Tuesday, April 28, 2009

School Closure and Swine Flu

One of the big lessons learned often cited from historians of the 1918 influenza pandemic is that communities who practiced social distancing had significantly less mortality than those who did not. A problematic lesson to emulate in places like New York City. But here in the land of desert and suburban sprawl it is a possibility. The media is reporting that school districts in Texas have closed schools due to this flu (which the pork industry is lobbying to change from swine flu to North American flu as they are already taking a financial hit from lowered pork sales).

School closure is a double edged sword. On the one hand, you have the potential (although there is little evidence based research to back this up) to quell flu activity in your community. On the other hand, with kids out of school you run the risk of losing a significant proportion of your workforce as they go home to care for the kids. Not a problem in some industries, but it is a problem when we talk about healthcare workers. Especially if the case count continues to creep up. So should we close the schools? The advice from CDC is yes when you have one confirmed case or one epi linked case. I have heard some health authorities who say that is too conservative -- the time to act is now, get ahead of the thing -- and others who think it is too liberal, a gross over reaction.

I caught a CNN reporter yesterday (it is now a permanent fixture in our emergency ops center) discussing the "scary, deadly virus." Um, CNN guy, that is not helpful. Fear mongering only makes this worse. A commentator from Mexico City on NPR stated that 20 million of his neighbors were infected -- with fear. Fear is what prompted the literally hundreds of calls my staff fielded today. A bit of fear is a good thing. Too much is paralyzing.

Should we panic? No. We should be cautious. We should all have enough food and supplies in our homes to minimize trips out in public. We should avoid crowds. And wash our hands a lot. And certainly if we are sick, we should take some personal responsibility and stay home.
The cases in the US reported so far have been relatively mild. I am hopeful that trend will continue. I would like nothing more than for this to fizzle out in a y2k bust and let us have egg on our faces for over reacting. I would much prefer that to the nightmare scenarios in our disaster drills. However it goes, to all the workers battling this disaster, take care of yourselves too. God bless, and God speed.

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