After the swine flu scare last spring and the precautions it prompted, College administrators spent the summer increasing institutional knowledge of the H1N1 virus and developing protocol in preparation for its arrival on campus. Though there were no cases on campus in the spring, one student has been isolated with the flu as of Monday.
According to Health Services Director Ruth Harrison, the administration expects more cases and is preparing accordingly. “We think it’s inevitable that it will happen on all college campuses,” said Dean Merrill. “I don’t see how we can escape it, given that the flu hits the young population, that students live in close quarters and that winter will have us inside. It’s a very contagious virus.” The New York Times reported last week that, according to an American College Health Association survey, over 2000 U.S. college students have been victims of H1N1. At institutions such as Emory, Carnegie Mellon and St. John’s, houses and gymnasiums have been set aside and outfitted for large numbers of ill students. At Cornell, over 450 students have been infected and one student died last week after contracting the virus.
Much has been learned about H1N1 since the original outbreaks last spring. It is believed to be very similar to the seasonal flu, both in its symptoms and transmission. It is a short-lived and mild illness for most people, although it presents more complications for some, particularly those with underlying medical conditions such as respiratory disorders, cardiac disorders, immunosuppressant disorders and diabetes. In addition, H1N1 spreads quickly and easily. “The virus is still mild, but is incredibly infectious, and it can just wreak havoc,” Harrison said.
Attempting to minimize the potentially chaotic impact of the virus, the Health Center has now developed a plan for diagnosis, isolation and treatment of ill students. If a student comes to the Health Center with flu-like symptoms, he or she is immediately given a mask and asked to wait in a room designated solely for flu patients. A nurse then visits the ill student with an eye for symptoms characteristic of H1NI. These include a fever of over 100-100.4 degrees Fahrenheit, a cough, a runny nose and a sore throat. “If they’re all present, especially the fever, we presume that to be H1N1,” said Harrison.
The College, like the state of Massachusetts, has stopped testing for H1N1, as epidemiologists expect that the virus will in most cases replace the seasonal flu. Taking flu-like symptoms as indicative of H1N1, as opposed to something less serious, is an important precaution, explained Harrison. “It could be a cold, but because it’s circulating in the community, we don’t want to take a chance,” she said. According to Harrison, flu and cold symptoms can sometimes be similar, but the flu is generally more severe and develops more suddenly than a cold. Flu symptoms often include body aches, tiredness and a dry cough, she said.
For students, being diagnosed with H1N1 prompts a mandatory isolation period. Health Center staff first determine whether the student can go home without using public transportation, and students who cannot do so are directed to self-isolate in their rooms. “We give them a mask and disposable thermometers and tell them to stay put,” Harrison said. The masks are to prevent spread of the virus for when infected students leave their rooms for the bathroom or medical treatment.
Isolation becomes more complicated for those with roommates, as two people are only allowed to stay in the same room if both have flu symptoms. In the case where only one person is infected, the College plans to use unfilled rooms to move the uninfected student out, while the ill person remains in isolation. Members of the College’s pandemic planning group are still developing protocol for an event where large numbers of students need to be moved out of roommate situations.
Isolation ends when an ill student has been free of fever for 24 hours without fever-reducing medication. The College’s plan provides for meals to be delivered to isolated students, and for a dean to be assigned to each sick student so that the academic repercussions of isolation are mitigated. “We’ve learned from other institutions that many concerns revolve around academic work, so a dean will know which classes ill students are in and contact professors, acting as a kind of go-between,” Merrill said. “Depending on when a student is sick, the dean may be more necessary in helping students to organize extensions, and so on.” Harrison stressed that concern over academics not keep students from isolating themselves. “The faculty knows about the possibility of H1N1, so they will work with the deans and students,” she said.
While having developed a plan to control the spread of the virus, the College is simultaneously working towards prevention, particularly by encouraging all students to get flu vaccines. The Health Center will offer seasonal flu vaccines in a clinic on Oct. 7 and plans on offering the H1NI vaccine after its release later that month.
The College will likely be a site for vaccine distribution, as college students are fourth in the list of priority groups, behind pregnant women, caregivers for children younger than six months of age and healthcare personnel.
Though the College is attempting to prepare for the worst, Harrison doubts the flu will prompt drastic measures such as closing the College. “The flu generally lasts only three to five days, so we hope that everyone won’t be sick at the same time,” she said. “We anticipate not having to close.”
Merrill confirmed that closing is an unlikely option, but emphasized the importance of planning for every possible outcome. “It’s going to be an evolving situation,” she said. “We need to have a set of responses we can go to.”