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My Brush with Swine Flu–We Dodged It, But What About Next Time?

At the beginning of June, swine flu or H1N1 hit my daughters’ school in full force.  Thankfully, everyone survived the outbreak, but what about next time?  Experts predict that we haven’t seen the last of H1N1, or its more troublesome sibling H5N1, better known at bird flu.  In a recent Washington Post article, John M.

At the beginning of June, swine flu or H1N1 hit my daughters’ school in full force.  Thankfully, everyone survived the outbreak, but what about next time?  Experts predict that we haven’t seen the last of H1N1, or its more troublesome sibling H5N1, better known at bird flu.  In a recent Washington Post article, John M. Barry, a scholar at the Center for Bioenvironmental Research at Tulane and Xavier Universities and author of the book, “The Great Influenza: The Story of the Deadliest Pandemic in History,” wrote:

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There have been four pandemics that we know about in some detail: 1889-92, 1918-20,, 1957-60 and 1968-70.  All four followed similar patterns:  in initial sporadic activity with local instances of high attack rates—just as H1N1 has behaved so far—followed four to eight months later by waves of widespread illness with 20 to 40 percent of the population sickened.  Subsequent waves followed as well.  In all four pandemics, lethality changed from wave to wave—sometimes increasing, sometimes decreasing.  It’s impossible to what will happen this time.” 

If this pattern holds, some time between October, 2009 and February, 2010 we could face an even stronger more widespread epidemic.  Over the past month, I’ve been awestruck, in a creepy, skin-crawling way, by how fast the virus moved through one population, and then began to infect other grades and schools in the district as siblings and friends exposed one another.  I watched the challenges public officials, parents and doctors encountered as they grappled to coordinate a response.  It makes me very afraid for the next go round.  Here are a couple of the observations that surprised me:   

It happens so quickly it’s hard to get in front of the outbreak. The first official notification that something was amiss in the school arrived via an email from the Superintendent on Monday, June 1st:

The school district is continuing to monitor the potential outbreak of H1N1 cases in our school community on a daily basis…Student absenteeism rates across the district have been close to normal, with the present exception of one elementary school.  Following a field trip to Philadelphia last Wednesday, a high number of 5th graders are now home with flu-like symptoms.  We have briefed health officials on this development, and will monitor attendance closely in the days ahead.”

But that was three days after the first unofficial signs something was wrong began to travel through the all-powerful “moms network.”  On the Friday after the Wednesday field trip, my 5th grader came home from school and told me that half of both fifth grade classes were out of school sick.  Clearly something was wrong, and she was running a low grade fever.  Soon phones buzzed with symptoms that sounded very similar.  Over the weekend, more cases emerged and people began to wonder if they should keep their kids home. 

Unfortunately, the school district wasn’t looped into the informal network.  So by Monday they were greeted with a big problem that was too far gone.  The exposure had occurred.  The H1N1 horses were out of the barn, and the county stopped testing once swine flu was identified in the school.  Eight days late on June 9th, we received this email update:

“There are now four confirmed cases, all of which were from a cluster of students tested on June 2. These students experienced mild flu symptoms, stayed home for seven days, and have now returned to school. Attendance rates at the elementary school have improved dramatically in the past five days.  The Junior School is now experiencing a higher than normal rate of absenteeism”

Parents lie because they need to go to work and can’t afford to have their child home for 7 days which undermines containment efforts. Maybe it’s a combination of economic fear, and a lack of paid vacation days but more than a few parents admitted that they’d sent a child who had exhibited flu-like symptoms to school before the 7 days mandated by the district.  The reason for most, “I can’t afford to miss work.”  Trust me, I was doing the happy-dance when my daughter’s fever went away in 24 hours and she exhibited no other symptoms.  So I understand their struggle.

The number of kids with flu-like symptoms who returned to class two or three days later got so bad that the district began to require doctor’s notes vouching that the illness was not the flu.  Some schools in other neighboring districts did close in an effort to get in front of the virus.  I’m beginning to think that may be the only response if we do experience a more intense second-wave later this year.  

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But then what about these parents and their jobs?  Will a school closure qualify under FMLA even if your child isn’t sick?  Will parents risk losing their jobs?  From a public health policy perspective especially in this economic environment, does the government need to pass legislation protecting parents if schools are shut down because of H1N1?  

Telecommuting/telework needs to become more commonplace and widespread.  If the history outlined above is an indicator, waves of H1N1 will continue for at least two years.  But what if more workplaces decided to telecommute at the first signs of an outbreak?  What if entire cities told employees to work from home for a week?  Would that cause the virus to die out faster?   Technology gives us a powerful weapon in the form of telecommuting to combat the flu that didn’t exist in 1889-92, 1918-20, 1957-60 and 1968-70.  Let’s use it.  Here are some excellent resources for managers and individuals who want to learn more about how to work remotely:

Our H1N1 outbreak was mild, but it provided a disturbing preview into how ill-prepared we are to deal with a deadlier, more potent challenge in the near future.  Mother Nature’s given us a trail run.  We have four to eight months to prepare given what we’ve learned.   The question is, will we?  What do you think? 

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