Testimony of Sterling W. Roberson, Director United Federation of Teachers School Safety and Health Department And Chris Proctor, Coordinator/Industrial Hygienist United Federation of Teachers School Safety and Health Department before The New York State Senate Minority Task Force on Homeland Security on New York’s School Safety
Sep 17, 2009 5:39 PM
Good morning, and thank you for this opportunity to testify today on New York City’s response to the H1N1 flu virus and assessing our influenza preparedness. We are Sterling Roberson, director of the United Federation of Teachers (UFT) School Safety and Health Department, and Chris Proctor, department coordinator and an industrial hygienist. Our union represents approximately 200,000 members, including New York City public school educators and several thousand hospital and visiting nurses.
Before we continue, we would like to note that the students and staff at IS 238 in Queens are starting the new school year without assistant principal Mitchell Weiner who died on May 17 from complications of the H1N1 flu that he likely contracted in an outbreak at his school. A student at IS 609 in Brooklyn also died of H1N1 on June 7. We again extend our condolences to the students, parents and staff at both schools, and we’d like to take this opportunity to thank again all of our educators, nurses and the school communities who were incredibly heroic in the face of last spring’s flu epidemic.
Since the very beginning of last spring’s flu epidemic, the UFT has worked closely with the New York City Department of Education and the Department of Health and Mental Hygiene to develop a program to address the concerns of parents, students and staff about the school system’s preparedness to deal with H1N1 and influenza-like illnesses (ILI). Thanks to our joint collaboration, plans and protocols are now in place, and an H1N1 vaccine that was approved by federal officials this week should be available in about another month. We will be working very closely with all of the relevant agencies to monitor the situation in schools and address problems quickly.
We will provide details about these programs and protocols momentarily, but in order to fully appreciate where we are now you have to understand where we started. Because this flu spread quickly through the school system beginning first in Queens and later in all boroughs, we’d like to give you some background on our experience.
As soon as the union became aware on Saturday, April 25, that flu cases at St. Francis Preparatory High School were probably of swine origin, we began putting a plan into action. By the time the federal government declared swine flu a public health emergency on April 26, the UFT had consulted with the Commissioner of the Office of Emergency Management as well as representatives from the New York City Department of Health and Mental Hygiene and the Department of Education. We also issued a fact sheet on the swine flu virus for distribution to UFT district representatives and school representatives – we call them chapter leaders – throughout the city.
The UFT fact sheet provided an overview of swine flu, including symptoms, transmission routes and preventive measures as well as joint UFT/DOE/DOH health and safety protocols. These protocols included increased cleaning and disinfecting of restrooms, cafeterias and doorknobs in common areas, making sure that all restrooms are stocked with soap and paper towels, opening windows to ensure the building is properly ventilated, running ventilation systems with maximum outside air and providing disposable respirators to the school medical offices. In addition, ill students with fever and flu-like symptoms were to be isolated in the medical room and not returned to the classroom or general office.
Although the UFT is not a designated emergency first responder, our preparedness was critical to assisting schools in dealing with the potential flu epidemic.
Consider the scene at PS 177 in Queens on Monday, April 27, and the reports we received that afternoon. Here is how one report read: “PS 177 has had one child hospitalized over the weekend with flu and an assistant principal was taken by ambulance to the hospital today. Additionally 10 students have been sent home today with symptoms and two other staff members, a para and a teacher, are ill. This is a total of 14 people from the school with flu or flu-like symptoms. There are approximately 480 students and 200 staff in the school. It is located about 5 blocks from St. Francis Prep. Several staff members have spouses or children who work at or attend St. Francis.”
When UFT staff arrived at PS 177Q early the next morning on April 28th they found confusion about how to proceed. There was no doctor on site, no respirators and no plan in place. The UFT quickly put together a set of protocols for how to proceed during a flu outbreak and the protocols provided guidance for schools citywide.
UFT representatives and safety and health staffers spent the day at PS 177 assisting the school in dealing with this situation, interviewing school staff and providing the school with disposable respirators, gloves and alcohol-based sanitizers. The union recommended that the school close, which it did on April 29 for a week. There were five confirmed cases of swine flu at PS 177, which reopened on May 6.
Flu outbreaks began to occur in many other Queens public schools and later spread citywide with schools in each borough reporting flu outbreaks. Regardless of the school or borough, the outbreaks were similar, and the following story from IS 227 in Queens could have just as easily come from a school in any of the other boroughs.
IS 227 Chapter Leader Tom O’Brien described what the school had been like during one week in May: “In my 30 years of teaching, I’ve never seen so many kids fall sick so quickly. Everyone feels under siege. One-third of our school population has been out sick this week, and we had 20 out of 98 teachers out today.
“Our medical staff is overwhelmed. We ended up having to use the science room across the hall from the medical suite when that was overflowing with students; 81 students were sent home on Tuesday.”
What made it all work was the tremendous cooperation by everyone involved, from teachers to administrators, the union, parents and students, O’Brien said. “Colleagues are taking kids from other classes, changing schedules and working in concert with administration and medical personnel to get through the day in these very unusual circumstances,” he said.
The UFT monitored each school by sending union staff there, maintaining contact with each chapter leader and, in turn, maintaining constant contact with the Department of Education and the Department of Health and Mental Hygiene. We collected information about each school with flu outbreaks, including the number of absent students and staff and how many students and staff with fever or flu-like symptoms were sent home each day. Over 900 schools routinely provided this information to the union, and we in turn provided all of it to the DOE and DOH.
The UFT also set up a special Web page containing a set of recommendations for schools, plus additional useful links to health information sources, available on our website at www.uft.org.
The DOH and DOE were assessing the situation in the schools daily. Decisions regarding school closings and other measures were being made on a case-by-case basis. Although information about H1N1 was provided (including guidance that sick students and staff should stay home), no one knew what to do in the midst of a spreading contagion. No one knew the criteria for assessing when to close a school. Information was not being provided to the school communities and the UFT about why one school was being closed and another wasn’t when both seemed to have similar flu outbreaks. As a result, concern and panic were spreading throughout the school system.
For example, on May 16, parents were protesting outside a Brooklyn school to have it closed based on a single case of flu while parents at other schools with 15, 20 or 25 students being sent home sick with fever or flu-like symptoms had no idea what was going on.
So on May 21, the UFT held a press conference outside IS 227 in East Elmhurst. To help prevent the spread of influenza-like illness and reduce panic, we urged the DOH and the DOE to provide parent and the public with accurate information in a timely manner, including the rationale and criteria for closing a school. Subsequently the DOE began posting school attendance rates on their website and the DOH posted rates of influenza-like illness in schools on their website along with their rationale and criteria for closing a school. This helped to reassure our school communities.
In light of our experience with H1N1, we stressed how crucial it is to communicate with the entire school community when suspected cases arise in schools. We called for full disclosure of information that is transparent so that everyone involved fully understands the risks and their responsibilities for taking preventive steps.
We also called for immediate notification of school communities, including parents, of any confirmed cases of influenza in public schools. Specifically, we asked that in any school where a case of the flu – swine or other strains – was confirmed that letters be sent to notify staff and parents so that those with underlying medical conditions could take appropriate precautions.
Since then, the DOH and the DOE, working with input from the UFT, have developed a flu preparedness plan for New York City public schools this fall. The flu preparedness plan includes three key components: provisions for infection control combined with an influenza prevention campaign; monitoring and surveillance of influenza-like illnesses in schools; and a vaccination program that includes the following components:
Infection Control and Influenza Prevention Campaign
·Emphasize prevention and infection control measures such as hand washing, avoiding touching one’s mouth, nose and eyes, and covering coughs and sneezes with sleeves or tissues. The DOE will also try to have hand sanitizers in place.
·The DOE will make outreach efforts to advise parents to keep sick children at home.
·Send a letter in nine different languages via students to parents the first week of school.
·Influenza prevention information, materials and posters will be provided to each school.
·The DOE will communicate weekly with principals through its Web site publication, Principal’s Weekly.
·The DOH/DOE will maintain ongoing communication with school nurses and DOE conducting outreach to Community Education Councils and parent groups.
Monitoring/Surveillance and Daily Posting of Absentee Rates and ILI
·School nurses will use a citywide data base to report the number of students treated for influenza-like illness (ILI) in school each day. ILI is defined as fever with a cough or sore throat.
·If more than five students have ILI, parents are to receive a second letter telling them to keep sick children at home and preventive measures including hand washing will be reinforced.
·If on a single day more than four percent of the student body (at least 15 students) are seen by the school nurse then a doctor or supervising nurse will visit the school to assess the situation to improve the school’s infection control efforts and determine whether students’ conditions put them at high risk of influenza complications. If the DOH determines that the school has a high concentration of medically vulnerable children, officials may consider closing it.
·The DOE and the DOH will post on a daily basis student absentee rates and ILI on the Web site www.nyc.gov/flu. The city will list all schools reporting five or more cases of ILI on the previous day and will also show the previous day’s absentee rates for every school.
Vaccination Program
The DOH/DOE will conduct outreach to parents to get their children vaccinated for the H1N1 flu. The vaccine is totally voluntary. The city will offer the vaccination to students in all NYC schools, both public and non-public and at all levels, at central sites in each borough.
Even with these critical improvements in this year’s preparedness plan, more still needs to be done. The school system also needs:
·A nurse in every school.
·Accommodations for school staff who do not have enough sick days or those staff members at risk for complications from the flu who are advised by physicians to stay home when there is flu in the school.
·Paid sick days in the private sector so parents can stay at home with sick children.
·N95 respirators for nurses and personnel staffing isolation rooms housing students with suspected, probable or confirmed H1N1 or influenza-like illness as per OSHA/PESH compliance directives.
·Now that an H1N1 vaccine has been approved, make it available to staff on a voluntary basis, making sure that the vaccine goes first to staff members who are especially vulnerable, namely pregnant women, members with chronic respiratory conditions such as asthma and staff on chemotherapy, which is especially important because the prevalence of breast cancer is high among teachers.
All of these steps, implemented as part of a comprehensive program, will go far to help us address any new epidemic of H1N1 or influenza-like illness in the months ahead. We can only hope these measures will not be needed, but in any case we must always be prepared and should have them in place. Thank you for your time and consideration, and we wish you all the best in your efforts to address this important issue.
