Information from County Health Officer Frank James
May 5, 2009
Subject: School Closures in San Juan County
We have spoken with all the Superintendents of schools in San Juan last Friday, on Sunday and yesterday. On yesterdays call daycare, preschool, after school, summer camp, and library leaders were also included.
We have decided to continue the policy of school closure when there is a case in a school. Beyond that we will close all schools in the district (each separate island) if there is a single case in that school system. We have one school (a small private school) closed at this time. School closures are based on a suspect case (with quick test confirmation when possible) but we will not wait for confirmation as that process clearly takes far too long for effective action to require that step to be completed. This policy will remain in place for the remainder of this week. We believe that students are best protected by this policy in our community at this time. Island communities that are relatively isolated have special challenges but some advantages.
While we have had a case in our community and likely about 9 others they were all from Bellevue and were returned to that community shortly after diagnosis. Because the data at the state level is residency data rather than occurrence data that case has been counted as a King County case. It was positive by quick test, and group A non-typable at the state lab last Sunday and has been forwarded to CDC for confirmation. That individual and nearly 300 traveling with them were returned to their homes after being isolated at the summer camp. Another group was returned to Richland (36). The summer camp staff have been stratified by risk and quarantined, two have developed cough but none fever to date.
All of our schools have "distance learning" plans in place for how to continue the educational process even if they are closed. Other facilities also have plans in place for making the use of their facilities safer in this situation (libraries). Our most active after- school program is voluntarily closing until next week. These were all joint decisions of the health department in dialog with educational and childcare providers. We based our discussion on two factors. First that this has proven to be a potentially lethal disease (on Sunday there were 506 confirmed cases in Mexico with 19 deaths, both numbers are higher now) and have morbidity risks (again on Sunday there were
226 cases in the US, 30 of which had required hospitalization). Likely the number of cases is dramatically higher than these numbers and the deaths and hospitalizations are likely only slightly higher than official counts. We recognize that the risk is fairly low but still significant, but better data will likely be available by next Monday.
Secondly we believe that while there are suspect cases in our community that it appears that if the disease is in our community that it is limited enough that closing schools and modifying other social contact situations will be of significant benefit.
Our community’s policy will be in place for the duration of this week and then reconsidered. We are not following the details of the CDC recommendations in that we are currently only closing for 7 days (one incubation period not two) but then we will reevaluate because the level of our understanding of the disease process may well change in that time frame. We are fortunate to have had already in place antivirals for treatment for more than a year and a cooperative and engaged community in the planning process over the past several years.
Being small, out of the way and independent is sometimes and advantage, Time will tell.
Frank James MD
Health Officer
San Juan County