Swine Flu Disruption Has School Officials Looking for Lessons

With hundreds of schools now reopened after closing because of swine flu, public officials are trying to distill lessons from the experience, including how decisions were made to shutter schools and whether more school-based nurses might help reduce the impact of such epidemics.

School officials, in some instances, were still grappling late last week with the practical consequences of the closures, such as the disruption to spring standardized testing and its effect on state and federal accountability demands—including the 95 percent participation rate on state tests required under the federal No Child Left Behind Act.

“This outbreak has proven that a pandemic can have a ripple effect in our communities,” U.S. Rep. George Miller, D-Calif., the chairman of the House Education and Labor Committee, said in remarks prepared for a May 7 hearing on ensuring preparedness against the flu virus in schools and workplaces. “It’s a delicate balancing act between taking necessary safety precautions without overreacting or igniting panic.”

Striking the right balance is no easy task.

Federal health officials originally advised schools to shut down temporarily if there were confirmed or probable cases of the H1N1 virus among their students. They reversed course on May 5, saying schools no longer needed to be closed because the virus had turned out to be milder than initially feared and it was already being spread through communities in other ways.

But even as the flu’s impact on the operation of schools seemed to abate, the federal Centers for Disease Control and Prevention was warning that the current outbreak was still unpredictable, and that the flu strain could well return later in the year.

At the peak of school closures on May 5, the U.S. Department of Education reported that some 726 public and nonpublic schools serving nearly a half-million students were closed because of the swine flu, though most schools were expected to have reopened by the end of last week. The closures spanned the country, touching 24 states and the District of Columbia.

In some instances, entire districts were closed, including the 80,000-student Fort Worth Independent School District in Texas and the 19,000-student Plymouth-Canton district near Detroit.

Debbie Ratcliffe, a spokeswoman for the Texas Education Agency, noted that the response to the flu situation from district to district in her state was uneven.

“It has varied, and I think that’s one of the issues we’ll want to look at as we debrief,” she said. “We’re a big state, and we have many school districts and many local health departments, and they didn’t always respond identically to the same situation.”

She added: “We told our districts to consult with their local health officials and follow their advice, and some of those health officials took a much more aggressive stance than others did.”

Schools first began closing in response to the H1N1 outbreak during the last week of April. Initially, federal health officials advised that schools strongly consider closing if they had a confirmed case or a suspected case linked to a confirmed case. On May 1, they said schools with a confirmed or probable case should close for up to 14 days.

In Fort Worth—which reopened May 8 after a six-day shutdown—Superintendent Melody A. Johnson said she had consulted with local health officials, as well as state health and education officials, in making the decision to close as of April 30.

“I will say, it’s easy to Monday-morning quarterback, and I’m sure we’ll have a lot of that going on,” she said. “But as the person responsible for 91,000 people a day [including adult personnel], our rule of thumb is you put children first, and that means their safety, well-being, and health as well as their education.”

She said that as of the middle of last week, the district had 14 confirmed cases of swine flu, and still more probable cases.

Ms. Ratcliffe, of the Texas Education Agency, said closing schools is a very disruptive action. It can cause a real hardship for some members of the school community, preventing students from receiving a free breakfast or lunch on campus, for instance.

On top of that, Texas schools were administering standardized state tests when some of them closed down. Ms. Ratcliffe said the state would work to help schools and students make up the tests. Another issue is the 95 percent participation rule for testing under the No Child Left Behind law.

“That could be a problem because even as our schools reopen, they’ll probably have lower-than-normal attendance rates, and we need them to test pretty quickly,” Ms. Ratcliffe said.

As for making up lost school days—a frequent subject of questions from parents—Ms. Ratcliffe said that, if needed, the state would waive on a case-by-case basis the state requirement for a 180-day school year.

Not all states may have such wiggle room. The New York education department put districts on notice May 4 that the agency was not legally authorized to excuse schools from that state’s 180-day requirement for flu-related closures, and that schools could lose a proportion of state aid accordingly. However, the department said that if the flu’s impact became “greater than anticipated,” it could ask the legislature to amend state law to excuse the missed days.

Compliant, But Reluctant

Some 20 miles west of Detroit, district officials closed the Plymouth-Canton district’s 24 schools, though only for two days. Superintendent Craig A. Fiegel expressed some reluctance about closing all of them. A 16-year-old student at one of the high schools—all three high schools share space on one campus—was suspected of having swine flu.

“I wasn’t sure of the severity of all of this, but I’m certainly not a medical doctor,” Mr. Fiegel said, noting that the decision was made in close consultation with local health officials and with federal guidelines in mind.

Mr. Fiegel said that school officials felt pressured by “public perception” and by recommendations from the CDC at the time to close the schools.

“I felt like we were kind of boxed in,” he said. “If you don’t take it seriously and end up with more cases, then it’s your fault.”

Mr. Fiegel also said the actions of school officials might not even have addressed the problem sufficiently.

“While we were preparing to close our schools down, there were community events all over that brought large numbers of people together,” he said.

In Maryland, state officials ordered the closure of five schools, including Rockville High School—in the 144,000-student Montgomery County school system—where there was one probable and several suspected cases of the virus among students and staff.

Although Montgomery County Superintendent Jerry D. Weast said he backed the initial decision to shut Rockville High, he wanted it to reopen sooner than state officials planned.

Early last week, before federal officials advised that schools no longer needed to stay closed, Mr. Weast sent a memo to the district school board lamenting that Rockville High still was not cleared to reopen.

“We do not believe that this is the right decision given the lack of compelling evidence for continued closure provided to us by state and county health officials,” he wrote. A day later, after the CDC changed its advice, all Maryland schools were allowed to reopen.

In announcing last week the change in the federal government’s stance on closing schools because of H1N1, federal health officials said that parents should still keep children with flu-like symptoms home for seven days. Federal health officials also acknowledged the need to balance concern about the flu’s spread with the many burdens involved with shutting schools.

The 435,000-student Chicago public school system announced May 4 that any student with a 100-degree or higher fever and a cough must stay home for seven days.

Call for Nurses

At the U.S. House hearing last week, Jack O’Connell, California’s state superintendent of public instruction, said one way to improve response to situations like the swine flu crisis may be to increase the number of school-based nurses. He noted that California’s public schools have fewer than 3,000 nurses serving some 6.3 million students.

“Perhaps more school nurses could have helped us with early detection and even prevention,” he said.

Mr. O’Connell also said communication needed to be improved between his department and local education agencies to ensure better tracking of individual schools that had been ordered by local health authorities to dismiss students.

During the hearing, U.S. Rep. Joe Courtney, D-Conn., questioned one element of the response by schools.

“One of the other ripple effects in terms of how school officials reacted, maybe overreacted, ... is [schools] were subjected to these pretty dramatic scrubdowns,” he said, referring to the intensive efforts to sanitize the schools. “Local school budgets are stretched thin. This is all overtime generated as a result of this effort.”