Published Online: April 29, 2009

Obama: Schools With Infections May Need to Close

President Barack Obama suggested Wednesday that school closings may be necessary, in an escalating global health emergency that claimed the first death in the United States and swept Germany onto the roster of afflicted nations. Obama said local educators across America should consider shuttering schools if conditions worsen.

Giving an update on a raging health menace that has dominated public officials' time and caused universal anxiety, Obama said, "Every American should know that the federal government is prepared to do whatever is necessary to control this virus."

He said he wanted to extend "my thoughts and prayers" to the family of a 23-month-old Texas boy who died, representing the first confirmed U.S. fatality in addition to more than five dozen infections.

Education Department Memo: Public Health Officials Offer Swine Flu Guidance to Schools

Schools can be leading indicators of public health outbreaks, so the Department of Education hosted a conference call this afternoon to guide education officials on how to identify, contain, report and prevent swine influenza in school facilities. Public-health and epidemiology experts from the Centers for Disease Control and Prevention (CDC) and President Obama’s Homeland Security Council joined officials from the Department’s Office of Safe and Drug-Free Schools to update the education community on the flu outbreak and recommend procedures for dealing with it.

More than 1,400 participants from school districts, state education offices and education associations across the United States listened in and asked a range of questions, many of which the CDC answers at its continually updated Swine Influenza site. (You can add CDC’s useful swine flu widget to your own Web site to funnel users to the Centers’ continually updated information.) CDC also advises common-sense measures for preventing flu—stay home if you’re sick, avoid close contact and wash your hands, among other steps.

One frequently asked question from today’s call: Under what circumstances should schools close? A few U.S. schools have closed. CDC offers this interim guidance, recommending strong consideration of closure of schools with a confirmed case of swine flu or suspected case that has been epidemiologically linked to a confirmed case. Broader school dismissal should be left to local authorities, taking into account the extent of [influenza-like illness] in the community.

If your school or district does decide to close, please notify the Department of Education’s Office of Safe and Drug Free Schools (OSDFS) by e-mail to osdfs.safeschl@ed.gov, in addition to your local public health authority. Educators may also e-mail OSDFS with questions about the proper response to swine influenza cases, and how to prevent the flu at schools.

Secretary of Education Arne Duncan, who received a briefing about swine flu from federal public health officials on Monday, encourages all schools, districts and states to monitor closely the health of their populations, communicate with local health authorities and political leaders and proceed with the safest and healthiest course for their students and communities. The Department of Education will post additional resources for educators, along with FAQs stemming from today’s conference call and a transcript of it, on ED.gov. Stay tuned to ED.gov’s blog for updates.

"This is obviously a serious situation" and "we are closely and continuously monitoring" it, Obama said.

The president said it is the recommendation of public health officials that authorities at schools with confirmed or suspected cases of swine flu "should strongly consider temporarily closing so that we can be as safe as possible."

"If the situation becomes more serious and we have to take more extensive steps, then parents should also think about contingencies if schools in their areas do temporarily shut down, figuring out and planning what their child care situation would be," Obama advised.

Just sending children from schools to day care centers in infected areas "is not a good solution," he said.

Obama said the federal government is "prepared to do whatever is necessary to control the impact of this virus." He noted his request for $1.5 billion in emergency funding to ensure adequate supplies of vaccines.

The government needs local agencies to help by looking out for any suspected flu cases, the president said.

And he advised individuals to take their own precautions — washing hands, staying home if they are sick, and keeping sick kids home.

The world has no vaccine to prevent infection but U.S. health officials aim to have a key ingredient for one ready in early May, the big step that vaccine manufacturers are awaiting. But even if the World Health Organization ordered up emergency vaccine supplies — and that decision hasn't been made yet — it would take at least two more months to produce the initial shots needed for human safety testing.

"We're working together at 100 miles an hour to get material that will be useful," Dr. Jesse Goodman, who oversees the Food and Drug Administration's swine flu work, told The Associated Press.

And the U.S. is shipping to states not only enough anti-flu medication for 11 million people, but also masks, hospital supplies and flu test kits. Dr. Richard Besser, acting head of the Centers for Disease Control and Prevention, was asked Wednesday why the problem seems so much more severe in Mexico than in the United States.

He replied that U.S. officials "have teams on the ground, a tri-national team in Mexico, working with Canada and Mexico, to try and understand those differences, because they can be helpful as we plan and implement our control strategies."

Cuba and Argentina banned flights to Mexico, where swine flu is suspected of killing more than 150 people and sickening well over 2,000. In a bit of good news, Mexico's health secretary, Jose Cordova, late Tuesday called the death toll there "more or less stable."

Mexico City, one of the world's largest cities, has taken drastic steps to curb the virus' spread, starting with shutting down schools and on Tuesday expanding closures to gyms and swimming pools and even telling restaurants to limit service to takeout. People who venture out tend to wear masks in hopes of protection.

The number of confirmed swine flu cases in the United States included 45 in New York, 11 in California, six in Texas, two in Kansas and one each in Indiana and Ohio, but cities and states suspected more. In New York, the city's health commissioner said "many hundreds" of schoolchildren were ill at a school where some students had confirmed cases.

But only in Mexico so far are there confirmed deaths, and scientists remain baffled as to why.

The WHO argues against closing borders to stem the spread, and the U.S. — although checking arriving travelers for the ill who may need care — agrees it's too late for that tactic.

Authorities sought to keep the crisis in context: Flu deaths are common around the world. In the U.S. alone, the CDC says about 36,000 people a year die of flu-related causes. Still, the CDC calls the new strain a combination of pig, bird and human viruses for which people may have limited natural immunity.

Hence the need for a vaccine. Using samples of the flu taken from people who fell ill in Mexico and the U.S., scientists are engineering a strain that could trigger the immune system without causing illness. The hope is to get that ingredient — called a "reference strain" in vaccine jargon — to manufacturers around the second week of May, so they can begin their own laborious production work, said CDC's Dr. Ruben Donis, who is leading that effort.

Vaccine manufacturers are just beginning production for next winter's regular influenza vaccine, which protects against three human flu strains. The WHO wants them to stay with that course for now — it won't call for mass production of a swine flu vaccine unless the outbreak worsens globally. But sometimes new flu strains pop up briefly at the end of one flu season and go away only to re-emerge the next fall, and at the very least there should be a vaccine in time for next winter's flu season, Dr. Anthony Fauci, the National Institutes of Health's infectious diseases chief, said Tuesday.

"Right now it's moving very rapidly," he said of the vaccine development.

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