When the so-called swine flu returns this fall, keep sick children at home, don’t spread the infection to co-workers, and ultimately, Gov. M. Jodi Rell told a gathering in town, “use common sense.”
That was Rell’s ultimate advice during a Wednesday meeting at Southern Connecticut State University with educators and state, and local public health officials on how to cope with an expected upsurge in swine flu cases in the coming months.
“Sometimes we can only use common sense with H1N1,” she said.
The knottier problems of making up lost federal funds for absent students, and who should receive a vaccine, if one is developed by then, remained unanswered for now.
“We’re going to depend on you to keep track of attendance,” Rell (pictured) told school teachers and administrators. “How many students are out? We’ll be doing that with emergency rooms and businesses.”
The only effective weapons against H1N1 flu are the anti-vital drugs Tamiflu and Relenza. Connecticut has recorded 5,648 cases of flu so far this year, and seven deaths. More than 800 of the cases were identified as H1N1.
H1N1 is considered dangerous because it is a novel strain, and most people have no immunity.
During an average flu season, about 2,000 to 3,600 cases are reported in Connecticut, of which about 20 percent lead to death from pneumonia or other illnesses.
The state departments of education and public health want to eliminate a repeat of the less than organized response to scattered cases of H1N1 type A influenza that appeared last spring.
Rick Matheny, director of the Farmington Valley Health District, said, “This whole experience is like building a plane while you’re flying it.”
The Farmington Valley Health District encompasses the Granby public schools, where the state’s first swine flu cases appeared.
Alan Addley, superintendent of Granby’s schools, decided to close a school for seven days in late April, 2008, after a female student who had returned from a trip to Mexico started to exhibit a fever and flu-like symptoms.
Addley said he found himself groping for answers about the schools’ responsibility to provide the required 180 days of classroom time every year, the confidentiality of the student, and steps that should be taken to curb the outbreak.
“The state should coordinate with the schools. What will the guidelines be? What is the chain of command? How does a superintendent deal with medical information and HIPAA?” he said.
HIPAA, or the Health Insurance Portability and Accountability Act of 1996, sets stringent privacy standards for patients, including students. All Addley could do was mail all parents a vague letter about a possible swine flu case.
Some adults were furious, he said, although he later found that everyone in the small town knew the identity of the girl and was bullying her sibling.
“Public health and education don’t speak the same language,” said Debbye Rosen, state department of health adult immunization coordinator.
“We need to collaborate, coordinate and communicate. As we look forward to the fall, everything will be perfect.”
A school nurse asked, “Why aren’t there state guidelines, so local health departments are not all separate?”
The state will issue “recommendations,” Rosen said.
Dr. Matthew Cartter, state epidemiologist, said in a Power Point demonstration that the “best place for well children is to be in school,” while “the best place for sick children is to be at home,” to avoid spreading the virus.
As of July 9, the U.S. Centers for Disease Control and Prevention reported that 21 percent of the country’s H1N1 patients are between 5 and 24 years old. Only 18.4 percent are older than 25. Generally, influenza hits older people the hardest.
Cartter said that early and prolonged school closure can substantially ease the flu burden on hospitals by reducing the number of cases. The downsides include a disruption in education, parents losing work if they stay home to care for their children, and malnourishment if sick children depend on school meals. Children could still congregate in malls and other places, too.
Leonard Guercia Jr., chief operating officer of the state’s health department, predicted that the U.S. will receive 40 million to 160 million doses of H1N1 vaccine by November.
Of that supply, Connecticut could get 480,000 to 1.8 million doses, he said.
Cartter said federal recommendations will be issued on who should be vaccinated and when.
If a severe, 1918-type flu hits with a 30 percent illness rate, about 422,000 Connecticut people will become ill, 102,350 will require hospitalization, and about 24,000 patients will die, Cartter estimated.