Schools Reopen, with Hand-Washing Replacing Widespread Closures to Fight Swine Flu

The CDC’s new game plan for schools includes lots of hand washing and keeping kids at home when sick.

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Swine flu interrupted our family dinner last night but in a good way: in a robocall from the Montgomery County school district announcing that Rockville High School was reopening today, after being closed because it had one swine flu case. As of today, the federal Centers for Disease Control and Prevention has changed its advice to schools. The CDC now says schools can stay open with swine flu cases, unless there are so many sick kids and teachers that the school no longer functions. This will come as a huge relief to the many families around the country who are wondering how on earth they are going to care for healthy kids during weeks of school shutdowns.

The new keep-schools-open advice is based on growing evidence that the people who are getting swine flu aren’t getting sicker than they would from the run-of-the-mill seasonal flu. It may be that swine flu was circulating for months in Mexico and that the deaths there that freaked out infectious disease experts were really a small part of a much larger pool of mild cases.

But we’re not out of the woods yet; swine flu is still very much with us. The number of confirmed cases throughout the United States continues to rise, with 642 cases of swine flu and a second death, that of a 33-year-old woman in Texas who was hospitalized with the flu during her eighth month of pregnancy.

Swine flu, or H1N1 as the CDC likes to call it, is now part of our lives. It’s our job to figure out how to live with it, while keeping our families safe, healthy, and functional. Adios, face masks! Hello, hand washing.

Here are the take-home points in the CDC’s new game plan for schools:

1. Schools should stay open “unless there is a magnitude of faculty or student absenteeism that interferes with the school’s ability to function.”

2. Students, faculty, or staff with influenza-like illness (fever with a cough or sore throat) should stay home and should not attend school or go into the community except to seek medical care. That self-quarantine should last for at least seven days, even if the person feels better. If you’re sick for more than seven days, stay home until at least 24 hours after the end of symptoms. (Here’s practical advice from the CDC on what do to if you get the flu.)

3. Schools should send home anyone who appears to have the flu.

4. Don’t send sick kids to alternate child care: hard to do, but perhaps easier now that baby sitters will know they face much less risk from swine flu than first thought. Here’s more CDC advice on dealing with kids and swine flu. And here’s some wise advice I got from a risk communication specialist on how to help kids deal with flu fears.

5. Students, faculty, and staff should “stringently follow sanitary measures to reduce the spread of influenza.” This means covering nose and mouth with a tissue when coughing or sneezing (or coughing or sneezing into their sleeve if a tissue isn’t available), frequently washing hands with soap and water, or using hand sanitizer if hand washing with soap and water is not possible.

That hand-washing advice may sound wimpy, but study after study shows it’s the best way to fight infections of all kinds—not just scary new flu viruses but also the pathogens that cause strep throat, stomach flu, ear infections, pinkeye, and many other infections that plague school kids. So why, oh, why did it take a near pandemic (and polite badgering by a parent who’s a registered nurse) for my daughter’s elementary school to suggest that kids wash their hands before lunch? Isn’t this a lesson worth teaching?

The CDC thinks so. As part of its new advice, it states, “Schools can help serve as a focus for educational activities aimed at promoting ways to reduce the spread of influenza, including hand hygiene and cough etiquette.” So please get with the program, educational establishment. The fact that I’m stuck at home today with a sick kid after strep swept through the classroom is enough to make me a believer in hand washing, even without swine flu in our school.

Last, a warning: Swine flu may very well be back in the fall. People won’t have developed widespread immunity by then, and there most probably won’t be a vaccine available to fight it. What better way for schools to get kids prepared for "Swine Flu, Phase 2" than designating the month of May as Totally Awesome Hand-Washing Month? I’ll bet Luke Skywalker and Hannah Montana wash their hands before lunch. Kids should, too.