H1N1 – BACK TO SCHOOL GUIDANCE
Do you have children in school? Grandchildren? How is the school preparing for the fall and the second wave of the H1N1 pandemic? This applies to 5 – 25 years of age so in other words, grade school through university. If you are a emergency manager or business continuity planner, you might be able to provide some real time assistance to schools who are often very short of resources…this could be a great volunteer project but you need to act now!
Friday CDC issued new school guidance designed to decrease exposure to regular seasonal flu and 2009 H1N1 flu while limiting the disruption of day-to-day activities and the vital learning that goes on in schools. CDC will continue to monitor the situation and update the current guidance as more information is obtained on 2009 H1N1.
Schools Have A Major Impact
About 55 million students and 7 million staff attend the more than 130,000 public and private schools in the United States each day. By implementing these recommendations, schools and health officials can help protect one-fifth of the country’s population from flu. To make this all work, collaboration is essential: CDC, the U.S. Department of Education, state and local public health and education agencies, schools, students, staff, families, businesses, and communities all have active roles to play.
The guidance is in “two flavors:”
Option One – Similar to the Spring 2009 outbreak
Option Two – Increased severity by comparison to the Spring 2009 outbreak
Option One – Under conditions with similar severity as in spring 2009
- Stay home when sick:
Those with flu-like illness should stay home for at least 24 hours after they no longer have a fever, or signs of a fever, without the use of fever-reducing medicines. They should stay home even if they are using antiviral drugs. CDC just issued specific guidance on this last week. (See Technical Report)
- Separate ill students and staff:
Students and staff who appear to have flu-like illness should be sent to a room separate from others until they can be sent home. CDC recommends that they wear a surgical mask, if possible, and that those who care for ill students and staff wear protective gear such as a mask. (See Technical Report)
- Hand hygiene and respiratory etiquette:
The new recommendations emphasize the importance of the basic foundations of influenza prevention: stay home when sick, wash hands frequently with soap and water when possible, and cover noses and mouths with a tissue when coughing or sneezing (or a shirt sleeve or elbow if no tissue is available). (See Technical Report)
- Routine cleaning:
School staff should routinely clean areas that students and staff touch often with the cleaners they typically use. Special cleaning with bleach and other non-detergent-based cleaners is not necessary. (See Technical Report)
- Early treatment of high-risk students and staff:
People at high risk for influenza complications who become ill with influenza-like illness should speak with their health care provider as soon as possible. Early treatment with antiviral medications is very important for people at high risk because it can prevent hospitalizations and deaths. People at high risk include those who are pregnant, have asthma or diabetes, have compromised immune systems, or have neuromuscular diseases. (See Technical Report)
- Consideration of selective school dismissal:
Although there are not many schools where all or most students are at high risk (for example, schools for medically fragile children or for pregnant students) a community might decide to dismiss such a school to better protect these high-risk students. (See Technical Report)
Under conditions of increased severity compared with spring 2009
CDC may recommend additional measures to help protect students and staff if global and national assessments indicate that influenza is causing more severe disease. In addition, local health and education officials may elect to implement some of these additional measures. Except for school dismissals, these strategies have not been scientifically tested. But CDC wants communities to have tools to use that may be the right measures for their community and circumstances.
- Active screening:
Schools should check students and staff for fever and other symptoms of flu when they get to school in the morning, separate those who are ill, and send them home as soon as possible. Throughout the day, staff should be vigilant in identifying students and other staff who appear ill. (See Technical Report)
- High-risk students and staff members stay home:
People at high-risk of flu complications should talk to their doctor about staying home from school when a lot of flu is circulating in the community. Schools should plan now for ways to continue educating students who stay home through instructional phone calls, homework packets, Internet lessons, and other approaches. (See Technical Report)
- Students with ill household members stay home:
Students who have an ill household member should stay home for five days from the day the first household member got sick. This is the time period they are most likely to get sick themselves. (See Technical Report)
- Increase distance between people at schools:
CDC encourages schools to try innovative ways of separating students. These can be as simple as moving desks farther apart or canceling classes that bring together children from different classrooms. (See Technical Report)
- Extend the period for ill persons to stay home:
If influenza severity increases, people with flu-like illness should stay home for at least 7 days, even if they have no more symptoms. If people are still sick, they should stay home until 24 hours after they have no symptoms. (See Technical Report)
- School dismissals:
School and health officials should work closely to balance the risks of flu in their community with the disruption dismissals will cause in both education and the wider community. The length of time schools should be dismissed will vary depending on the type of dismissal as well as the severity and extent of illness. Schools that dismiss students should do so for five to seven calendar days and should reassess whether or not to resume classes after that period. Schools that dismiss students should remain open to teachers and staff so they can continue to provide instruction through other means. (See Technical Report)
CDC notes that there are two types of school closures:
- Reactive dismissals might be appropriate when schools are not able to maintain normal functioning for example, when a significant number and proportion of students have documented fever while at school despite recommendations to keep ill children home.
- Preemptive dismissals can be used proactively to decrease the spread of flu. CDC may recommend preemptive school dismissals if the flu starts to cause severe disease in a significantly larger proportion of those affected.
Schools are starting up nationwide this month and in some communities this week. Click on the links below to get started. Time is of the essence. Work now to ensure schools are as safe as they can be this fall.
CDC Basic Guidelines http://www.cdc.gov/h1n1flu/schools/schoolguidance.htm
CDC Technical Report for Schools http://www.cdc.gov/h1n1flu/schools/technicalreport.htm
CDC Preparing for Flu – Communication Toolkit for Schools http://www.cdc.gov/h1n1flu/schools/toolkit/