Swine flu: jumping the wrong way in New York?

by revere, cross-posted from Effect Measure

Five more schools in the New York City borough of Queens have closed because of suspected swine flu cases. Eleven schools have now been closed there and hundreds of students are down with a flu-like illness. Parents are understandably concerned, the more so because not many days ago Mayor Bloomberg and the city's health commissioner (just named by Obama as the next director of CDC) were reassuring city residents this was pretty much lie seasonal flu.

We thought that was something that might come back to bite them, and now it has:

The cityâs schools seem to have become both a sentinel and an incubator for the new H1N1 strain of flu, Mayor Michael Bloomberg and his departing health commissioner, Dr. Thomas R. Frieden, acknowledged Friday.âIt appears at this point in schools in New York City in these days to be spreading more rapidly than traditional influenza,â Dr. Frieden said. âWe donât know why that is, but the fact we have neither a vaccine nor experience being infected with this strain of influenza are likely explanations.â

Some parents, school staff and teachersâ union officials wondered whether the city was moving too slowly to close schools with high absenteeism. Nancy Crespoâs daughter, Alexis, a seventh grader, attends Intermediate School 238 in Queens, which was closed Thursday. She said that nearly 80 children were quarantined Tuesday in the auditorium, and that her daughter had a 102-degree fever that night. She called the schoolâs main office Wednesday but was brushed off, she said.

âI wish it would have been easier for me to get answers,â Ms. Crespo said. Mitchell Wiener, an assistant principal at the school, was still in critical condition Friday at Flushing Hospital Medical Center.

Mr. Bloomberg and Dr. Frieden defended their caution by saying that they were trying to balance the health of students with the child-care and educational needs of families.

âDay by day weâre learning more,â Dr. Frieden said. âItâs a judgment call.â

Mr. Bloomberg added: âWe close schools as infrequently as we can. Our kids need more time in school, not less.â(Anemona Hartocollis and Javier C. Hernandez, New York Times)

 

They aren't sure why the flu is spreading more quickly than seasonal influenza? Maybe because it's a strain to which there is no natural immunity in the school population of students or staff? That was certainly the reasoning behind CDC's initial recommendations to close schools when swine flu cases appeared. Closing schools is a tough call. It affects a lot of families and produces immediate push back, and CDC has modified its recommendations since the first week of the outbreak. But their first instincts were sound, and to their credit they have not engaged in the tendency to minimize the seriousness of the situation that Bloomberg and Frieden have yielded to.

Bloomberg may have been surprised by this development, but Frieden shouldn't have been. I agree with him it was a judgment call. And no matter which judgment was made, there was a risk that someone would say he made the wrong one.

But I hope that seeing which way Frieden jumped on this one isn't a harbinger of things to come when he is CDC Director.

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By Ellen Silbergeld (not verified) on 20 May 2009 #permalink

Ellen: We were calling attention to the fact that this virus was, in a sense, prejudged by Bloomberg as "no worse than seasonal flu," with his commissioner nodding in the background. Frieden has been praised for his handling in some quarters, which is also premature, as your response implies. In negotiating the tricky line between reassurance and expressing warranted concern, in our view Besser has done it better, more accurately, and, as it is turning out, more adroitly.

It is indeed too early to say how this will turn out, but it is not too early to comment on the ways policies are being communicated and justified. It wasn't the actions we were commenting on. There is no meaningful difference between what CDC is recommending and what Fieden/Bloomberg have done. The difference is in how each has communicated the substance.