WORCESTER PUBLIC WORCESTER PUBLIC SCHOOLSSCHOOLS

COMPREHENSIVE H1N1 COMPREHENSIVE H1N1 PLANPLAN

Worcester H1N1 Task Force: established April 2009Worcester H1N1 Task Force: established April 2009 David Clemons, Worcester Emergency Communication, ChairDavid Clemons, Worcester Emergency Communication, Chair

Appointed by City ManagerAppointed by City Manager

Membership included representatives from:Membership included representatives from:

Worcester DPHWorcester DPH Worcester Public SchoolsWorcester Public Schools Worcester PoliceWorcester Police Worcester FireWorcester Fire U Mass EMSU Mass EMS U Mass Div. of Disease ManagementU Mass Div. of Disease Management Great Brook Valley Health CareGreat Brook Valley Health Care Family Health CenterFamily Health Center St. Vincent HospitalSt. Vincent Hospital City Manager’s OfficeCity Manager’s Office Worcester Regional MRCWorcester Regional MRC

PURPOSEPURPOSE

• Review DPH and DESE guidance concerning H1N1 to coordinate surveillance and preventative measures

• Collaborate to articulate coherent media messages, Connect-Ed message and press releases

• Met daily, then weekly in the Spring and bi-weekly this fall

SummerSummer 20092009

•Smaller group (DPH, WPS, D. Clemons) met weekly for updates

•Worked collaboratively to develop surveillance, preventative measures

•Explore city-wide vaccination messaging and plans

WORCESTER PUBLIC SCHOOLS - Fall 2009WORCESTER PUBLIC SCHOOLS - Fall 2009

Receive frequent updates from MA DPH and Receive frequent updates from MA DPH and DESE through Superintendent’s Office and DESE through Superintendent’s Office and Nursing OfficeNursing Office

Participated in conference call with MA DPH and Participated in conference call with MA DPH and DESE on Wednesday, September 9DESE on Wednesday, September 9thth for for additional information and guidanceadditional information and guidance

H1N1 Task Force meets bi-weeklyH1N1 Task Force meets bi-weekly Focus on keeping schools openFocus on keeping schools open Focus on prevention strategies – educationFocus on prevention strategies – education Isolate and send home students and staff who Isolate and send home students and staff who

become sick at schoolbecome sick at school CDC is not recommending H1N1 confirmation CDC is not recommending H1N1 confirmation

testingtesting

Exclusion period Exclusion period

1.1. Must stay home for 24 hours after Must stay home for 24 hours after no fever and no fever-reducing no fever and no fever-reducing medications.medications.

2.2. Most can expect to stay home Most can expect to stay home about 4 days: 3 with fever plus about 4 days: 3 with fever plus one more dayone more day

3.3. Fever with influenza can last 2-5 Fever with influenza can last 2-5 days or moredays or more

DPH/DESE GuidanceDPH/DESE Guidance

H1N1 Symptoms: similar to normal human seasonal influenza

► Fever 100.4 ► Coughing or sore throat

► Headache/body aches ► Runny or stuffy nose

► Chills ► Fatigue

In addition to the above symptoms, a number of H1N1 flu cases reported vomiting and diarrhea.

Why the focus on schools?Why the focus on schools?Confirmed Cases of H1N1 Influenza in MA, as of 9/3/09Confirmed Cases of H1N1 Influenza in MA, as of 9/3/09

0

5

10

15

20

25

30

• 1399 confirmed cases

• Median age 14 yrs

• 63% of confirmed cases ≤ 18 years

• 13% hospitalized

• 11 H1N1 attributable deaths

• 36 child deaths in US; 80% > age 5

• Southern US now seeing increase in cases

<5 5-11 12-18 19-25 26-44 45-64 65+

Age Group in Years

Percen

tage o

f con

firmed

cases

Source: Commonwealth of Massachusetts Department of Public Health

Education of WPS Staff, Students and FamiliesEducation of WPS Staff, Students and Families

Staff EducationStaff Education Reassure all staff that there is no need for special “disinfection” or Reassure all staff that there is no need for special “disinfection” or

“decontamination.” When respiratory secretions dry out, virus is “decontamination.” When respiratory secretions dry out, virus is no longer infectious.no longer infectious.

At full faculty meetings nurses presented information on H1N1 and At full faculty meetings nurses presented information on H1N1 and all faculty reviewed DVD developed collaboratively by MTA, DPH all faculty reviewed DVD developed collaboratively by MTA, DPH and WPS which focused on pandemic and preventative measures.and WPS which focused on pandemic and preventative measures.

All teachers received the teacher fact sheet: Action Steps for All teachers received the teacher fact sheet: Action Steps for Teachers to Prevent the Spread of FluTeachers to Prevent the Spread of Flu

Cafeteria staff, bus drivers and monitors received similar trainingCafeteria staff, bus drivers and monitors received similar training Custodial staff met with administrators and Coordinator of Custodial staff met with administrators and Coordinator of

Custodial Staff & Maintenance Services to review building Custodial Staff & Maintenance Services to review building cleanliness guidelines with regard to H1N1: provide routine cleanliness guidelines with regard to H1N1: provide routine cleaning of “high touch surfaces”cleaning of “high touch surfaces”

Nurses received DPH immunization training on August 31, 2009Nurses received DPH immunization training on August 31, 2009 Nurses will be test-fitted for N95 masksNurses will be test-fitted for N95 masks

Student EducationStudent Education

Classroom teachers and nurses collaboratively planned and Classroom teachers and nurses collaboratively planned and delivered lessons on coughing etiquette, appropriate hand delivered lessons on coughing etiquette, appropriate hand washing and the importance of staying home when sickwashing and the importance of staying home when sick

Health and physical education teachers will deliver lessons Health and physical education teachers will deliver lessons throughout October focused on preventative measures to throughout October focused on preventative measures to stay healthystay healthy

Coaches will deliver the same message to all athletes Coaches will deliver the same message to all athletes participating in fall and winter sportsparticipating in fall and winter sports

Schools are displaying prevention posters in key areas such Schools are displaying prevention posters in key areas such as entrances, cafeterias and offices as entrances, cafeterias and offices

Allied Health class at Worcester Technical High School is Allied Health class at Worcester Technical High School is focusing a Community Service Project on preschool lessons focusing a Community Service Project on preschool lessons on H1N1 preventive measureson H1N1 preventive measures

Family EducationFamily Education

All families received All families received H1N1 Action Steps for Parents to H1N1 Action Steps for Parents to Protect Your Child and Family from Flu this School Year Protect Your Child and Family from Flu this School Year and Action Steps for Parents if School is Dismissed or and Action Steps for Parents if School is Dismissed or Children are Sick and Must Stay Home. Children are Sick and Must Stay Home. This information This information is also posted on our website.is also posted on our website.

Reassure all families that there is no need for special Reassure all families that there is no need for special “disinfection” or “decontamination.” When respiratory “disinfection” or “decontamination.” When respiratory secretions dry out, virus is no longer infectious.secretions dry out, virus is no longer infectious.

A letter to parents was sent home the first week of A letter to parents was sent home the first week of school and is posted on our websiteschool and is posted on our website

A link to A link to www.flu.govwww.flu.gov is posted on our website if is posted on our website if parents want additional informationparents want additional information

SurveillanceSurveillance

SPRING 2009SPRING 2009 Student dismissals due to Influenza-like illness (ILI) were Student dismissals due to Influenza-like illness (ILI) were

monitoredmonitored Collaborated with DPH, City Manager’s Office, Emergency Collaborated with DPH, City Manager’s Office, Emergency

Management concerning confirmed cases and messages to Management concerning confirmed cases and messages to familiesfamilies

FALL 2009FALL 2009 CDC, state and local DPH not requiring H1N1 confirmation testingCDC, state and local DPH not requiring H1N1 confirmation testing H1N1 confirmation testing recommended for high-risk cases only H1N1 confirmation testing recommended for high-risk cases only

(e.g. hospitalization) (e.g. hospitalization) Student dismissals due to ILI are monitoredStudent dismissals due to ILI are monitored Gathered and analyzed student and staff absences for 07-08 and Gathered and analyzed student and staff absences for 07-08 and

08-09 to monitor for possible increase in absences in 09-10 08-09 to monitor for possible increase in absences in 09-10

Materials PreparationMaterials PreparationSPRING 2009SPRING 2009 Masks, gloves and Sani-Cloths HB germicidal disposable Masks, gloves and Sani-Cloths HB germicidal disposable

wipes were purchased and distributed through the nurses’ wipes were purchased and distributed through the nurses’ officeoffice

FALL 2009FALL 2009 Sani-Cloths HB germicidal disposable wipes distributedSani-Cloths HB germicidal disposable wipes distributed Planning to deploy hand sanitizers in each schoolPlanning to deploy hand sanitizers in each school Donation of two touchless foam hand sanitizer dispensers Donation of two touchless foam hand sanitizer dispensers

for each schoolfor each school Partnering with DPH to access state-based fundingPartnering with DPH to access state-based funding

VACCINATION GUIDANCEVACCINATION GUIDANCE

H1N1 initial target groups as identified by the CDC:H1N1 initial target groups as identified by the CDC: Pregnant womenPregnant women Household contacts/caregivers of infants < 6 monthsHousehold contacts/caregivers of infants < 6 months Children and young people, age 6 months to 24 yearsChildren and young people, age 6 months to 24 years People age 25 to 64 with certain medical conditionsPeople age 25 to 64 with certain medical conditions Health care providers and emergency medical services personnelHealth care providers and emergency medical services personnel

VACCINATION AS PROTECTIVE MEASURE:VACCINATION AS PROTECTIVE MEASURE: Seasonal flu vaccination is being recommended for children/young Seasonal flu vaccination is being recommended for children/young

people between the ages of 6 months and 18 years oldpeople between the ages of 6 months and 18 years old H1N1 flu vaccination is recommended for children/young people H1N1 flu vaccination is recommended for children/young people

between the ages of 6 months and 24 years oldbetween the ages of 6 months and 24 years old Participation is voluntaryParticipation is voluntary WPS will partner with DPH and local health organizations to WPS will partner with DPH and local health organizations to

develop a coordinated plan for the administration of vaccine to develop a coordinated plan for the administration of vaccine to school-age children and families school-age children and families

SCHOOL CLOSURE DECISIONS IN THE EVENT SCHOOL CLOSURE DECISIONS IN THE EVENT OF INCREASED SEVERITY OF CONDITIONSOF INCREASED SEVERITY OF CONDITIONS

Primary goal is to keep schools open and Primary goal is to keep schools open and functioning as usualfunctioning as usual

Schools closure on case-by-case basis if Schools closure on case-by-case basis if influenza-like illness has impaired school’s influenza-like illness has impaired school’s ability to functionability to function

School officials will collaborate with the School officials will collaborate with the Worcester Department of Public Health Worcester Department of Public Health prior to final decisionprior to final decision

DPH will alert DESE and schools of DPH will alert DESE and schools of increased severity of conditionsincreased severity of conditions

IN THE EVENT OF SCHOOL CLOSUREIN THE EVENT OF SCHOOL CLOSURE

All school-related activities, sports events, etc. All school-related activities, sports events, etc. should be cancelledshould be cancelled

Discourage students from congregating Discourage students from congregating elsewhereelsewhere

Duration of closure should be discussed with DPHDuration of closure should be discussed with DPH Closures must be reported to DPH and DESEClosures must be reported to DPH and DESE We will use parental and staff notification We will use parental and staff notification

systems to inform of school statussystems to inform of school status Exploring options to maintain studentExploring options to maintain student learning learning

during recuperation and/or school closureduring recuperation and/or school closure

QUESTIONS/COMMENTSQUESTIONS/COMMENTS