Swine Flu: Helping Schools Plan and Respond

President Barack Obama is calling on schools with suspected or confirmed cases of swine flu to close temporarily. In Texas alone, more than 130,000 students will miss class as districts shuttered this week. But what happens to those students when they’re not in school? How are daycare organizations affected? What precautions should schools and families be taking? Our guests answered your questions.

Chat: Swine Flu: Helping Schools Plan and Respond

Friday, May 1, 3-4 p.m., Eastern time.
Read the transcript.

President Barack Obama is calling on schools with suspected or confirmed cases of swine flu to close temporarily. In Texas alone, more than 130,000 students will miss class as districts shuttered this week. But what happens to those students when they’re not in school? Does it make sense to suspend school throughout entire districts at this stage? How are daycare organizations affected? What precautions should schools and families be taking? And what is the long-term outlook? Our guests answered your questions.

Guests: Bill Modzeleski, director of the office of safe and drug-free schools, U.S. Department of Education
Scott McQuigg, CEO of HealthTeacher.com

Jeanne McCann, managing editor at edweek.org, moderated this chat.

Related Coverage:
As Swine Flu Closes Schools, Tech. Could Keep Doors to Learning Open;
Closing Schools May Not Stop Flu From Spreading

Swine Flu: Helping Schools Plan and Respond(05/01/2009)


2:29 Jeanne McCann: Hello everyone, welcome to today’s chat on helping schools plan for and respond to instances of swine (or H1N1) flu. We’ll be starting at 3 p.m., but please send your questions in now.

3:01 Jeanne McCann: Hello and welcome to today’s chat. We are lucky to have two guests to take your questions today, Scott McQuigg, CEO at HealthTeacher.com, and Bill Modzeleski, director of the office of safe and drug-free schools at the U.S. Department of Education. Thanks to both of you for jumping in on such short notice.


Jeanne McCann: One caveat: Our guests are not health professionals, so we won’t be able to answer any questions that are strictly medical in nature.

Bill, Scott, why don’t you introduce yourselves, and then we’ll get right to the questions.


Scott McQuigg: Scott McQuigg, CEO of HealthTeacher. HealthTeacher is the leading online K-12 health education curriculum used in nearly 8,000 schools. We developed a list of “7 actions schools can take to prevent the spread of swine flu” with the American Association for Health Education and Dr. Jeff Andrews of Vanderbilt University Medical Center.

I have first-hand experience with the swine flu as my son’s school was closed Wednesday for the next 7 days because a student has the first suspected case of swine flu in Tennessee.

3:02 Jeanne McCann: And bill...

3:03 Jeanne McCann: We’ll be posting a list of resources at the end of the chat, just FYI. If you have something to share please, don’t hesitate.

3:04 [Comment From Scott W.]
We are a K-8 district with elementary buildings and a junior high. If a case is confirmed in one elementary building, is it recommended to close the jr. high as well due to siblings? Or is it recommended to close all buildings in a small district?

3:05 Jeanne McCann: Scott, why don’t you take a shot at this while we’re waiting for Bill.

3:06 Scott McQuigg: You should only close if you have a confirmed case of swine flu/H1N1 at your school, this according to the CDC. Likely the state department of health and the CDC will advise you on which to close - the elementary or middle or both. It really depends on how much cross pollenation the schools have.

3:06 Jeanne McCann: We’ll get this thing rolling in a minute, folks!

3:06 Bill Modzeleski: I’m sorry I just got on..

3:06 [Comment From gloria]
we are a registered home care this is our home as well we open our doors to parents and children daily we washing hands spaying our lysol and keeping sanitation Is there more we can do to prevent from getting sick?I know news saying not to panic want to learn more

3:06 Jeanne McCann: Hi Bill!


Bill Modzeleski:

I would encourge children to stay home if they are sick..refer to ED’s and CDC web site for specific information.

3:08 Scott McQuigg: Hygiene and cough etiquette are important. This is likely the biggest factor in reducing the spread of the virus

3:08 Jeanne McCann: Bill, this next one for you

3:08 [Comment From Al W.]
Please clarify. Close schools when? If you have a suspected, probable or confirmed case in your school district? In your county? In your region? Also, does the local health department make the determination of a “probable” case?

3:08 Scott McQuigg: This is what we are suggesting schools and community organizations teach/remind children about coughing and sneezing: Cover nose and mouth with a tissue when coughing or sneezing. Throw the tissue in the nearest trash receptacle after use. If tissues are not readily available, cough or sneeze into the sleeve of a shirt or jacket by raising the elbow in front of the mouth.

3:10 Jeanne McCann: People are really looking for guidance about when to close schools and when not.

3:10 Scott McQuigg: Regarding when to close schools: the first test a local physician will give is to determine “probable infection.” this test is 95%-98% accurate. schools are closing, as did my son’s school, once the “probable” test results come in.

3:10 Bill Modzeleski: Guideance on school closings can be found as part of CDC community mitigation guidance. You really need to review the guidance that is on their web page as it can change. Current guidlines call for affected communities with laboratory confirmed cases of H1N1 consider activiating school dismissal policies

3:10 Jeanne McCann: We’ll post a link to the guidance in a minute.

3:10 Scott McQuigg: The CDC administers the definitive test to determine a “confirmed” case, but this can take up to 72 hours post the “probable” results

3:11 Jeanne McCann: Lots of questions about pregnant staff. Bill or Scott

3:11 [Comment From Jennifer Glyptis]
What are the recommendations for pregnant school staff?

3:11 Bill Modzeleski: Again we encourage school officials to work with local health officials on issues related to when to close a school and for how long to close the school CDC guidance recommends that schools remain closed for 14 days. See CDC.gov

3:12 Scott McQuigg: I think this is a question for an OB-GYN.

3:12 Jeanne McCann: People are worried about schoolwork, especially seniors.

3:13 [Comment From Mary Gregory]
How can students be held accountable for academic work/assignments while schools are shut down?

3:13 Scott McQuigg: Pregnant women are already more susceptible to all infections. I would suggest talking to an OB-GYN. If one lives in a community with a confirmed case likely this question takes on a different level of concern.


Bill Modzeleski:

Our position {ED} is that we want to do everything possible to ensure the health safety and welfare of students and staff and will work with States and local districts on waivers for testing.

3:15 Scott McQuigg: We suggest developing a plan to send all school and materials home each day in the event a shut-down is announced after hours.

3:15 Web Producer: Jennifer: While Scott’s suggestion about talking to an OB-GYN seems like the best course of action, the CDC issued guidelines today that are specific for pregnant woman. They can be found at http://www.cdc.gov/h1n1flu/clinician_pregnant.htm


Jeanne McCann: Here’s a question from me: I read that 36,000 people died in the u.s. last year from seasonal flu, but no one was sterilizing classrooms and closing schools. What makes this situation--

3:15 Jeanne McCann: different?

3:16 Bill Modzeleski: States have been thinking about the issue of school closures --and expectations for students. All states have developed plans related to the flu...I’d check with state plans.

3:16 Scott McQuigg: this flu is more virulent and is thought to have a higher mortality rate than other influenza viruses, though this is unproven, that is why the CDC, state depts of health and school leadership are taking this so seriously

3:17 Scott McQuigg: the good news is this virus, like other flu viruses, doesn’t survive long outside of the body or a tissue, maybe a couple of minutes
that is why we think schools should be educating/reminding children to cough or sneeze into arm, the virus won’t live long on cloths

3:17 Bill Modzeleski: Schools should always maintain safe and clean environments, cleaning and disinfecting frequently touched surfaces following manufacturer’s instructions. It is not recommended at this time for schools to do extensive cleaning of walls and those types of surfaces like we’ve been seeing all day on CNN.

3:18 Jeanne McCann: A lot of questions about how students can keep up...EdWeek just addressed this question this morning, in this story: With Swine Flu Closing Schools, E-Learning Eyed as Option

3:18 Jeanne McCann: Question from carol, for scott:

3:18 [Comment From Carol]
Are schools employing distance education tech, so students do not miss out on learning? Will this type of health concern stimulate development in this field?

3:18 Scott McQuigg: As Bill noted there are not recommendations yet for cleaning. Since the virus doesn’t live long outside fo the body, cleaning schools with bleech during a shutdown might make parents feel better, but will have little impact


Bill Modzeleski:

An issue to consider with H1N1 is the speed it is spreading and how far it is spreading. While we don’t know much about its severity [we have one death in the US] we are concerned that it not spread any further and therefore taking mitigation steps.

3:19 [Comment From Ann]
What other contingency plans do schools have --other than to close a school?

3:20 Jeanne McCann: What about ann’s question? are there other plans in place?

3:21 Scott McQuigg: we published a list of 7 actions schools can take to avoid spreading the swine flu. I think this list is a good guide to the precautions schools should take. Here is the link http://www.healthteacher.com/news/Article/955

3:21 Bill Modzeleski: Not sure I understand the question about other contingency plans. But in addition to closing schools, schools should be working with parents and community groups to ensure children who are not in school are fed, have appropriate supervision and support.

3:22 Jeanne McCann: Another question about closing. Bill, give this one a shot.

3:22 [Comment From Guest]
The President asked schools to consider closing in the event that students and/or educators become ill. Who makes that decision? Is the process the same as for school closure due to inclement weather? School closure for medical reasons seems to require a more complex information/decision-making metric than declaring a snow day. How are school boards, superintendents and principals approaching this important decision?

3:22 Scott McQuigg: The best contingency is proper hygiene education and communication to parents stressing the importance of keeping children who display symptoms, particulary a fever at home.

3:23 [Comment From barbara pereyra]
I think we should remind people about the importance of sleep in maintaining a healthy immune system.

3:24 Scott McQuigg: Proper rest, exercise, eating right, hygiene - good lessons for this flu or any infection control effort

3:24 Jeanne McCann: Any recommendations about field trips, bill?


Bill Modzeleski:

Decisions about closing schools are made primarily at the local level with guidance from the State. The role of the Federal gov is to provide guidance on closing. but the decision is local

3:24 [Comment From DASD]
Do you have recommendations regarding field trips in-state and out-of-state?

3:26 Scott McQuigg: I think the swine/H1N1 offers a great teachable moment. Children are very aware of the flu. I think we need to sieze this opportunity to reinforce proper hygiene and other healthy habits.

3:26 Jeanne McCann: Say more about that Scott. What messages are children getting?

3:28 Bill Modzeleski: In regards to field trips I would again review CDC guidance re. attending places where lots of people congregate. Also would communicate with health officials in location you are traveling to.

3:28 Scott McQuigg: Kids are hearing about this in the media, online, at home and discussing it among friends at school. Younger children are scared. Its an opportunity to discuss hygiene, how public health works, etc.

3:29 Jeanne McCann: Lots of questions about AP exams. Not sure if either of you can answer them. We’re trying to get an answer here at edweek.

3:29 [Comment From Tara Farr]
National AP exams start next week. What will happen for students whose schools are closed?

3:29 Bill Modzeleski: Follow up to travel question...to the extent practicable it is important to maintain a sense of normalcy for children. We do not want to needlessly frighten them.

3:30 Bill Modzeleski: Will try to find out little more about this --the AP issue.

3:30 Jeanne McCann: Michele wonders why CDC is recommending a 14-day school closure? Are they? Bill, can you field this?

3:30 Scott McQuigg: Parent communication is key to all of this. kids with any symptoms need to stay at home! whether going on a field trip or going to school

3:30 [Comment From michele]
It sounds like CDC recommends that a school that closes remains closed for 14 days. Why so long?

3:32 Scott McQuigg: here is a link the CDC recommendations for schools with confirmed H1N1 virus: http://www.cdc.gov/h1n1flu/k12_dismissal.htm

3:32 Scott McQuigg: It is saying 14 days because children are likely to be infectious for 7-10 days post onset

3:33 Bill Modzeleski: Couple of things here...first, remember the guidance is changing. It is changing as we learn more about H1N1 Currently it is felt that in order to successfully mitigate against it schools need to remain closed that long to prevent against further transmission. Because the virus appears to be spreading so quickly, there are possibly more cases in the school and closing for 14 days would help keep kids separated for that long to prevent additional spread.

3:33 Scott McQuigg: My son’s school closed for 7 days, sounds like we might be adding to this


Bill Modzeleski:

the guidance is continuing to change and emerge as we learn more...

3:34 Scott McQuigg: We suggest schools have a high index of suspicion of symptoms; its better to send a child home and be wrong, than to allow a child to stay in school and possibly infect others

3:35 [Comment From Robyn H.]
It would probably be great if your district has internet access to go to some type of virtual classroom setup or e-mail assignments.

3:35 Scott McQuigg: As the swine flu has multiple symptoms, it is strongly suggested that any student or staff with a body temperature of 100° or higher stay at home. Students or staff who have had a fever should not return to school until it has been more than 24 hours since they last recorded a temperature above 100°.

3:36 Jeanne McCann: scott a question for you.

3:36 [Comment From ES]
For Scott, What are the 7 actions schools can take to prevent the spread of swine flu?

3:36 Bill Modzeleski: Agree...also encourage folks to go to free.ed.gov that site contains free educational resources


Scott McQuigg: here is an abreviated list. the full list is online at http://www.healthteacher.com/news/Article/955

* Encourage students to stay home if they are sick.
* Teach about personal hygiene.
* Remind students to cover their mouths if they cough and wash their hands regularly.
* Provide disposable tissue and hand-sanitizing gel.
* Clean all surfaces between groups of children.
* Consider alternative teaching methods if an outbreak occurs.
* Communicate with parents about good hygiene.

3:38 Jeanne McCann: Bill or Scott:

3:38 [Comment From Guest]
Do you think that the media is blowing this out of proportion?

3:39 Scott McQuigg: The media coverage is adding to the concern. But the media also has an information dissemenation role to play.

3:39 Bill Modzeleski: Let me add one more...and that is we encourage every school to have a Emergency Management Plan and if they do make sure the plan addresses issues of disease including but not limited to flu. It is essential that every school have such a plan as “things” that disrupt teaching and learning happen every day and we must be prepared to deal with them.

3:39 Jeanne McCann: As a member of the media, we thank you.

3:40 Bill Modzeleski: I think it is imperative that educators have quality information. Recommend that they go to sites such as ed.gov and cdc.gov for information. these sites often will refer folks to other sites that have quality information.

3:40 Jeanne McCann: Debbie needs your help.

3:40 [Comment From Debbie Grace]
Please say, 24 hours fever-free, without medications. Our childcare parents don’t seem to get that if they take a fever reducer and don’t have a fever, they still have a fever.

3:41 Jeanne McCann: Folks, we’ll have a complete list of resources at the end of the chat.

3:41 [Comment From Florence]
As far as E-learning, many families have no internet connection at home, and not being a neighborhood school, getting work home would be difficult. I read CDC recommends if schools close it should be for 11 days to to the length of the contagion stage.

3:42 Scott McQuigg: Debbie makes a good point, one that we need to clarify on our list. the 24-hour free period is sans fever-reducers - aspirin, Advil, etc.

3:42 Bill Modzeleski: one other thing to think about the media is that especially with young kids, there may be some disturbing information or images.

3:42 Jeanne McCann: What can/should parents be doing? There’s a lot of confusion.

3:42 Scott McQuigg: First, if you have a sick child, keep them home.

3:44 Jeanne McCann: Bill or Scott: can you reiterate this info about cleaning schools? some people may have missed it.


Bill Modzeleski:

Parents should reinforce messages about good hygiene and as Scott says if their child is sick to keep him/her home. Parents should also be conscious that their kids may be anxious and be ready to answer questions, even if the answer is that we don’t know yet. Being calm and reassuring will go a long way to prevent panic.

3:44 Scott McQuigg: Additionally, parents should be aware of the symptoms and closely monitoring. Parents should also be aware of who their children are playing - are others sick. Parents need to reinforce good personal hygiene at home - the best way to avoid this flu or any other is regular handwashing and coughing/sneezing etiquette

3:45 [Comment From Judy]
We do not have any cases but want to be proactive. Currently we use all purpose cleaner for desktops etc. and antibacterial for bathrooms. Is this satisfactory?

3:45 Scott McQuigg: Concerned parents should monitor the CDC website and/or be in touch with their pediatrician


Bill Modzeleski:

All schools should practice good cleaning habits and regularly clean and disinfect frequently touched surfaces following manufacturer’s label instructions. CDC does not advise at this time that it is necessary to do extensive cleaning on surfaces such as walls or doors themselves (doorknobs, yes).

3:46 Jeanne McCann: Thanks Bill.
Here’s more info from the National Association of School Psychologists, the National Association of School Nurses, and the National PTA, about Talking with Children:

3:46 Scott McQuigg: I touched on cleaning earlier. Since the flu virus only lives for minutes outside the body, cleaning hours/days after the outbreak will have little-to-no impact. it will likely make parents feel better, but there is no evidence to support it.

3:47 Jeanne McCann: Is this flu airborne? Bonnie asks.

3:47 Scott McQuigg: Yes. Flu particles travel when an infected person coughs or sneezes.

3:48 Bill Modzeleski: All purpose cleaner may be sufficient for cleaning but for frequently touched surfaces should also be disinfected, which may require additional or different products. My understanding is that antibacterial soaps are not required especially for this situation, as influenza is a virus (not a bacteria). Regular soap is sufficient.

3:48 [Comment From W Meagher]
On behalf of National PTA, I also want to share a resource that we just released this afternoon, in collaboration with the National Association of School Nurses and the National Association of School Psychologists: Talking to Children About Swine Flu: A Parent Resource (http://www.pta.org/Documents/Talking_With_Children_About_Flu_FINAL.pdf).

3:48 Jeanne McCann: Thanks PTA


Bill Modzeleski:

Hi Whitney! Glad you released this!

3:49 Jeanne McCann: We just got a statement from the College Board, we’ll be posting in a moment.

3:49 Jeanne McCann: What about facemasks? Scott?

3:50 [Comment From Bonnie]
In a state where there are no ‘confirmed’ cases, children have seen people around town wearing face masks and were traumatized. (stores are handing them out) How should we know when and if we should practice these measures?


Scott McQuigg: You don’t need a mask unless you are caring for someone who you suspect has the flu. Not all masks are effective. Here is our guidance from our list of actions:

As an extra precaution, schools can provide respirators/masks (N95 or higher filtering face piece) to school nurses who come in direct with students who have flu symptoms. These respirators/masks could be used by students who have flu symptoms to stop the immediate spread of germs while awaiting transportation home.


Bill Modzeleski:

CDC has guidance on use of facemasks and respirators. They may be effective if someone is actively coughing or for people treating those who are sick, like school nurses for example, but we defer to CDC. It’s important to remember that if someone is going to wear a respirator, that they use it correctly, change it often, and dispose of it correctly.

3:51 Jeff Lambert: The CDC released some guidance on facemask use in schools. Check it out here: http://www.cdc.gov/h1n1flu/masks.htm

3:52 Jeanne McCann: Jeff is one of our web producers here at edweek.org. Thanks for the link.

3:53 Jeanne McCann: What about summer school? Bill any guidance yet?

3:53 [Comment From Bob O]
Our business is running education enrichment camps during the summer. Do you think schools would have any reason to shut down for the summer?

3:54 Bill Modzeleski: We have not had any guidance yet on summer school. One thing to note is that flu typically tapers off in the summer months.

3:55 Jeanne McCann: Beth has a question about childcare facilities. Scott or bill?

3:55 [Comment From Beth]
What should childcare facilities do when schools begin to close? Would we not be cross contaminating the children if we allow them to come to the childcare center if their school had been sent home? If we do not allow school age children to come the childcare center there will still be possible contamination by younger siblings. In a community where schools are closing due to possible cases should childcare center take the precautionary stance and close too?

3:55 Bill Modzeleski: I thing the advice for camps is to follow guidance --community mitigation guidance --offered by CDC. Also, camps are encouraged, if they don’t already have one, to engage in close collaboration with a health entity.

3:57 Bill Modzeleski: Childcare facilities should not accept students from schools that have been closed. If there are siblings in the childcare setting of students in closed schools, the CDC guidance recommends that child care also consider closing, in collaboration with the local health department.

3:57 Jeanne McCann: College Board just set up a hotline #.


Web Producer: Jennifer: In regards to the AP Exams, Megan Dearing at the College Board just sent this statement to Education Week:

The College Board is monitoring the H1N1 (swine flu) outbreak and is actively working with school officials where Advanced Placement (AP) Exam administrations may be delayed due to school closings. If you are in an affected area, please speak directly with your school’s AP Coordinator to discuss how this outbreak may impact your AP Exam administration.

The AP Exam administration is designed and prepared for unforeseen school closings and other emergencies. In addition to the AP Exams that are offered during the first two weeks in May, we provide a set of make-up exam dates that occur in the third week of May. In cases where a problem or situation persists, and students are unable to test on those alternate dates, even later make-up exam dates can be arranged with the school. The College Board will assist in whatever way possible to ensure that students affected by this matter have the opportunity to take their AP Exams.

They emphasize that schools should contact their local AP Coordinators who can be reached at

AP Coordinator Hotline: 877-274-6474

Email: apexams@info.collegeboard.org

3:59 Jeanne McCann: How will we know when the threat is over, Georgia asks.

4:00 Scott McQuigg: most flu viruses deminish in the summer. I suspect there will be communication from the CDC or WHO.

4:01 Jeanne McCann: Technical glitches, folks. Too many people online, I guess!

4:01 Scott McQuigg: however, there is some thought that H1N1 is here to stay. we must start early next school year educating children about hygiene and communicating with parents regarding the winter flu season


Jeanne McCann: Here’s the link to Scott’s 7 steps schools can take:

The American Association for Health Education and http://www.HealthTeacher.com developed 7 actions schools can take to limit the spread:

4:02 Bill Modzeleski: Also need to be mindful that H1N1 can come back in the fall..

4:02 Jeanne McCann: Last question on public transport, Bill or Scott:

4:02 [Comment From Susan]
I am in a district where students use public transportation to get to school (metro/buses). If cases become prevalent in our district, should we close school? (We are a charter school system separate from the main LEA).

4:03 Scott McQuigg: I’ll let Bill take this one

4:03 Bill Modzeleski: The CDC recommends that schools in areas where there are large numbers of cases to consider closing schools in that geographic area. Would recommend reviewing CDC’s updated interim guidance for school closure at www.cdc.gov.

4:04 Jeanne McCann: While we wait for Bill, edweek has just published a collection of info related to the outbreak:

4:05 Jeanne McCann: Thanks to both our guests today, I apologize for the lousy connection!

4:05 Jeanne McCann: We’ll continue bringing you the latest info on edweek.org.


Jeanne McCann:

One more link: advice to schools from CDC and the Ed. Dept.:


4:06 Bill Modzeleski: Appreciate it...please check our web site at www.ed.gov and flu@ed.gov if you have questions or know of a school closure.

4:06 Scott McQuigg: Thank you Jeanne. Remember good health is contagious. Lets use this opportunity to educate kids about good hygiene and cough etiquette.

4:06 Jeanne McCann: Thanks again to both Bill and Scott. UPDATE, Monday, May 4, 2009, from Scott at HealthTeachers.com: “Updated guidance has come out about how long the flu virus can live outside of the body. . ... the CDC updated H1N1 info saying the virus can live on soft surfaces for up to 20 minutes, and on hard non-porous surfaces for between 2-8 hours. There is still no guidance or evidence that suggests that schools should be cleaned during a closure, though, cleaning commonly used surfaces during school – as we suggest in our “7 actions” - is still suggested.”