and regular to holiday periods mainly due to the reduction in work and/or school contacts. For most countries the basic reproduction number decreases from the week to weekends and regular to holiday periods by about 21% and 17%, respectively. However for other countries no significant decrease was observed.

Conclusions

We use a large-scale social contact survey in eight different European countries to gain insights in the relative change in the basic reproduction number on weekdays versus weekends and during regular versus holiday periods. The resulting estimates indicate that school closure can have a substantial impact on the spread of a newly emerging infectious disease that is transmitted via close (non sexual) contacts.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Afghanistan Closes Schools Due To H1N1

 

# 3974

 

 

Six days ago Afghanistan declared the pandemic to be an emergency (see Afghanistan Declares H1N1 Emergency), warning that 1 infected person in 80 die from the pandemic virus.  As many as 70,000 deaths.

While those estimates may turn out to be high, there is no doubt that developing nations have graver concerns with this pandemic virus than do countries with access to antivirals, antibiotics, and hospital care.

The challenges facing developing nations in this pandemic are many and very serious (see A Tale of Two Pandemics).   In order to stem the spread of the virus, Afghanistan has now decided to close schools for most of the month of November.

This report from the VOA.

 

Afghanistan Closes Schools Due to Increasing H1N1 Cases

By Sean Maroney

Kabul
08 November 2009

The Afghan government has closed the country's schools and universities for most of November in response to an increased number of H1N1 flu cases. Since July, officials have diagnosed nearly 350 people with the virus. There have been a total of 772 confirmed cases, and 10 people have died.

 

Afghan officials say most of the flu cases have been in Kabul, Parwan and the provinces of Herot, Kandahar, Ningrahar and Bamayan.

 

Afghanistan's Health Minister Dr. Sayed Mohammad Amin Fatemi says only Afghans so far have died from the virus.
He says the basic reason for the deaths has been because the victims went to treatment centers too late. He says most of the foreigners with the virus have been with the NATO forces, and they were able to start their treatments early, which helped their chances for survival.

 

The United Nations World Health Organization representative for Afghanistan, Peter Graass, says that despite the last eight years of medical improvements in the country, there is still a lot more work left to do.

 

"Somewhere between 60 and 70 percent of all Afghans have access within two hours of walking or traveling to basic health services, so that means that under the best of circumstances we have a very sizable - still very sizable - proportion of the population that is basically missing out," he said.

 

He says the Afghan health services are reasonably prepared to deal with the H1N1 outbreak. But he adds that officials believe the actual number of cases is much higher and are preparing for scenarios in which a fourth of the country contracts the flu virus.

 

(Continue . . . )

Two Reports Out Of Russia

 

 

# 3964

 

As the H1N1 virus continues its fall and winter march across the Northern Hemisphere, reports of its impact are starting to emerge from places like the Ukraine, Belarus, and now Russia.

 

Thus far, the reports we get describe a pandemic that is very wide, but not terribly deep. 

 

A lot of illness, but relatively low mortality rates.

 

Today we learn, via Dutchy on FluTrackers, that Moscow will keep their schools closed for at least an additional week on top of the current school holiday now in progress. 

 

MOSCOW SCHOOLS SHUT BECAUSE OF FLU

05.11.2009

School holidays in Moscow will last a week longer than scheduled - until November 16 inclusive. As reported in Thursday, November 5, in the City of sanitation and epidemic commission, the decision was taken because of the epidemic of seasonal flu and SARS.(=ILI, ed) Teachers call up the students and tell them the news.

 

Holidays, which began Monday, were to be completed on November 8.

 

This information was confirmed spokesman Sergei Tsoi mayor. As reported earlier press office of Mayor and the Moscow government, the incidence of SARS and avian influenza in Russia's capital to date has exceeded the epidemic threshold by almost half.

 

As of 1 November, in Moscow, SARS and flu are sick more than 166 thousand people, including nearly 106 thousand children.

 

Recall, registered in Russia for 13 deaths from swine influenza. The most unfortunate situation with the epidemic develops in Transbaykal, Krasnoyarsk, Khabarovsk, Primorsky regions, Sakhalin Oblast, and Moscow. Vaccination against swine influenza begin in Moscow for November 9.

 

According to WHO, worldwide, most cases still occur in adolescents and young adults, with the highest rates of hospitalization observed among very young children. From 1% to 10% of patients with clinical manifestation of disease require hospitalization. Of the hospitalized patients from 10% to 25% need to be admitted to ICUs and from 2% to 9% die.

 

In general, from 7% to 10% of all hospitalized patients are pregnant women in the second or third trimester of pregnancy. Compared with the general population the likelihood that pregnant women need medical care in the intensive care ward, ten times higher.

 

And from Itar-Tass News agency, a column (as opposed to a news story) about how the pandemic is progressing across Russia.   While calling the situation in the Ukraine `alarming’, this report tries to downplay the impact in Russia and the `tone’ is reassuring.

An interesting read, but as always, Caveat Lector. A hat tip to Cathy M  on the Flu Wiki for finding and posting this report.

 

 

Flu situation in Russia not as bad as in Ukraine, but far from calm

05.11.2009, 20.06

By Itar-Tass World Service writer Lyudmila Alexandrova

Over 3,000 cases of swine flu have been registered in Russia. Fourteen patients have died from the disease. In most cases the victims turned for medical assistance when it was already too late. Although the situation in Russia is not as alarming as in neighboring Ukraine, where swine flu and viral respiratory diseases have killed 86, it is far from calm.

 

"There are no fears over the risk of a negative pandemic scenario," says Deputy Health and Social Development Minister Veronika Skvortsova. So far laboratory tests have confirmed 3,122 cases of A/H1N1 flu in Russia. Most of those who contracted it have recovered and 1,200 others are still sick. In six percent of patients the illness has proved grave.

 

Skvortsova warned against breeding panic for which there is absolutely no reason. A total of 4,000 patients die in Russia every month of cardiovascular diseases, 24,000 of cancer, and 2,600 of infection diseases. In the meantime, swine flu has claimed only fourteen lives.

 

"Our country is among those where the march of events is favorable," she said. Russia has managed to avoid a negative flu epidemic scenario.

 

At the same time the republic of Buryatia on November 4 declared a state of emergency due to the highly pathogenic virus. As at November 72 patients in Buratia were down with swine flu. On the whole, the epidemiological threshold has been exceeded 3.1 times. All crowded events have been canceled, including conferences, public festivities and rallies. The same applies to business trips.

 

Wearing masks in public places is obligatory and visiting patients in hospitals is not allowed.

 

(Continue . . . )

Germicidal Maniacs

 

 

# 3809

 

 

There are certainly times, and circumstances, where it makes a lot of sense to disinfect surfaces to try to limit the spread of the H1N1 virus.   

 

When I was at my local Walgreens a couple of weeks ago to get my seasonal flu shot, one of the employees at the Rx window sprayed down the pickup counter with alcohol. It was an area where hundreds of people stood each day, placing their hands on the surface, and probably coughing and sneezing as well.

 

Coming out every 30 minutes or so and giving it a disinfecting wipe down probably makes some sense.   I know I was glad to see them taking this flu virus seriously.

 

This sort of real-time cleaning and disinfecting, while patrons are continually coming and going, could be argued as being a good hygienic practice.

 

But of late I’m reading more and more about schools (and sometimes businesses) that are shutting down, often for days, in order to give them time to perform a `deep disinfecting cleaning’ of the premises - and here the science and logic isn’t quite so clear.

 

A couple of examples from today’s news, then some discussion.

 

Arizona school closes with flu outbreak

(AP) 

HUACHUCA CITY, Ariz. — Health officials suspect an outbreak of swine flu has caused an Arizona school to shut down after more than a third of the students called in sick.

 

Huachuca City Elementary will closed, the rest of the week followed by the regular fall break. Crews will disinfect everything that children put their hands on, from door knobs and desks to restrooms, and the cafeteria.

(Continue . . . )

 

 

Corbin schools cancel class

 

25 teachers call in sick Monday; students resume Oct. 19 after fall break

By Samantha Swindler / Managing Editor
Corbin schools will be closed the rest of this week due to illness, and class won’t be back in session until Oct. 19, following fall break.

<Snip>

“Twenty-five teachers were out also and we didn’t have enough subs to go into six classrooms,” McNeel said.

Corbin Intermediate School had the lowest attendance rate at 84 percent. That’s down from the normal 94-95 percent attendance.

Over the break, McNeel said custodial staff will be disinfecting walls, desks, door handles and other surfaces often touched.

 

This seems to be a common reaction.  Close the school for a week, bring in the custodial staff, and maniacally disinfect all surfaces.

 

I’m sure it is very reassuring to the the students, their parents, and the general public.   It shows the school is concerned, exercising due diligence, and that the health and safety of those in attendance is important.

 

But . . . does it make any sense?  

 

From a scientific standpoint, that is.

 

According to the CDC’s guidance, it doesn’t appear to.

 

Questions & Answers

2009 H1N1 Flu (Swine Flu) and You

September 24, 2009 10:00 AM ET

How long can influenza virus remain viable on objects (such as books and doorknobs)?

Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for 2 to 8 hours after being deposited on the surface.

 

In other words, if school lets out at 3 o’clock in the afternoon, by about midnight each night any viruses deposited on surfaces will have probably died.  

 

Which means that closing a school for days, and bringing in a cleaning crew, is of dubious value at best.

 

Now . . . if the point is to reassure the public, and to show that the school is being`proactive’ and protective of the kids, I suppose it has some `public relations’ value.  

 

But if the point is to protect the students and staff from infection, this would seem to be a less than cost-effective way to go about it.

 

Worse, it may instill in some people a false sense of security.  A belief that since the school has been disinfected, there is no need to take other precautions.

The evidence strongly suggests that most influenza infections are acquired through a respiratory route, and the role of fomites (inanimate objects like books, door knobs, desks) is probably limited.   

 

Those infections that do come from fomites almost certainly come from relatively `fresh deposits’ of viral material . . . minutes or hours old  . . .  not left over from yesterday or last week.

 

And last but not least, even the most thorough deep disinfecting of the school premises can be undone in the time it takes a returning student with the virus to sneeze.

 

All of which calls into question the disinfecting tactics being employed by schools around the country.  The money being spent on deep cleaning of schools would be better spent on more hand sanitizer, paper towels in the bathrooms, and perhaps `real-time’ cleaning of surfaces during school hours.

A Darwin Award Nomination

 

# 3758

 

Note: I don’t usually rant in this blog, but today, I make an exception.

 

 

While it may not bode particularly well for our species, Charles Darwin was on to something when he observed that adaptation is an important characteristic for any organism’s survival.

 

Which brings us to an article I found today about the `dangers’ of hand sanitizers in schools, and the fears that some parents and officials have over their fire hazard and potential abuse.

 

A brief excerpt from a much longer article follows:

 

Hand sanitizers a new schoolroom staple, but ingredients stir controversy

Noreen S. Ahmed-Ullah

September 20, 2009 5:14 AM

MCT NEWSFEATURES

Chicago Tribune

(MCT)

 

CHICAGO - Some kindergartners call it ''the magic soap,'' and in schools across the country hand sanitizers are quickly emerging as the weapon of choice against swine flu.

 

School districts are installing wall dispensers in classrooms. Teachers are squirting the gel into not-so-clean palms before lunch or after a visit to the bathroom. In some districts, parents had to buy hand sanitizer along with paper and pencils as part of their kids' back-to-school supplies.

 

But a wrinkle has emerged in the world of the squirt happy: Hand sanitizers have a fairly high alcohol content. That has some officials worried about flammability and potential misuse as an intoxicant.

 

In Kane County, Ill., students can't use hand sanitizers in school except under adult supervision. The county regional office of education requires school districts to have a formal plan for how they'll dispense the germ-fighting product in classrooms and lunchrooms, and they must store larger pump containers and extra bottles in fireproof cabinets or outdoor sheds like other flammable products.

 

(Continue . . . )

 

 

Stop the presses! 

 

Alcohol based hand gel burns when touched off with a lighter or match.  

 

As does a crumpled ball of paper . . .  (see photo below).  

 

Bad news, I would venture, for the American pulp & paper industry should that news ever leak to the papers.  Schools, I understand, are absolutely lousy with paper.

 

(Hand gel & paper burning side-by-side)

 

Not to be unkind, but isn’t this isn’t carrying the `obsessive parental worrying thing’ just a little too far?    

 

 

Parents can (and should) be teaching their young children not to arbitrarily set fires, and that glycerin and propylene glycol are inferior mixers for alcoholic beverages.  Lessons that will serve them well their entire lives.

 

This is 2009, after all. 

 

Kids should be smart enough to know that the best libations can be found in their parents liquor cabinet, not their medicine cabinet.

 

Granted I grew up in the 1950s, back before every kid had a cell phone umbilical cord to stay connected to a supervising adult.

 

Kids as young as 6 years of age would leave the house after breakfast rarely to be heard from again until supper time.   If they came home for lunch, fine, otherwise they’d get a sandwich at a neighbor’s house.

 

It was a time when a 12-year-old was considered old enough to babysit.  Today, that would probably result in a visit from Children’s Services.

 

Eight year-olds had BB guns, sharp sticks, pocket knives (necessary for sharpening sticks) and kid-engineered forts in the woods to play in.  

 

We drank water from garden hoses, climbed trees, and while aloft would sometimes eat the unwashed fruit hanging about.  We learned the hard way the perils of landing on our knees on the sidewalk, and soon learned that the metal slide at the school playground would scald your backside on a hot summer’s day.

 

And yet - amazingly, most of us survived to adulthood.

 

It’s not that I’m arguing that we should go back to the `bad old days’; when kids rode bikes without helmets, no one wore seatbelts (and kid carrier seats for cars didn’t exist!), everyone smoked, and schools would hand out mercury to kids to play with (watch it roll around in your hands, kids . .it’s liquid metal!).

 

Obviously, we’ve made some rational decisions along the way.

 

But if we’ve really raised a generation of school aged kids incapable of using hand sanitizer without  A) getting drunk off of it   or B) setting the school house on fire  . . . .

 

. . . . we’ve got bigger problems as a society than a flu pandemic to deal with.

The Readymoms College Flu Kit

 

 

# 3757

 

 

Last year I had the opportunity to speak to hundreds of College Health Professionals at the 2008 ACHA (American College Health Association) annual meeting in Orlando.

 

I, along with Readymoms Alliance  Director Dr. Susan Chu , held down the Readymoms booth in the exhibition hall.  We provided information to hundreds of doctors, nurses, and school administrators on ways students, their families, and schools could prepare for a pandemic.

 

One of the Readymoms Displays.

The Readymoms are a volunteer, grassroots, organization that began a little more than two years ago to spread the pandemic preparedness message.

 

Over the past two years they have attended many high profile events, such as the APHA (American Public Health Association) Convention in Washington D.C  and the Second National Emergency Management Summit, also held in the nation's capital.

 

At the ACHA meeting one of the things we were promoting was that all students needed a pandemic plan which would include emergency travel plans back home, and a `flu kit’ to give them a week or two worth of food/supplies in case they found themselves quarantined in their dorm.

 

Most of the college health care professionals we spoke to seemed very receptive to the ideas.   You can read more about the ACHA conference in Feedback From The ACHA Conference and The Readymom's Alliance In Orlando.

 

While much of the material we were handing out at the time was geared to a more severe H5N1 pandemic, a lot of the information still applies to the novel H1N1 pandemic we now find ourselves dealing with.    

 

Karen, the founder of the Readymoms, has been working to upload revised Readymom’s guidance documents to her Scribd account, where anyone can download them for free.

 

I’ve just reproduced part of the 2-page document below.  Get the whole thing by going here. 

 

 

This is just one of the many Readymoms Alliance guidance documents you can download, use, and share with others.  

 

The idea behind the Readymoms is to give people the information they need so that they can go out into their community and help spread pandemic awareness.    All of these toolkits are free, and easily adaptable to your own needs.

 

Other handouts available include:

 

• Handout-Flu Buddy-PDF Version
  
• Handout-Pandemic Parenting 5-PDF Version
  
• Handout-Oral Re Hydration Solution
  
• Handout-Flu Buddy
  

 

Plus numerous other guidance documents on emergency cooking, sanitation, water supplies, etc.

 

The take home message with everything provided by the Readymoms is that individuals and families are not powerless in a pandemic (or any other disaster).

 

We can all take steps to prepare and to protect our loved ones.

 

Armed with these downloads from the Readymoms, you’ll be in better shape to do just that.

Egypt Closes Schools Due To Flu Fears

 

 

# 3743

 

 

Over the past few days the Egyptian government has been ordering the closure of some foreign schools and Universities due to the novel H1N1 `swine’ flu threat.  According to this article from the BBC, they have now decided to suspend all classes until early October, in a bid to slow the virus.

 

This comes in the wake of a WHO briefing last week that suggested that early, pre-emptive school closings could be effective in slowing the spread of the flu virus. 

 

The closing of schools is controversial, and not all countries are in agreement of its merits.   Here in the US, officials have expressed the desire to keep schools operating if at all possible.  

 

While some school closings around the US are considered inevitable, that decision will be left to local officials.

 

Egypt’s reactions to the H1N1 virus are more extreme than some other countries, perhaps, because they are also dealing with endemic H5N1 in their poultry, and have seen 34 human H5N1 infections this year.  

 

This has raised concerns over the two viruses meeting up in the same host, and reassorting into a new, hybrid virus.   While the likelihood of that happening may be small, it is still a concern.

 

Earlier this year, Egypt culled their entire pig population, out of just such fears.

With different policies being tried in different countries around the world, we will undoubtedly come out of this pandemic with more knowledge about what works, and what doesn’t, when it comes to community mitigation of a pandemic virus.

 

Important data that could prove invaluable the next time a novel pandemic virus emerges. 

 

This from the BBC.

 

 

Egypt closes schools to curb flu

Page last updated at 11:02 GMT, Thursday, 17 September 2009 

 

The Egyptian government has ordered all schools and universities to close until October in an attempt to slow the spread of swine flu.

 

State-run schools were due to start the academic year in the last week of September. Foreign schools that have already started will also be affected.

 

The Ministry of Health announced on Sunday that five new cases of swine flu had been detected.

 

It is the latest strategy enacted by the government to combat the virus.

 

Restrictions have already been imposed on those wanting to attend the annual Hajj pilgrimage in November. Only those between the ages of 25 and 65 will be granted the necessary visas.

 

Egyptian Health Minister Hatem al-Gabaly refused to rule out an all-out ban on Hajj travel if the outlook becomes worse. A similar ban was last imposed in 1947 due to a cholera epidemic.

 

((Continue . . .)

WHO Pandemic Briefing Note 10

 

 

# 3719

 

The World Health Organization has released their 10th Pandemic briefing note, this time addressing the plusses and minuses of school closings as a pandemic mitigation measure.

 

As I read these recommendations, I’m reminded of the old quote attributed to Harry Truman (because there are no new ones), where he said what he wished for most as President was “A one-armed economist . . . one who couldn’t say `But, on the other hand . . .’”.

 

That, of course, is the problem with a pandemic.  There are no hard and fast rules, no certainties over what will work and what won’t, or what is best in the long run for individuals and families or for the larger community.  

 

Of course, sometimes those interests are at odds with each other. And what might be best in one locality might be disastrous in another. 

 

In other words, the WHO doesn’t make specific recommendations simply because there is no one-size-fits-all solution.

 

They do point out the benefits of proactive early school closings, and suggest that they may be useful, although their benefits must be weighed against the social costs.

 

My thanks and a hat tip to the indefatigable @Dutchy123 on Flutrackers for tweeting and posting this link.

 

 

 

Measures in school settings

Pandemic (H1N1) 2009 briefing note 10

11 SEPTEMBER 2009 | GENEVA -- WHO is today issuing advice on measures that can be undertaken in schools to reduce the impact of the H1N1 influenza pandemic. Recommendations draw on recent experiences in several countries as well as studies of the health, economic, and social consequences of school closures. These studies were undertaken by members of a WHO informal network for mathematical modelling of the pandemic.

 

Experience to date has demonstrated the role of schools in amplifying transmission of the pandemic virus, both within schools and into the wider community. While outbreaks in schools are clearly an important dimension of the current pandemic, no single measure can stop or limit transmission in schools, which provide multiple opportunities for spread of the virus.

 

WHO recommends the use of a range of measures that can be adapted to the local epidemiological situation, available resources, and the social role played by many schools. National and local authorities are in the best position to make decisions about these measures and how they should be adapted and implemented.

 

WHO continues to recommend that students, teachers, and other staff who feel unwell should stay home. Plans should be in place, and space made available, to isolate students and staff who become ill while at school.

 

Schools should promote hand hygiene and respiratory etiquette and be stocked with appropriate supplies. Proper cleaning and ventilation and measures to reduce crowding are also advised.

 

School closures and class suspensions

 

Decisions about if and when schools should be closed during the pandemic are complex and highly context-specific. WHO cannot provide specific recommendations for or against school closure that are applicable to all settings. However, some general guidance comes from recent experience in several countries in both the northern and southern hemispheres, mathematical modelling, and experience during seasonal epidemics of influenza.

 

School closure can operate as a proactive measure, aimed at reducing transmission in the school and spread into the wider community. School closure can also be a reactive measure, when schools close or classes are suspended because high levels of absenteeism among students and staff make it impractical to continue classes.

 

The main health benefit of proactive school closure comes from slowing down the spread of an outbreak within a given area and thus flattening the peak of infections. This benefit becomes especially important when the number of people requiring medical care at the peak of the pandemic threatens to saturate or overwhelm health care capacity. By slowing the speed of spread, school closure can also buy some time as countries intensify preparedness measures or build up supplies of vaccines, antiviral drugs, and other interventions.

 

The timing of school closure is critically important. Modelling studies suggest that school closure has its greatest benefits when schools are closed very early in an outbreak, ideally before 1% of the population falls ill. Under ideal conditions, school closure can reduce the demand for health care by an estimated 30–50% at the peak of the pandemic. However, if schools close too late in the course of a community-wide outbreak, the resulting reduction in transmission is likely to be very limited.

 

Policies for school closure need to include measures that limit contact among students when not in school. If students congregate in a setting other than a school, they will continue to spread the virus, and the benefits of school closure will be greatly reduced, if not negated.

 

Economic and social costs

 

When making decisions, health officials and school authorities need to be aware of economic and social costs that can be disproportionately high when viewed against these potential benefits.

 

The main economic cost arises from absenteeism of working parents or guardians who have to stay home to take care of their children. Studies estimate that school closures can lead to the absence of 16% of the workforce, in addition to normal levels of absenteeism and absenteeism due to illness. Such estimates will, however, vary considerably across countries depending on several factors, including the structure of the workforce.

 

Paradoxically, while school closure can reduce the peak demand on health care systems, it can also disrupt the provision of essential health care, as many doctors and nurses are parents of school-age children.

 

Decisions also need to consider social welfare issues. Children’s health and well-being can be compromised if highly beneficial school-based social programmes, such as the provision of meals, are interrupted or if young children are left at home without supervision.