City Announces New Swine Flu Strategy

Focuses on Keeping Public Schools Open

By Conor Greene

The city’s strategy to fight the expected breakout of swine flu this fall includes offering free vaccinations to all elementary school children and providing the public with information regarding the number of cases reported in a specific school.

The plan, announced on Tuesday by city officials at Gracie Mansion, includes an “open school policy” that seeks to slow spread of the H1N1 virus and avoid mass closures. Mayor Bloomberg sought to assure residents that the city is better prepared to deal with an outbreak this fall after hospitals were overwhelmed this past spring and parents complained about a lack of information.

A recent White House study predicted that as many as 90,000 Americans could die as a result of a new H1N1 outbreak, with 60 million to 120 million becoming sick and hospital emergency rooms overwhelmed. However, the mayor on Tuesday said signs suggest a more “moderate” outbreak than predicted in the panel’s report.

“There is no indication the virus will be more virulent than what we experienced in May and June, but we must have and do have contingency plans in place in case the virus becomes more widespread or more severe in its symptoms,” said Mayor Bloomberg. “In situations like this, it’s natural to imagine the worst-case scenario, but all signs at this point in time do point to an outbreak that will be much more moderate.”

The city’s strategy to fight the spread of swine flu, particularly in schools, centers on measures “designed to slow transmission while classes and activities continue,” according to a press release. Aspects of the plan include getting children vaccinated, keeping them home when sick and following basic procedures such as thoroughly and frequently washing hands.

Once a vaccine for H1N1 becomes available this fall, the city plans to distribute it to health care providers and offer it for free to school-aged students. For elementary-aged students, the vaccine will be available within each school building, while older students will have to travel to central sites within each borough. Parental consent will be required before students are vaccinated.

The city also plans to use a central database to allow school nurses to report the number of students seen for influenza-like illness during each day. A daily public report will be posted on nyc.gov/flu listing schools reporting five or more cases the previous day. The daily report will also show the previous day’s absentee rate for every public school – though the city stresses that it is “important to understand that absenteeism is not by itself a measure of influenza activity.”

The third aspect of the city’s plan is an influenza-prevention campaign in each of its 1,500 public schools. Signs and classroom instruction will stress the importance of covering coughs and washing hands, restrooms will be continually stocked with soap and paper towels and parents will get written reminders to keep their children home when they’re sick. That message will be reinforced if a nurse sees five or more cases of flu-like illness in one day.

If a school experiences “excessive influenza activity” – defined as four percent of the student body (at least 15 children) being seen by a school nurse on a single day – a doctor or supervising nurse will visit the school to assess the situation. The supervisor will determine whether the school has students whose health conditions place them at high risk of influenza complications and may “recommend additional safety measures.” However, school closure will only be considered “as a last resort,” the city announced.

“Today is the first of what will be many efforts to keep New Yorkers informed about what we are doing to prepare for the return of the H1N1 and seasonal flu,” said Mayor Bloomberg. “We can’t predict this year’s flu season, but we can make sure that city government is fully prepared for whatever happens.” It was noted that 15 separate groups worked over the summer to create a strategic citywide response to the expected outbreak.

Still, the mayor’s announcement was met with concern from some local elected officials, including Councilwoman Elizabeth Crowley (D-Middle Village), who is worried the vaccinations won’t be available in time. She also argued that outside nurses should be hired to administer the vaccine, instead of having school nurses shoulder that responsibility as currently planned. “Flu season officially starts today and we still do not know [by] who andwhere the H1N1 vaccinations will be administered,” she said.

Nick Comaianni, president of Community Education Council 24, said city officials should consider closing entire school buildings if an outbreak is detected. “Obviously they will have to use judgment, but if you’re trying to prevent something from spreading, the best option is to close the school for a few days and let the germs die,” he said. “If you have cases out there within a school population, then I agree the schools must be closed… Once you see it spreading, I think the best thing is to close the schools.”

On the national level, President Barack Obama was briefed by cabinet members including Secretary of Health and Human Services Kathleen Sebelius and Secretary of Homeland Security Janet Napolitano. “I don’t want anybody to be alarmed, but I do want everyone to be prepared,” he said.

The virus killed about 500 Americans after first emerging in April and sickened more than 1 million individuals across the nation. Worldwide, more than 2,000 people died during the initial outbreak. Development of the vaccine is still underway and officials expect it to be available to the public by October. While it is taken on a voluntary basis, the president said it is “strongly recommended.”

“We know that we usually get a second, larger wave of these flu viruses in the fall, and so response plans have been put in place across all levels of government,” added President Obama. “Our plans and decisions are based on the best scientific information available, and as the situation changes, we will continue to update the public.” The president also reminded Americans to take basic precautions, including staying home if sick and frequently washing hands. “I know it sounds simple, but it’s important and it works,” he said.

Locally, borough hospitals are making preparations to handle the expected influx of new patients this fall. Michael Hinck, director of public relations for MediSys Health Network, which runs Jamaica, Flushing and Peninsula hospitals in Queens, said preparation efforts have been ongoing after receiving as much as double the typical patient-load on certain days last spring.

“We’ve been expecting this since we were really at the center of the last outbreak. Our expectations are to see an increase,” said Hinck, who noted that two area hospitals closed earlier this year, just before the initial swine flu outbreak hit the area. “It put a strain on us, but luckily we have a long history of disaster preparedness so we quickly devised a plan. Like in the spring, we want the public to know we are prepared and will do everything we can to meet the needs.”

To prepare for the higher patient levels, Jamaica Hospital has added 40 additional in-patient beds and has plans to reallocate additional space for swine flu patients if necessary, added Hinck. Officials are also ready to be in constant communication with city and state health officials to monitor spread of the virus. “We’re going to manage all aspects of this situation and make sure we will be able to have continuity of care in other operations so other areas don’t suffer,” he said.