Stat of the Week — Feb. 16, 2007

February 16, 2007 5 min read
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How States Mention Schools in Pandemic Flu Plans

Health experts at the World Health Organization and the U.S. Centers for Disease Control and Prevention are concerned that the H5N1 strain of avian flu could evolve into a pandemic, or worldwide spread of serious illness, against which people will have little natural resistance. This week’s Stat of the Week focuses on how schools are incorporated in state pandemic flu plans.

As centers of community life, local schools have a key role in flu pandemic preparedness. The U.S. Department of Education has issued numerous guidelines to help school officials plan for worst-case scenarios. In a March 2006 letter to school district leaders, Secretary of Education Margaret Spellings said, “Pandemic influenza could have a profound effect on our nation’s school systems… Our schools also must be ready to deal with possible school closings, staff and student absences, medical care for children, and the need to maintain and restore the student-learning environment.”

For background, previous stories, and Web links, read Student Health.

State pandemic flu plans are posted on the official U.S. government Web site for pandemic influenza. Most state-level plans serve as recommendations to local officials, although some cite the state’s legal authority during such an emergency. Differing in level of detail, almost all plans are at least 30 pages, but New York’s plan, for example, is more than 400 pages. The EPE Research Center conducted an analysis of school references in plans by searching for the term “school” and coding the surrounding text in each state’s plan. A lack of finding simply means that there was no mention of the coding category related to schools in the state’s plan. It must be noted that many state departments of education and local school districts have their own pandemic flu plans and those plans were not examined here. References to schools in the state pandemic flu plans fall into six major categories listed below. The number of states containing each category and a related example of each is also presented.

1) Closure of schools (when to close and for how long) - 46 states
Since school closures may be effective in slowing down influenza transmission in the community, and certain school buildings must be adapted to other purposes, a plan has been developed for school closures for a two-week period of time at the exponential phase of influenza transmission. This containment plan is based on the premise that the most impact from school closure can be achieved during the exponential phase of the initial wave of pandemic influenza. This plan is certainly subject to change based on new models of transmission and empiric observations.

2) Surveillance of absenteeism in schools (as part of an early-warning system) - 37 states
The Department of Education obtains daily student absenteeism rates from all local public school systems through an electronic reporting system. The Department of Education will share these data with the Tennessee Department of Health to enhance surveillance for influenza activity evidenced by increasing absenteeism levels.

3) Communication to schools (messages for students, staff, and parents) - 22 states
Following the development and promotion of the website, Department of Health and Hospitals will partner with the Department of Education to launch a school-based pandemic preparedness program to teach students the importance of healthy behaviors, such as germ and infection control, healthy living, and immunizations. The program will be designed to demystify the information they hear about pandemic flu and will teach them basic behaviors that will keep them healthy and will help to protect them from any pandemic outbreak.

4) Use of school property and resources (using school buildings as “alternative care sites” or vaccination clinics) - 21 states
New Jersey
In extreme emergencies, where hospitals cannot expand to meet needs and transfer to outlying facilities is impractical, space in large public buildings will be made available. The New Jersey Army National Guard Armories with Medical Units and large public buildings such as college dormitories, schools, office buildings, community centers, etc. may become “non-traditional” in-patient care or emergency treatment facilities.

5) Prevention in schools (screening for possible illness, vaccination, or providing hand sanitizer) - 19 states
Frequent hand washing with soap and water will help protect students and staff from viruses. Wash hands for 15- 20 seconds (long enough to sing the “Happy Birthday” song twice.) Alcohol-based hand rubs may be used as an alternative. Students and staff should be advised to rub their hands thoroughly until dry. Work with your school’s janitorial staff to ensure that restrooms are stocked with soap and paper towels or working hand dryers. Work with teachers to have a supply of alcohol-based hand-rub in each classroom.

6) Distance lessons from schools (virtually-provided continuing education in the event schools are closed) - 4 states
Develop alternative procedures to assure continuity of instruction (e.g., web-based distance instruction, telephone trees, mailed lessons and assignments, instruction via local radio or television stations) in the event of district school closures.

The following chart shows the number of states that have each coding category represented in their state pandemic flu plan:


This table shows contexts in which schools were mentioned in the pandemic flu plans for each state:

Click to view the table.

An October 2006 survey by Robert J. Blendon and colleagues at the Harvard School of Public Health Project on the Public and Biological Security (Pandemic Influenza Survey) found that the majority of Americans interviewed said they would be willing to make significant changes and follow the advice of public health authorities if a pandemic flu occurred. Those who had children were asked how they would respond if schools and daycare centers were closed for a month. Most (93 percent) said they would try to make arrangements so that one adult in the household could stay at home. Just 25 percent said they would be able to work from home and care for their children. If schools were closed for three months, 95 percent said they would be willing to teach their children school lessons; however, few state pandemic flu plans reviewed actually addressed the issue of schools preparing for distance learning. Only New York, Tennessee, Virginia, and Wyoming mentioned measures for continuing schooling virtually in their state pandemic flu plans.

To find out more about education policies in the 50 states and the District of Columbia, access the Education Counts database.

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