Monday, August 10, 2009

Swine Flu, Cellular Quarantine, and Education

Swine flu is on the news in America, as the school systems around the country try to convince parents that they are on top of the potential crisis, at the start of our new school year.  Most take the form of disinfecting the schools during the summer break, and educating the school staff on swine flu and precautions.

However, one refrain I've heard from the school systems is, "We will not close the schools during a Swine Flu outbreak," to accommodate the working parents who cannot find alternative childcare arrangements.  That is suicidal.

I will not discuss the potential virulence, or the absence of, of swine flu for this fall/winter flu season, because it is mostly an unknown factor at this time.  Instead, I will focus on the general quarantine procedure policy here.

When swine flu, or a general flu outbreak, hits a school (probably defined as 5+ patients at the same time), we have to quarantine the student population.  Parents know that the schools in America serve as the disease incubator and transmission vector for the community; students get sick first, most of the time, before passing it onto the rest of the households.  So schools have to take the lead in minimizing disease transmissions.

At the same time, working parents have a legitimate concern over childcare during a school close.  Schools serve a secondary function as general daycare for working parents, who need to make ends meet.  So we need to provide an alternative childcare function during the quarantine as well.

The answer, logically then, is a cellular quarantine.  Essentially, the school teachers and students disperse away from the school during such a quarantine, but keep up the school days. 
1. The students in a subdivision or a neighborhood meet up at a location, either a teacher's house or that of a parent volunteer. 
2. The student group is made up of all students in that local area, regardless of grade, age, school, or other groupings. 
3. We keep the groups small, at 5 to 20 per group, depending on staff availability.
4. We assign a teacher or a school employee to supervise the student group.  The adult preferably lives close to the student group.
5. The students work on their assigned homework under adult supervision, a local Study Hall for an American equivalent.  The adult, or other students, provide homework assistance when necessary.
6. The local study hall can operate during the regular school day, or go on until 5pm, depending on the school policy.
7. In the litigation-prone America, the school district takes on all legal liabilities of the study hall, to encourage the house volunteering from parents.  The students then can walk to study hall.
8. Parents have the right to keep their children home, away from even the study hall, if they choose.  It is treated as equivalent to school absence.
9. Private schools are on their own, but they can work out memos of agreement with the public school systems, if they want to participate in the cellular quarantine.

We keep the students and staff dispersed into local cells.  These cells minimize interaction with each other, so there is no disease transmission across cells.  Any outbreak is immediately contained.  Parents will continue to have their day care.  The school staff continue to receive their working salary during the school close.  We keep the students occupied during the day.

This policy of a cellular quarantine provides a spectrum of policy responses for the public health officials and the school systems.  Instead of choosing between a business-as-usual versus a total system lock down (school closing), now we have a third choice of a cellular quarantine.  If the school system has a Geographical Information System, then it can even calibrate the size of the cells based on a risk assessment.  In other words, it can set the group size, 5 vs 10 vs 20, depending on the speed of disease transmission.

For the school systems in Northern America, who frequently have to contend with Snow Days during the winter time, this cellular quarantine provides an alternative as well.  Students can walk to their local rendezvous point during the snow days.  Parents have a daycare available, and we keep the kids occupied.  The school system gets a workout of its cellular quarantine procedures as well.

I hope some school districts will pick up on this idea and thus become less afraid of the political costs of a school closing.


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