As students return, 'U' preps for swine flu's arrival as well
Stephanie Steinberg
Daily Staff ReporterSeptember 6th, 2009
The much-hyped swine flu epidemic is expected to sweep across college residence halls and classrooms this fall, as students from all corners of the world converge on their respective college towns. But University of Michigan officials say they've got the game plan to effectively fight the flu.
Dr. Robert Winfield, the University's chief health officer, said the strategy has been in the works since the avian flu scare three years ago.
At that time, the University formed the All Hazard Planning Group — a committee of individuals from various University departments — that made preparations for any pandemic that might reach the campus.
“We assembled a group of about 50 people from across the University to consider what could happen, how we would prepare for that, what things we could do to prevent spread, what things we could do to assure the safety of students, faculty and staff, how we could keep operations going academically and research-wise and how to keep the hospital system running in the event of a pandemic,” Winfield said.
After plans were developed, the work was put aside and the emergency planning group began considering other kinds of emergencies, including how to deal with active shooter situations like the one at Virginia Tech in 2007.
With the outbreak of H1N1 in Mexico last April, Winfield said the committee reconvened to update pandemic prevention strategies — holding daily phone conferences in the spring and numerous meetings throughout the summer.
“We reactivated our influenza plans and began actively screening for H1N1 disease, paying a lot of attention to (World Health Organization) notices, the (Centers for Disease Control and Prevention) guidelines, the Michigan Department of Community Health guidelines and working closely with the Washtenaw County Community Health Department,” he said.
HOUSING'S PLAN
The All Hazard Planning Group has been collaborating with University Housing on plans to prevent H1N1 from spreading through residence halls. Housing Spokesman Peter Logan said the University advises ill students who live nearby to leave campus and go home to recover.
“We’re going to ask students who are sick to either go home to recuperate or, if that’s not possible — and there are a lot of students where it wouldn’t be feasible — to stay in their apartments and ride the flu out in isolation,” Logan said.
He added that the residence halls will be at full capacity and that there is no space available to isolate and quarantine students to prevent the spread of the virus.
Housing will provide meals to students isolated in their residence halls, so as not to infect healthy students eating in the dining halls. Students will be able to order meals on the Housing website through Residential Dining Services, and food will either be delivered to an ill student’s room or the student can have a roommate or friend pick up food from the closest dining hall.
Logan wrote in an e-mail that the plan is tentative and can be adjusted based on the amount of students in isolation.
"If the scale of illness and in-room meal requests gets so large that this standard program is not sufficient, University Housing will then implement a plan for delivering meals to the residence halls," Logan wrote.
The University is also working on developing an online communication database where ill students can inform the University if they are going home to recuperate or if they will self-isolate themselves in their rooms.
Earlier plans called for resident advisers in residence halls to check on sick students and communicate the student’s status to the University. But emergency planners later decided that this system would not be effective.
“RAs are students and they have academic responsibilities as well, and if they had to suspend this that could be a problem,” Logan said, adding that resident advisers also would have a greater chance of becoming exposed to the virus.
TEST RUN
In July, the University’s preparedness plans were tested when 15 high school students attending a summer program on campus came down with the H1N1 virus. The students were staying at Alice Lloyd Residence Hall, but were moved to an unoccupied residence hall for a seven-day isolation period. The students recuperated after about one week.
Winfield said they worked “very aggressively” to contain the virus and efforts were successful, but more importantly, the outbreak allowed for emergency coordinators to evaluate their readiness before this fall.
“We all did a gap analysis identifying things where we recognized we hadn’t done sufficient planning or the planning that we had done wasn’t quite perfect,” Winfield said. “We have been identifying those gaps and have been addressing them all summer.”
INFORMATION CAMPAIGN
As part of the University's overall strategy to fight the virus, the Office of the Provost sent e-mails to students, families, faculty and staff that include information of symptoms to look for, like a fever over 100.4 degrees Fahrenheit, sore throat, coughing, sneezing, vomiting, headaches, muscle aches and diarrhea.
The University is following guidelines from the CDC, part of which includes asking students who become ill to self-isolate themselves in their rooms for the duration of the illness plus 24 hours after their fever ends.
In an effort to prevent the spread of germs, several committees have designed personal hygiene posters and mirror cling-ons that will be placed in campus bathrooms. The messages will remind students to wash their hands regularly with hot water and soap and cover their cough.
Andrew Burchfield, manager of emergency planning for the University, said these simple acts are the most effective way to reduce the spread of germs.
“(We’re) just trying to keep that constant reminder within people’s minds that washing their hands on a regular basis is critical and covering your cough is also extremely important,” Burchfield said.
The H1N1 virus is similar to the seasonal flu in that it can be transmitted through surfaces or contact with other ill people.
Robert Ernst, medical director of University Health Service, said washing your hands is the best way to protect yourself from getting influenza.
“Every time you shake hands with somebody or touch surfaces that are shared you run the risk of picking up the virus on your hands,” Ernst said, “and if you wash your hands in preferably hot soapy water or alternatively with some sort of hand sanitizer, you reduce the risk that your hands will be contaminated.”
Ernst added that coughing and sneezing directly contaminates other people and surfaces, so coughing into a shoulder or sneezing into a tissue can greatly cut down the spread of germs.
UNIVERSITY HEALTH SERVICE'S PLAN
UHS is asking students who become sick with H1N1 to not visit the health service unless they are pregnant or have an underlying condition as designated by the CDC. These conditions include students with diabetes, severe asthma, HIV and immune deficiencies.
UHS will not prescribe Tamiflu, the antiviral drug used to treat and prevent H1N1, to all ill students. In order to conserve supplies, only those who fall under high-risk categories like pregnant women, people with underlying health conditions and those at high risk who are exposed to people who already have H1N1 will receive medication.
“If your roommate gets H1N1 and you have asthma, we’ll treat you preventively," Winfield said. "But in general, we’re not going to be giving Tamiflu to the general public in order to conserve for when we really need it."
According to Cindra James, emergency preparedness coordinator at the Washtenaw County Public Health Department, the Health Department has about 3,500 doses of Tamiflu for Washtenaw County residents, not including University students. James said she expects that total will be an adequate amount to support the county.
“We have a stock pile here to work with in the fall,” James said. “Should that dwindle and should the hospital’s supply dwindle, we can always reapply and ask for more.”
Winfield said the University has a short supply of Tamiflu that will last if only those labeled as high-risk by the CDC are prescribed medication.
“We’ve been told we can get more from the federal government as we need it,” he said. “So we’re pretty sure we will be OK, but we aren’t sure how much were going to able to get.”
Ernst said the majority of patients visiting UHS with H1N1 have had symptoms similar to those of people who get sick every year from seasonal flu, including vomiting and high fevers.
“The reassuring thing is that most people who get H1N1 are not getting seriously ill,” he said. “The actual manifestation of H1N1 infection in young people tends to be not that different than the usual seasonal influenza, meaning people don’t feel well for several days, but they aren’t being hospitalized at a high percentage.”
Treatments for H1N1 are also comparable to those for the seasonal flu as they include staying well hydrated and taking medications with ibuprofen to reduce fevers. Students can recuperate without consulting a physician, but students who fall into the high-risk categories should visit UHS, Ernst said.
“Who should go see the doctor are those people who have underlying serious health conditions — so diabetics, or people who are on medications that may suppress their immune system or people who have underlying conditions that are being treated for on a regular basis,” he said.
Students who visit UHS seeking treatment for H1N1 will be asked to wear a mask to protect the health care providers and healthy patients in waiting rooms.
“That’s going to be one of our concerns — protecting our staff and protecting the other people in the waiting rooms from people who may be sick,” Ernst said. “Wearing a mask while they’re in the building is one way we can do that.”
In case the number of influenza cases needing treatment becomes increasingly high, UHS officials are creating contingency plans for limiting some of the more routine types of care. Ernst cited gynecological exams as one practice that could be put on hold if UHS becomes overwhelmed with influenza cases.
“We're creating continuity plans to try and make sure we have adequate staffing to handle what we think might be a high level of influenza cases,” Ernst said. “If that occurs, we may have to put off some types of elective visits.”
But Ernst said that will only happen if the volume of cases becomes “critical.”
The likelihood that the situation gets to that point is up in the air, though, as there’s no way to predict how large the outbreak will be on campus, Burchfield said.
“We really don’t know how bad it’s going to be — if it’s going to be bad, if it’s going to be really bad, it’s somewhat of a guessing game in waiting to see what the results are,” Burchfield said. “But I think overall, the University of Michigan has done a tremendous job in preparing and thinking about as many issues and making sure that we’re keeping our students, faculty and staff as safe as possible.”
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