Reducing Transmission of Pandemic (H1N1) 2009 in School Settings

This 9-page document from the World Health Organization (WHO) outlines a framework for national and local health and school authorities to consider when developing pandemic planning and decision-making guidance to reduce school-associated pandemic (H1N1) 2009 infections. The framework is applicable from primary to secondary school levels of education; it is not applicable to infant or other child-care settings or boarding/dormitory settings.

The components of the framework include the following 3 areas (the emphasis in this summary is placed on communication-related elements; please see the document for other aspects).

1. Planning in advance:
   • Establish an authoritative decision-making body - ensuring adequate participation of and providing information to all stakeholders - and develop communication strategies. According to WHO, reducing transmission requires the engagement and commitment of school community members (e.g. principals, teachers, students, school staff, and parents) and public health authorities at local and national levels. Information and lessons identified from countries' initial experiences with pandemic H1N1 can be helpful in revising earlier plans. To WHO, it is essential that effective lines of communication and education are opened and maintained between students, parents, and staff.
   • Include planning measures to mitigate the secondary impacts of school closures or class suspensions on the community - for example, promoting coordination among adjacent school districts to maintain trust and avoid fear among the public and minimising disruption of education through alternative strategies.
2. Implementing measures to reduce transmission:
   • Stay away from school when ill ["This is one of the most important measures to reduce transmission of pandemic influenza in school settings and applies to students, teachers and other staff."]
   • Use hand hygiene and respiratory etiquette
   • Isolate students and staff who become ill while at school
   • Reduce crowding
   • Ensure proper cleaning and ventilation
   • Disseminate relevant public health messages ["Reducing fear and panic and empowering students, parents and staff to make informed decisions heavily depend[s] on providing adequate, timely and clear messages which are updated and reinforced regularly. Schools should collaborate with national/local health authorities and follow their guidance on which key messages to deliver and try to ensure the messages reach and are acceptable to the target audiences."]
   • Guarantee essential services and supplies
3. Assessing the role of class suspension and/or school closure - WHO seeks to facilitate this assessment at national or local levels by:
   • Outlining necessary advance preparation [e.g., "...Decisions should be consistent and well-documented. Care must be taken to avoid discrimination..."]
   • Reviewing the evidence and experience of countries to date [e.g., "'Substantial' reductions in peak attack rates (and thus reductions in demands on health care systems during peak periods) might be achieved with relatively short periods of school closure."]
   • Presenting the key issues for consideration [e.g., "to achieve maximum reductions in attack rates, suspensions/closures must be implemented early in a pandemic outbreak....There are no agreed triggers to implement school closures; some that have been proposed include the first case in a student or staff member, the initial outbreak in a school, cases or outbreaks in schools that are nearby or cases or outbreaks in schools that students have had contact through shared academic, sports or other social interactions."]
   • Examining impacts and secondary consequences [e.g., "Media reporting of school closures could increase pandemic-related fears and concerns in the local community."]