Closing Schools Early In A Pandemic

Closing Schools Early In A Pandemic

# 816

For many of us, the chart above illustrates our greatest concern about the next pandemic.

Simply put, the virus appears to prefer children and young adults.

We've seen this sort of pattern before with novel viruses. In 1918, a disproportionately high number of healthy young adults succumbed from the Spanish Flu, while the excess death rates in those over 65 actually dropped. And this is exactly the opposite of what we normally see with seasonal influenza.

While seasonal flu normally claims thousands of lives each year, it usually exacts its toll from the elderly, or those with compromised immune systems, or other concurrent health problems. For healthy children, and adults, the flu is rarely life threatening.

While we can't be assured that the demographics of the attack rate, and mortality, of the H5N1 virus will remain constant if it should become a pandemic, the evidence is fairly strong that the young will be at higher risk of contracting the virus, and of dying from it.

Thus far, 90% of the cases we've seen have been under the age of 50, and roughly half have been under the age of 20. The highest mortality has been seen in those aged 10 to 19 years of age. Teenagers. High school kids.

Grim statistics for a society that treasures the next generation.

Exactly why younger people appear to be more susceptible to the virus is unknown. It may be that the older we become, the more flu viruses we've been exposed to, and we may have picked up some form of limited immunity. Some of it may be due to the role of children in developing countries, where they may be more likely to come in contact with infected birds than older adults. And the numbers may be skewed slightly by the higher ratio of young people in some of these countries.

Right now, we simply don't know.

But based on the evidence to date, we have to assume that young adults and children will be at the highest risk during a pandemic. And that has far reaching consequences.

Primarily, though, it amplifies the need to close schools early.

Waiting until 20% or 30% of the students are out with the flu during a pandemic would be, in my opinion, a tragic mistake. By then, many of the students would have been exposed, and have carried the virus back to their homes. As difficult of a decision as it might be, and regardless of the social impacts it might cause, closing schools early will save lives.

There is surprising resistance to this idea. In some school districts they have yet to decide when, or even if, they will close the schools.

There are some who worry about the loss of federal funds to school districts, or the impact on working families when they no longer have the day-care option, or subsidized lunch programs, provided by schools. Both are genuine concerns, but they pale in comparison to the costs to society, and more importantly to families, if the virus is allowed to propagate through the school system unchecked.

Our school systems would recover if they were forced to close for a few months, families would find ways to cope with not having a built-in day care option. They do so every summer, when school is out of session. Students could catch up on their studies, even if they missed a semester. There are worse things in life, and in a pandemic, to deal with.

What we can't afford is to lose is a large number of our children. That trumps every other consideration, and that should be our primary concern.

The emotional trauma of losing our children would be incalculable. We don't expect to outlive our offspring, it isn't the natural order of things. There is no grief that can compare to that of a parent who loses a child.

The debate over closing schools, and whether it would cause other problems, reminds me of my early years as a CPR instructor. Occasionally a student would balk, and say "What if I break the guy's ribs? I might puncture a lung!".

Both are possible side effects, but neither are as bad as not doing CPR, because without it, the patient dies.

Sometimes, it simply comes down to that. We act, or the patient dies.

We won't be able to painlessly mitigate the effects of a pandemic. There are no easy, foolproof solutions. Everything we do will have side effects. And not all of them will be pleasant.

• If we close public gatherings, such as theaters and sporting events, we will force some businesses to close, and put some people out of work. It's unavoidable.

• If we ask those exposed to the virus, but not sickened, to stay home, many sectors of the economy will suffer, but it may be the best way to slow the spread of the virus.

• And if we ask people to avoid crowds, we may derail our public mass transportation system, and that could affect the economy as well.

Everything we do will have consequences. Some positive, some negative. And it will be a balancing act to determine what things are worth the costs.

Closing the schools early would entail a cost, no doubt. It would inconvenience a great many people, and disrupt many lives.

But in the end, the decision must be made as to which is worse; absorbing the societal costs of closing the schools, or risk losing our children?

And in my mind, there is no contest.