Governor's Office of School Accountability H1N1 Teleconference for School Superintendents 8/27/09

This afternoon, I had the opportunity to participate in a teleconference hosted by the Governor’s Office of School Accountability that provided to School Superintendents an update on H1N1 in Georgia.  Presenters on the teleconference included Dr. Rhonda Medows, Commissioner of the Georgia Department of Community Health and Dr. Garry McGiboney, Associate Superintendent for Innovative Instruction at the Georgia Department of Education.    These presenters were accompanied by others from their agencies.

 

We have been experiencing H1N1 in the United States since April 2009.  This is the first pandemic since 1967.  The term pandemic does not refer to severity.  It simply describes a new virus to the human race for which we have no immunity.  A huge number of people across the US will most likely be impacted by the H1N1 pandemic.  The symptoms could remain mild.  So far, this year the severity of the H1N1 flu are the same as that of seasonal flu.  For a few years we have been planning for the worst case scenario.  When the H1N1 pandemic first hit health officials erred on the side of assuming the worst until more could be known about the virus.  The CDC has classified the severity of the current H1N1 as low to moderate.  At this level health officials are not recommending any preemptive school dismissals but would support school closing decisions made by local school systems if so many staff or students were out sick that the school cannot continue to operate.  Health officials will continue to monitor the situation and adjust these recommendations accordingly.  To date, the H1N1 virus has shown very little resistance to traditional flu treatments. 

 

An H1N1 specific vaccine is currently being tested.  It is likely to become available for use about October 15^th.  The H1N1 vaccine will only be released if clinical studies show that it meets FDA standards for safety and effectiveness.  Initially only limited quantities will be available and will be targeted for high priority populations including children age 6 months to 24 years.  Caretakers of children younger than 6 months, pregnant women, adults age 24 – 65 years who have other complicating health factors, and healthcare workers including EMS who are likely to come into contact with persons infected with H1N1.  The H1N1 vaccine will be free but providers will be allowed to charge a small administration fee.  Health officials will be very diligent in monitoring any adverse events associated with the new vaccine.  They will also perform thorough screenings prior to administering the vaccine.  The seasonal flu vaccine is more important than ever and highly recommended.  Health officials do not want anyone to become infected with both the seasonal flu and H1N1 flu as this increases the possibility that the flu strain could mutate and become worse.

 

Dr. Medows made several summary points:

1.       It is very likely that there will be an increased volume of students who become ill with flu-like symptoms. 

2.       As long as there are adequate staff and students in attendance there is a preference to keep schools open.

3.       School systems should continue to maintain positive working relationships with the local health district (in Barrow County we do this).

4.       The severity of the H1N1 flu has not increased since April.

5.       State, national and International health officials continue to monitor the progression of H1N1 to identify any changes in severity or resistance to treatment.

6.       Thorough and frequent hand washing is critical especially prior to eating, after going to the bathroom and at the end of the day.

7.        All people should get a flu shot.

8.       Kids who are sick with flu like symptoms at school should be isolated until they can be picked up and taken home. 

9.       School personnel should take care of themselves to prevent illness.

10.   Students and staff may return to work after 24 hours without a fever or other flu-like symptoms.

 

There was a question and answer session that generated the following information:

·         At this time the treatment for H1N1 is the same as that of seasonal flu.  The two are basically identical in severity and treatment.  Routine testing to confirm H1N1 is not recommended and not a very good use of resources.  The CDC will perform laboratory confirmatory tests for H1N1 if a person has been hospitalized or the health district recommends a particular case for confirmatory testing.  A laboratory confirmation performed by the CDC is different  from a rapid test performed in a doctor’s office.  The rapid test can produce false negatives (this means that the rapid test may show that the sample is not H1N1 when in fact it is).  Testing is of limited use and school personnel should depend on doctors to make treatment decisions for their patients. 

·         Not every person who gets sick with the flu will need to be treated with prescription flu medications.  These should only be used when it is determined by a doctor to be needed.  Overuse increases the possibility that the flu will become resistant to the treatment.  Many mild cases of the H1N1 flu can be treated with over the counter medication to treat the symptoms and rest. 

·         People who are vaccinated for seasonal flu may still become infected with H1N1 flu.  Likewise, people who are only vaccinated for H1N1 flu may still get seasonal flu.  It is important to get both vaccinations as they become available. 

·         When isolating sick students in school, while waiting for someone to pick up the student to take them home, it is important to create a barrier to prevent the spread of respiratory droplets.  This can be done by keeping the student at a distance of 3- 6 feet from other students and/or having the student wear a surgical mask. 

·         There is a network of providers scattered throughout Georgia that send samples to the CDC for routine testing.  The results of these tests show that 98% of flu cases at the current time are H1N1 cases.  However, these cases are not different in severity or treatment than seasonal flu cases. 

Barrow County Pandemic Flu (H1N1) Briefing 8/27/09

This morning I had the opportunity to be a presenter at the Barrow County Pandemic Flu (H1N1) Briefing for Department Directors and Elected Officials.  The purpose of the meeting was to provide an update on the current state of the H1N1, vaccination plans and other issues relative to H1N1 in Barrow County.  Presenters included Jimmy Terrell, chairman of the Local Emergency Planning Committee; Steven Dumpert,  PIO Northeast Georgia Public Health; Missy Chalker, RN, Barrow County Health Department; myself and Brent Burish, COO Barrow Regional Medical Center. 

 

I will not attempt to summarize everything that was said in the briefing but only those pieces of information most relevant, in my opinion, to Barrow County Schools.  The information presented below is my best interpretation of the information that was presented at the briefing.

 

Steven noted that the label pandemic refers to the spread of an illness not the severity.  To date H1N1 has been very similar to seasonal flu in terms of severity.  While H1N1 as a type of flu has been around in humans for some time the particular sub-type that is currently concerning us is new.  This sub-type is being referred to as Novel H1N1 and it is a recombination of 4 strains of H1N1.  Humans currently have very little to no immunity to Novel H1N1.    

 

In terms of vaccinations, the production of seasonal flu vaccine has been reduced in order to devote resources to increase the production of a vaccine for H1N1.  This vaccine is currently undergoing clinical trials and cannot be released to the public until the FDA deems the vaccine safe.  Currently there are too many unknowns in the clinical tests.  It is likely that there will be an approved vaccine at some point in the future. 

 

Everyone should prepare to be infected with the flu this year.  Everyone is also encouraged to get the flu vaccine.  Do not wait to get the flu vaccine when it is available because the chances of the virus mutating increases if a person is infected with both seasonal flu and Novel H1N1 flu at the same time. Most likely anyone who gets the flu at the moment is going to have H1N1 but H1N1 is no more serious at the present time than is seasonal flu.  Employers should be prepared to deal with extensive absences.  People who have been in contact with H1N1 infection and not become sick, and there are many examples, have developed some immunity.  The virus can survive for 2 – 8 hours or more on surfaces and it prefers surfaces that are cool and dry.  Frequent cleaning of surfaces and hand washing is recommended.

 

Missy told the group that seasonal flu vaccines were arriving today and the health department will start rolling out vaccines on Monday.  People interested in getting the seasonal flu vaccine can walk in to the health department between 8-12 and 1-4 on regular work days. 

 

I reported on H1N1 related activities within the school system including the fact that we have been engaged in pandemic flu planning for a few years now.  We have participated in a community-wide drill related to Pandemic Flu and have two representatives who are active on the Barrow County Pandemic Flu Planning Committee.  We continuously monitor the CDC website for changes to the guidance for schools and follow the guidance provided.  That guidance has not changed during the 2009-2010 school year but is different from the guidance the CDC issued in spring 2009.  We also maintain regular contact with Susan Kristal, Nurse Manager Barrow County Health Department, as our point of contact with public health.  We continue to emphasis flu prevention activities which include washing hands thoroughly and frequently, covering coughs and sneezes, staying home when sick for at least 24 hours after the fever breaks, and more frequent cleaning of surfaces.  Each of our schools have a Pandemic Flu plan that is updated as needed.  We are also monitoring staff and student attendance and will report to the local health department anytime absences reach a 10% threshold or an unusual pattern develops.  I also told the group about this blog as a resource for information. 

 

Brent Burish reported the Barrow Regional Medical Center is as prepared as any hospital can be.  They partner with a network of other hospitals which would allow them to call in additional resources if an outbreak was localized to a particular area.  Hospital staff have participated in multiple exercises to test their plan and preparedness. 

 

Ken Greene

 

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CDC Media Briefing 8/21/09 summary

This afternoon I listened in on a Media Briefing from the CDC. I will try to post a link to the transcript and recording of this briefing in the links section to the right when it is available. In this blog, I will summarize the most important points in this briefing as they apply to Barrow County Schools.

The speakers on the briefing were Dr. Jay Butler, Dr. Jesse Goodman, and Dr. Anthony Fauci.

Throughout the summer months there have been low levels of flu activity in the US and this unusual activity has primarily been attributed to H1N1. Currently the CDC is not doing routine testing for H1N1 cases if the patient is not hospitalized. The H1N1 flu disproportionally affects young people. To date, normal flu treatments seem to be working. The incidence of H1N1 cases in the southern hemisphere seem to be decreasing in most places. The southern hemisphere seems to have experienced a flu season similar to that of the US this past spring. The CDC and other health organizations continue to closely monitor H1N1 around the world.

A vaccine for H1N1 is being developed and tested. It is expected that there will be 45-52 million doses by mid-October. Currently, plans are to distribute the doses to states based on population probably through an upgraded version of the Vaccines to Children program. The target groups for the first doses of the H1N1 vaccine include pregnant women, children 2 years to 24 years, people 25-64 with other flu susceptible medical risks, and those with an increased risk of exposure to H1N1 or a higher likelihood of transmitting H1N1 to high risk persons. Vaccines will be voluntary. The FDA is closely monitoring the production of the vaccine to ensure that it is safe and available. So far the clinical trials have been positive with no red flags to date regarding safety.

The CDC will continue to plan for the worst case scenario and lots of flu activity during the current school year. They strongly urge everyone to remain diligent in utilizing flu prevention techniques such as frequent hand washing, covering coughs and sneezes and staying home when sick.

They likened the possibility of stopping the spread of H1N1 to altering the course of a hurricane or stopping the earth from shaking during an earthquake. However, we can mitigate the severity of this pandemic.

The message that I took away for Barrow County Schools is that we need to remain diligent in continuing to follow good prevention techniques and staying abreast of information as it becomes available.

H1N1 Updates blog created 8/21/09

I am creating this blog as a resource for followers who want to know more about H1N1 and actions Barrow County Schools are taking to respond to this pandemic flu.  In addition to the blog updates I plan to also add links to other resources that I believe would be helpful for followers that want to know even more about H1N1.  You may subscribe to this blog via email to receive notices when new blogs have been posted.  Simply enter your email in the email subscription box in the upper right corner of this page.