‘School Closing’ as a - PowerPoint Presentation

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‘School Closing’as a Potential Means to Counter Pandemic Influenza

Table Top Exercise (TTX)

Public Health Measures

Categories of Interventions

Pharmaceutical

Non-Pharmaceutical

Public Health MeasuresPharmaceutical Interventions

Vaccines

Antivirals

Public Health Measures

Individual Measures

– ‘

Hygienic’

Hand washing

Cough etiquette

Washing inanimate surfaces

Masks & respirators

Community-based Measures

Self-isolation

Self-quarantineSocial Distancing MeasuresWork Place PoliciesGatherings restrictionsTravel restrictionsSchool Closings

Non-Pharmaceutical Interventions

‘School Closing’as a Potential Means to Counter Pandemic Influenza

School Closing Warrants Special ConsiderationChildren among the highest at-risk population

Children among most likely to spread the disease

Poses an immediate community-wide impact from a single policy decision

Substantial adverse socioeconomic impacts

Pros & Cons of all stakeholders must be considered

Overview / PurposeProvide a Public Information Exchange Forum for Pandemic Influenza IssuesDiscussion to facilitate planning and to assess School Closing as a potential means to counter a Pandemic Influenza outbreakProvide valuable feedback for policy formulation at all levels of government

Exercise Scenario - 1The World Health Organization (WHO) has confirmed sustained human-to-human transfer of a virulent influenza virus in several Asian countries and has determined that an influenza pandemic is underway (WHO Phase 6).CDC has advised that the pandemic influenza virus is likely to reach one or more contiguous 48 states in the next 30 days.

(USG Stage 4).

HHS has issued guidance for State and Local governments to consider non-pharmaceutical measures as potential countermeasures.

Discussion Questions - 1Realistic expected range of morbidity & mortality for the community? (Identify your Science Advisor!)

Likely healthcare demands upon hospitals & other healthcare facilities?

Expected quantity of antiviral drugs?

Plans for use of antiviral drugs?

How would school closings affect response plans?

Other community-wide actions?

(Public Health Risks & Countermeasures)

Exercise Scenario - 2The World Health Organization (WHO) has confirmed sustained human-to-human transfer of a virulent influenza virus in several Asian countries and has determined that an influenza pandemic is underway (WHO Phase 6).CDC has advised that the pandemic influenza virus is likely to spread across all 50 states

(USG Stage

5

).

HHS has issued guidance for State and Local governments to consider non-pharmaceutical measures as potential countermeasures.

School Closing ConsiderationsChildren are efficient transmitters of fluIn Asian flu pandemic of 1957-58, the highest rates were seen in school age childrenData on School Closing is limitedOne published study found significant decrease in incidence of disease as result of school closures

Risk of infection & illness likely decreased with closures

Mathematical modeling suggests reduction of transmission due to School Closing

Child Care arrangements will be required if School Closing

School closures also have significant impact on the community and the workforce

Discussion Questions – 2Who has authority to close some or all of entire public school system? (similar to snow days?)What is ‘procedure’ for routine closings?Is the locus of authority different if 4 - 6 weeks?

Is there a state authority for resolving disagreements between adjoining jurisdictions?

Public school officials authority over private schools?

Decision to ‘Re-open’ Schools? Who? When?

(Decision Making Process)

Break

Discussion Questions - 3What % of teachers / admin would be idled?Policy for compensation of idled workers?Program for continued ‘at home’ education?‘Latch-key’ special needs?Status of ‘other school-based services’?

If extended period (4 – 6 weeks), what is the requirement for make-up days? (Longer?)

Plans to preclude ‘unofficial mall’ gatherings?

(Impacts from Closing Schools)

Additional Information

Discussion Questions - 4Parents away from jobs to supervise children?Employers ‘telework’ arrangements?Employers liberal leave policies?Employers Continuity of Operations Plans?Assistance from other public or private entities to assist parents with their ‘at home’ children?

Absentee Impact on community infrastructure?

(Other Public & Private Entities)

Final Comments

Conclusions from the Historical Record: 1918 Pandemic“Swift, agile, decisive, and coordinated action based on accurate information and advanced preparedness planning, before the appearance of influenza in the local area, is

critical

.”

Howard Markel, MD, PhD www.dtra.mil/asco/DTRAFinalInfluenzaReport.pdf

End