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Swine Flu And Schools: Officials Expect Another Bout

ARIELLE LEVIN BECKER

July 23, 2009

NEW HAVEN — - The concept is simple enough: The best place for sick children is at home. And the best place for well children to be is at school.

But if a resurgence of swine flu hits as expected this fall, deciding whether to send children to school won't be quite so simple for all parents, Dr. Matthew Cartter, the state epidemiologist, said Wednesday. Some won't be convinced that a school is safe under any circumstances during a pandemic and will keep their children home.

That could be the challenge schools face come September, and on Wednesday, more than 250 local school and health officials gathered at Southern Connecticut State University as part of an effort to prepare for the first flu pandemic in 41 years. Cartter and other state officials offered details on the outbreak and prevention efforts, while school and local health department leaders who dealt with cases of swine flu in the spring described their experiences on the front lines.

If the current outbreak does not become more severe — even if it's more widespread — officials will try to keep schools open, Cartter said. But that's no easy feat. "It's easier to close schools than it is to open them or to keep them open," he said.

The pattern of pandemic H1N1 virus so far makes schools a key battleground in the fight against the flu. Nearly three-quarters of the confirmed and probable U.S. cases have occurred in people under 25, according to the federal Centers for Disease Control and Prevention.

And while experts advise people to stay 6 feet from others to avoid the spread of flu, Cartter said the average distance between people in schools is only 3 feet, compared with 13 feet in an office, and 18 feet in a home.

Among the challenges school and health officials will face will be addressing parents' concerns and determining how to accommodate the needs of medically fragile children and pregnant staff members — both considered groups at high risk from the virus.

At Wednesday's conference, speakers, including Gov. M. Jodi Rell, emphasized the importance of coordination between school and health officials and communication with the public.

"Certain parents are willing to take certain risks that other parents aren't willing to take," said Deb Rosen, adult immunization coordinator for the state Department of Public Health. But if they are given information and told what the risks are, they can make decisions about which risks to take, she said.

While school closings would be recommended if the pandemic becomes much more severe, Cartter said there is still a debate among experts about the role school closings should play in containing a pandemic. Evidence from past pandemics suggests that to have a lasting effect on stopping flu transmission, schools must close for four to six weeks, he said, and decisions about closing schools should be made after weighing their ability to stop transmission and the severity of the pandemic against the importance of keeping students in school.

School and local health officials who already grappled with the decision of whether to close schools in the face of early swine flu cases offered advice based on their experiences.

Region 13 Superintendent Susan Viccaro saw the importance of communication in May when she decided, with input from health officials, to keep schools open after a pupil was confirmed to have swine flu. The child had not attended school for two weeks before the case was confirmed, but had a sibling who had no symptoms and was still in school.

Knowing that parents were "up in arms" about the decision, Viccaro scheduled a public information session, which state health officials attended. She said she let parents know that if they were still not comfortable, they could keep their children home. She also updated the district website daily. "Communication really was the key," she said.

Looking back, Viccaro said Wednesday, she could have handled the situation better by asking the sick child's family for permission to notify the sibling's class about the potential connection to a case of swine flu.

Parents criticized the district's handling of the case at the May information session, but Viccaro said that when the district had a second case, "I had zero response."

Granby Superintendent Alan Addley described problems with confidentiality in the spring when an intermediate school closed after a confirmed case of swine flu.

Addley said he had trouble finding out who the sick child was from the child's doctor, but everyone in town knew.

Tom Murphy, a spokesman for the state Department of Education, suggested that schools tell parents ahead of time that it will help the community if they notify the school about their child's symptoms if they become ill.