Categorical Denial

Categorical Denial

# 738

Earlier this year, the CDC release their Pandemic Severity Index, which is displayed in the graph above. Along with it, they released a series of community intervention strategies based on the severity of a pandemic.

Among those strategies is the closure of schools, albeit only for a category 2 or higher viral storm. The deadlier the pandemic, the longer the schools would be kept closed. For a Category 2 or 3 event, the thought is roughly a month, for a category 4 or 5 pandemic, up to 3 months.

Given that schools would be a primary reservoir of the virus and promote its rapid spread, canceling classes makes a great deal of sense from a public health perspective.

Still, there are some who anguish over the side effects of such an action. They point out that school systems would lose money for every day the classes were empty, and that many kids rely on the school lunch program for proper nutrition, and working parents use the schools to watch their kids so they can work.

This from an editorial yesterday in the Anniston Star.

The best response to a pandemic would be to close the schools, but that would set off a ripple effect felt far and wide. Education would be disrupted and graduations would be delayed. Some parents and some school systems might turn to home schooling and online courses, but in the poor and more rural counties those options often don't exist.

What of the parents who would be forced to stay home, for schools are day-care centers as well as educational institutions? The labor force would suffer, business would be disrupted, the economy would slow and a recession might follow.

Unlike some opponents to the idea, this newspaper didn't come out against school closures, they simply listed the fallout from such a reaction.

Does anyone seriously think that by keeping the schools open we would avoid the deterioration of the labor force, disruptions in business, and a recession?

That somehow, during a severe pandemic, it would be the school closures would be the catalyst to plunge us into an economic downturn?

If so, they obviously have no appreciation of the differences between seasonal influenza and pandemic flu.

With seasonal flu, a healthy child or adult suffers for a few days, and in a week or so is able to return to work or school. The aged, or those with chronic health problems, sometimes succumb; but for most of us it is a miserable inconvenience more than a life-threatening illness.

Pandemic flu is many times more severe, and even those who survive are likely to endure weeks of illness, and a slow recovery.

And I don't think the critics of school closures understand that.

Thus far, the H5N1 virus has proved to be the deadliest influenza scientists have ever seen. We can hope its virulence will diminish, but there are no guarantees that will happen.

Over the past year, experts have spoken less and less about a mild pandemic scenario, and we've seen more acknowledgment that we may be looking at a repeat of 1918. And during that Spanish flu, we should remember, many people needed 6 weeks or longer to recover from the illness.

And of course, tens of millions didn't recover at all.

If we leave the schools open, we could be risking a million school kid's lives. Tens of millions of kids would be infected, and would bring the infection home to their families. Those parents who worked would likely spread it to their workplace.

In short order, whatever inconveniences caused by school closures would pale against the damage keeping them open would cause.

Like it or not, it will not be `business as usual' during a category 4 or 5 pandemic. There will be many businesses that will be impacted; some will probably close for the duration. A recession is all but inevitable.

We have to accept that we have limited options during a pandemic, and none of them are ideal. Vaccines will be very late to the scene, antivirals will be in short supply, and hospitals will be overrun. Our only real weapon will be finding ways to reduce the spread of the disease.

The question of school closures may be moot, however. Most parents will simply refuse to send their kids to school during a pandemic, either for their kids welfare, or out of fear of them bringing the disease home.

I can only assume that the hand wringing over the fallout from school closures, no matter how well intentioned, is simply a case of people being in denial over what a category 4 or 5 pandemic would really be like. That some people simply fail to appreciate how deadly a pandemic can be.

The alternative, that people would be willing to sacrifice the lives of kids in order to protect the economy, to me is simply unthinkable.

Of course, I may be in denial too.