PREPARING FOR H1N1: Students, education officials take precautionsLast year, when a parent called a Grand Forks school to report a sick child, a district employee made a simple computer entry — “ill” — by the student’s name.
By: Chuck Haga, Grand Forks Herald
Last year, when a parent called a Grand Forks school to report a sick child, a district employee made a simple computer entry — “ill” — by the student’s name.
This year, the entry may still be a three-letter word, but it may carry more punch: “Flu.”
Jody Thompson, assistant superintendent and the district’s point person in preparing for the H1N1 virus, said the word change is part of a new computer program the district has to track reported flu illnesses among students and provide early warning of a flu “spike” anywhere.
The season’s first confirmed case of H1N1, a high school student who recovered at home from mild flu symptoms and has returned to school, did not surprise or alarm Thompson.
“We’ve probably had many people with H1N1 in the community this summer,” he said, so it was inevitable that the virus would show up when students came together in large numbers this fall.
In the initial case, “the parents did all we asked,” Thompson said, “keeping the student out 24 hours after the fever subsided” to minimize the possibility of the virus spreading.
“That’s the advice we’ve given staff: If you’re not feeling well, if you’re displaying flu-like symptoms, please stay home. I know that’s difficult for our teachers. They’re from a culture that says even if you’re not feeling well, you get up and get to work. We’re going to have to deal with that mentality.”
The district has “a good, liberal sick leave policy” that will allow teachers and others to abide by the stay-home advice without suffering financially, he said.
Some uncertainty exists among health professionals concerning the 24-hour-after-fever standard. Scientists presented studies last week at a conference of the American Society for Microbiology suggesting that when the coughing stops may be a better guideline for determining when a patient with H1N1 flu is no longer contagious.
“This study shows you’re not contagious for a day or two,” said a scientist at the Institute of Public Health in Quebec. “You’re probably contagious for about a week.”
In East Grand Forks, school nurse Christy Carlstrom said the H1N1 threat is being treated much like the seasonal flu, with teachers and others emphasizing “the common sense things, such as cover your cough and don’t come to school until after your fever goes away.”
The school district is coordinating H1N1 vaccination plans with Polk County health authorities, she said, and has placed hand sanitizers in classrooms.
“We’re doing everything we can” to minimize the new flu’s impact, East Grand Forks Supt. David Pace said, “and that includes asking parents to watch their kids closely” for signs of the flu.
If students come to school with fever, “we’ll keep them separate and have the parents come for them,” he said.
“Awareness certainly is heightened,” Pace said. “We have Minnesota Health Department information on our Web site, and I’m looking at attendance figures earlier than ever, asking what are the reasons for people being out. We’re in our second week and we’re getting some students who are sick, but that’s normal.”
While nobody is panicking over H1N1, “They’re scared of the unknown,” Carlstrom said. “How bad is it going to get? We don’t know.”
“This is a different strain of the flu,” he said. “The unknown is always concerning.”
UND ‘flu buddies’
UND Student Health Services has scheduled walk-in clinics for administering the vaccine for seasonal flu, starting today with a students-only clinic at the College of Nursing (10 a.m.-1 p.m. in the first-floor hallway).
Student clinics are scheduled Tuesday at the School of Medicine, Wednesday at Wilkerson Hall and Thursday in the Memorial Union, with more clinics — again, for just the seasonal flu vaccine — scheduled for students, faculty and staff next week. The health office expects to offer the H1N1 vaccine when it becomes available, with pregnant women and other priority groups first in line.
A full UND vaccination schedule is listed on the university’s health and wellness Web page: http://conted.und.edu/healthtopics/.
UND has an “emergency response team” working closely with Grand Forks Public Health and the state health department to monitor and respond to flu developments.
The wellness site sounds the anti-flu mantra: Cover coughs and sneezes; avoid touching your eyes, nose and mouth; clean your hands with soap and water; avoid close contact with others, and stay home when sick.
Students are urged to “self-isolate” if they become sick with flulike symptoms, in their residence halls or homes, for at least 24 hours after their fever is gone.
Students with flulike symptoms should call Student Health Services before seeking care but should seek emergency care if they have difficulty breathing, pain or pressure in the chest or abdomen, sudden dizziness or other conditions spelled out on the site.
UND also is encouraging students to pair up with a “flu buddy,” an arrangement that would make one student the designated caregiver — making runs for food and medicine, for example — if the other became sick.
Sick wards at U?
Jason Uhlir, director of campus safety and security, said UND has looked at H1N1 plans developed by the University of Minnesota and other schools.
“Some schools have designated a residence hall as the place where students who come down with the flu would be relocated, a sort of sick ward,” he said. “We took a different approach. We don’t want to move people away from their stuff, their area of comfort. But if a roommate or a suitemate wants to relocate, we’ll do it that way.”
He said he will monitor employee and student absenteeism, use of the university’s wellness center, numbers of people on meal plans skipping meals and other data for early signs of a spike in flu cases. If numbers reach certain points, or the severity of the strain grows, “we might look at closures or cancellation of some activities,” he said.
“But people are cautiously optimistic. There’s been so much attention given to H1N1 that people know it’s out there, it’s inevitable.”
The university is “putting a lot of effort into preserving continuity of action, by having departments identify essential functions and how you would continue to do those,” he said. “Who’s next in command? Who’s next after that? At what point might we have to move employees from one area to another?”
Officials also are urging everyone to get vaccinated, for both seasonal flu and H1N1.
“That’s critical,” he said. “People forget how many people die every year from seasonal flu.”
How to sneeze
Much of the local school districts’ preparation, appropriately, has involved education — for staff and parents as well as for students.
“We’ve put up a ton of posters, especially in the elementary schools, showing the kids how to sneeze properly,” Thompson said. “Our nurses have been to all the elementary schools to teach them how to wash their hands.”
The district has three nurses assigned to the 12 elementary schools, one covering three middle schools and one serving the high schools, plus a teaching nurse at each high school.
Custodians have been told to pay more attention to doorknobs, computer keyboards, water fountains and other surfaces where the virus could be spread.
And the district has spent $6,000 to place bottles of hand sanitizer in every classroom, lunch room, reception area and other gathering places, with a recommendation they be used after any physical contact, including a handshake.
“It’s a tough habit to lose,” Thompson said, smiling thinly after shaking a visitor’s hand.
He said that staff members, students and parents all have been supportive of steps the district has taken to gird itself against the virus.
“There’s been zero pushback,” he said.
That could change if circumstances require more drastic steps, such as travel restrictions on athletic teams and other student groups.
Coaches have been told to emphasize cleaning of shared equipment and to discourage the sharing of water bottles. “So far, we haven’t limited travel,” Thompson said. “If in the future we get into an outbreak or we’re hit with a more severe strain, we might get into restricting travel. For now, we don’t see the need.”
Principals, nurses and secretaries have been told to isolate sick students as much as possible until parents can collect them.
A widespread outbreak could lead to the closing of a school or schools, which would be a decision taken jointly by school and public health officials.
“We would have to decide who stays home and how many days they should be out,” Thompson said. “We know that would create a whole lot of problems for people. And kids are kids: they’re going to want to get together at the malls or at somebody’s house. So closing a school is a last step.”
The World Health Organization said recently that closing a school “has its greatest benefit … very early in an outbreak, ideally before 1 percent of the population falls ill,” to avoid a rapid spread of the disease that could overwhelm caregivers. That would mean a trigger of 10 or 11 sick students at one of the Grand Forks high schools, or about five at most elementary and secondary schools.
Late last week, Thompson said the CDC hasn’t changed its guidance on school closings, but the district is consulting with local health officials “to determine if we need to change our monitoring criteria.”
Officials at a closed school also should plan to discourage students gathering elsewhere, according to the WHO statement. “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.”
School closings would require many parents to stay home, including some doctors and nurses, which also would stress the health care system.
If schools are closed, the Grand Forks district’s plan anticipates ramping up home study through the Internet, email and educational television, building on already established trends.
“We could continue to provide education,” Thompson said.
“The reality is we’re not going to stop H1N1. It’s here. But we’re very confident we can minimize its impact as much as possible.”
Reach Haga at (701) 780-1102; (800) 477-6572, ext. 102; or send e-mail to email@example.com.