ACUHO-I News Blog

Editor’s Note: In the November+December 2009 issue of the Talking Stick we asked members to discuss how they are addressing H1N1 on their campus. As you would expect, they had plenty to say on the subject; so much that their ideas overflowed the magazine pages and onto this blog. So much that we’re even breaking it into three separate posts (read part 1 here and part 2 here). Participating in the Conversation is Mike Krenz, assistant manager for risk management at Texas A & M University in College Station; Gary McLaughlin, business manager for housing at Flinders University of South Australia in Adelaide; Steve Palmer, director of residence life at Western Michigan University in Kalamazoo; Robert Tattershall, director of housing and conference services at Washington State University in Pullman; Dima Utgoff , director of residence services at the University of Alberta in Edmonton, Canada; Joe Gonzalez, associate dean of residential life at Duke University in Durham, North Carolina; Sean Duggan, managing director of university student housing at Texas Tech University in Lubbock; and Bes Liebenberg, coordinator for student support  residences at the University of Pretoria in Gauteng, South Africa.

Question: Under what circumstances, if any, would you not isolate students that have H1N1 or are suspected of having H1N1?

Tattershal: We chose self-isolation this time, so in this wave of H1N1 we chose not to isolate.  Some time ago, during SARS and H5N1, helping the university understand that true isolation was virtually impossible in a high occupancy residence hall system (over 80 percent of our residents live with a roommate and have to leave their rooms to go to the bathroom and most have to leave at some time to get food), made quite a bit of difference in the current H1N1 discussion.  We were successful in getting the committee to think not only of the first few cases of H1N1, so as not to tailor our response just for the beginning of the epidemic on our campus, but for the epidemic after a few weeks, when the numbers would be much larger and overwhelm any attempt to isolate people in the handful of empty spaces we had.

In our situation, we had one case during sorority recruitment, the week before school started. That one case, because of her contact with other students, and their contact with many more, became hundreds of suspected cases of influenza-like illness before we could have implemented an isolation program. Our health professionals stopped testing after the first few cases of H1N1 because of the time lag and cost, and the CDC statements that 98 percent of all influenza A illnesses were H1N1 at this time, which meant that we only knew people were sick, and it was probably H1N1. Therefore, isolation for us would have meant isolating hundreds of residents that had influenza-like illness, and doing so within days of the initial awareness that an outbreak was already here.

We knew last spring, that unless H1N1 mutated very quickly, and became much more lethal and the symptoms were much more severe, our response to H1N1 would be very different compared to what we were planning to do if SARS or H5N1 ever made it within 100 miles of our campus; i.e., recommending to our leadership to close the university.  Interestingly, of course, closing the university doesn’t necessarily mean that we could close the halls, as several hundred of our residents simply wouldn’t be able to go home in the face of a infectious disease with high virulence and mortality.

McLaughlin: We did not specifically isolate any residents because by the time a resident was diagnosed they would have infected close contacts (if they were to be infected)anyway. In addition we do not have shared rooms so each resident was in their own room and that made it much easier to keep them away from others. By using the common area specifically set up plus having meals delivered, the infected residents were isolated but were not forbidden going to other areas of the complex.

Duggan: We suggest that students go home if that is an option, or self isolate to their res hall room.

Liebenberg: Only if the diagnoses are not confirmed. Out of a possible 8,000 residents we had only 12 confirmed cases reported and they all went home. I’m convinced that a severe outbreak would necessitate alternative measures. (more…)

Editor’s Note: In the November+December 2009 issue of the Talking Stick we asked members to discuss how they are addressing H1N1 on their campus. As you would expect, they had plenty to say on the subject; so much that their ideas overflowed the magazine pages and onto this blog. So much that we’re even breaking it into three separate posts. Participating in the Conversation is Mike Krenz, assistant manager for risk management at Texas A & M University in College Station; Gary McLaughlin, business manager for housing at Flinders University of South Australia in Adelaide; Steve Palmer, director of residence life at Western Michigan University in Kalamazoo; Robert Tattershall, director of housing and conference services at Washington State University in Pullman; Dima Utgoff , director of residence services at the University of Alberta in Edmonton, Canada; Joe Gonzalez, associate dean of residential life at Duke University in Durham, North Carolina; Sean Duggan, managing director of university student housing at Texas Tech University in Lubbock; and Bes Liebenberg, coordinator for student support  residences at the University of Pretoria in Gauteng, South Africa.

Question: How has your office responded to differences between the actions your office can take versus the actions expected by your students/parents?

Tattershall: The fact that we had a process in place to help residents pair up with a flu buddy, if needed, and a way for the residents to get food and know when they were well enough to resume their normal daily activities, helped us respond to the varying parent requests. Talking with the parents, getting people to understand the progress of H1N1 and that we had these other processes in place to help, made the conversation much easier.

Krenz: We have been holding to the “party line” and referring parents to how the university is responding and how residence life is responding . We have to keep explaining — like a broken record — that we will treat all of the students the same.  No one is “special.”  We have assured students and parents that we are taking our guidance from local health authorities and the university, and if things should get worse, we will modify our plan and respond appropriately.

McLaughlin: We had few questions from parents and they were advised exactly the same as residents of what procedures and safeguards we had put in place. Residents and parents were assured of continued occupancy if the resident caught H1N1. We would however isolate them but provide whatever they required.

Palmer: Education and more education has been our best bet. Our president is fully supportive of the directions we’re taking which is outstanding. We also discuss our limitations and continue to emphasize that if possible, students return home.

Utgoff: One such situation has just come up. The president of one of our residence associations has expressed his displeasure with the way we are responding to H1N1. Among other suggestions (and there are some good ones) he has asked us to provide small bottles of hand sanitizer to all residents (all 1,750 plus of them) in his residence. Our view is that this is unreasonable for many reasons and flies in the face of advice that the best personal hygiene involves washing ones’ hands with soap and water.

We have yet to hear from any parents, but I would expect to hear from some when they find out that we have made a conscious decision not to provide any isolation areas. In conversations with the Public Health Response Team, the University Health Centre, our Occupational Health Manager, our bio-hazards officer and one of our vice-provosts who, among other things, is a nursing professor, we have been advised that moving sick people to another area is likely to make things worse for the sick student. We also considered creating an isolation area for those who are healthy if they wanted to get away from a sick roommate. We understand that people who are infected with H1N1 may be contagious before they are even aware that they have the virus. Thus, someone who appears healthy could actually infect a large group of people. As well, because of the demand for residence space, we are not in a position to leave residence beds unoccupied. We could have consolidated the few empty spaces we do have (mostly as a result of “no-shows”) but for the reasons mentioned above we have chosen not to. Obviously, if Alberta Public Health directs us to do something different we will do whatever we can to comply.

Duggan: We are a pretty responsive department, within reason.  We will try to accommodate requests or work toward compromised solutions.  We have not really been up against an undo-able task. We will not force an ill student to relocate and have not been asked to, which has been somewhat surprising to me.  We have encouraged responsibility, and taking care of each other which I think has dulled the “panic” somewhat.

Liebenberg: What we have done is 1) Sent the same literature to both student and parents, and 2) We assured students and parents that we are continually assessing the situation and will modify and respond accordingly. Unconfirmed reports in the media created the impression that our TuksRes team is not doing enough. This was however rectified by the students themselves who categorically denied any outbreaks of the virus in their residences. (more…)

Editor’s Note: In the November+December 2009 issue of the Talking Stick we asked members to discuss how they are addressing H1N1 on their campus. As you would expect, they had plenty to say on the subject; so much that their ideas overflowed the magazine pages and onto this blog. So much that we’re even breaking it into three separate posts. Participating in the Conversation is Mike Krenz, assistant manager for risk management at Texas A & M University in College Station; Gary McLaughlin, business manager for housing at Flinders University of South Australia in Adelaide; Steve Palmer, director of residence life at Western Michigan University in Kalamazoo; Robert Tattershall, director of housing and conference services at Washington State University in Pullman; Dima Utgoff , director of residence services at the University of Alberta in Edmonton, Canada; Joe Gonzalez, associate dean of residential life at Duke University in Durham, North Carolina; Sean Duggan, managing director of university student housing at Texas Tech University in Lubbock; and Bes Liebenberg, coordinator for student support residences at the University of Pretoria in Gauteng, South Africa.

Joe Gonzalez: What steps have your housing office taken to prepare for and respond to the H1N1 situation?

Mike Krenz: We had conversations with Texas A&M student health services, dining services, the vice president for student affairs office, and the university president’s office and came up with a unified solution. This was crucial. Before anything was issued to the public, we made sure we all agreed on the plan and all agreed on the wording of the messages being sent out. This went very smoothly with this approach: (1) Send messages to all faculty, staff, students, and parents; (2) Set up rooms for sick or well students for the purpose of isolation; (3) Set up a sick-tray process with dining services for sick students; (4) Work with student health services to have a flu vaccination clinic as soon as possible; (5) Check all stock piles of masks, gloves, and hand sanitizers, and (6) Educate, educate, educate, and educate some more.

Gary McLaughlin: In Australia we have just gone through our peak flu season, and at Flinders housing we did have several cases of H1N1, including one staff member. We had a meeting of senior management (as soon as we realized we were at risk), at which we determined the course of action we would take, which included identifying medical resources both at the university and off campus and setting up an isolation area, catering services, and ongoing monitoring procedures for infected residents. We ensured that we had a good and easily accessible supply of appropriate prevention items such as gloves, masks, and sanitary hand wash for use when dealing with infected residents. All residents were advised of arrangements that were in place. (more…)

LAST UPDATE, 10.29.09, 11:45 A.M.: A New Surge in Flu Cases; Vaccine is Hard to Find

ACUHO-I has covered H1N1 in depth here on the blog (view stories in the “Health” category or search for the H1N1 tag), and also has established a resource page on our Web site for further information. ACUHO-I members are also encouraged to visit the Health & Safety forum on the ACUHO-I network to post questions for other members.

As stories continue to come out, we will utilize the “sticky” tag to keep this post at the top of our blog feed and simply update the post as necessary. Click on the link to read more of this post and look for updates. (more…)

The American College Health Association, in the first of a series of weekly reports, announced that more than half of the 165 colleges surveyed reported at least one occurrence of the H1N1 virus on their campus. While 55% is an unnerving number, the illnesses, when compared with the total number of students at the institutions, 7.9 per 10,000 students, show the outbreak is still mild.

Swine Flu, AKA H1N1, AKA Novel H1N1, is joining students at move-in, apparently. Fortunately, the number of cases reported, while stretching nationwide, are hardly epidemic: a few people here, a few there.

Some institutions have had more sickness than others; the University of Kansas had 319 affected students at one point, but that number is now decreasing. The institution has 30,000 students, so while the illnesses are disconcerting, they represent just over 1 percent of the student population. Colleges and universities nationwide are urging students to protect themselves from infection and offering instructions for ill students.

You will all be surely comforted, however, that this valiant crusader is on your side against H1N1.

The New York Times has now chimed in on the Higher-Education-and-H1N1 conversation, with an article on how various institutions are trying to get ahead of a potential pandemic. Most are advising students to be clean and hygenic; to not go out in public when sick and to convalese at home with the help of their parents, if possible.

The exception is the United States Military Academy, where going home isn’t an option. Incoming cadets who have had recent contact with a flu victim were tested for the virus, and personel switched to elbow bumps rather than handshakes for a while, to slow the spread of the virus. Only six cadets have gotten the flu, so their strategies are apparently working.

A selection of college housing and student affairs headlines from InsideHigherEd.com. This week, the US government releases guidance for higher education institutions for various H1N1 scenarios.

COMMON SENSE AND SCENARIOS ON H1N1: U.S. releases guidance for colleges on possible flu outbreaks. Goal is to keep institutions open, but officials say fall semester could pose unusual challenges:

RANKINGS FRENZY ’09: ‘U.S. News’ sees slight uptick in participation in controversial peer rankings, but shift in methodology may anger SAT-optional colleges. Plus, alumni group issues new ratings based on traditional curricular requirements:

MIXED RESULTS FOR ACT: Overall scores are stagnant and some racial gaps grow, but testing outfit sees progress because of rapid expansion of the test-taking pool and shifts in preparedness:

ARE VETS’ CHECKS BACKLOGGED?: Government denies report of major delays, but some on campuses see evidence that influx of veterans isn’t being matched by speed in processing their benefits:

REORIENTING THEMSELVES: Some community colleges move substantial portions of new student orientations online to maximize efficiency; others push face-to-face programs to make process more personal. Is there a happy medium?

The advice is similar or the same as what we’ve already heard about H1N1, but it’s helpful to have for the sake of justifying policies and actions. Inside HigherEd summarizes the guidance, also check the source at the CDC.

There are a few items that jump out:

• Pre-plan flu buddy systems so healthy students can bring food to their ill roomates or friends.
• Create a system that ensures ill students are visited by a staff member.
• Consider reducing the size of large gatherings. Also think about moving furniture, such as desks and couches, farther apart so very close contact is minimized.
• Pre-plan the vaccination process, so when the vaccination is ready (perhaps late October) the process can go as smoothly as possible.
• Plan accommodations and education for students in special circumstances, for example: Pre-college students and students with health issues that put them at additional risk.

Here’s our latest collection of information on H1N1, the vaccine, and plans for dealing with infections.

Many thanks go to Jon Zuhosky, library intern, for researching some of the items in this post!

Many universities and colleges have pandemic plans; this one from North Carolina Central University details the responses for each department, including residence life. Also look at appendix A, which describes each person’s role, their alternates and the protective gear necessary. This presentation, from the University of Kansas, is among the pandemic-oriented items available in the online library. These, and examples such as the University of Florida H1N1 plan that we blogged about, can help when crafting or modifying your own plan. Also, look at the American College Health Association’s Guidelines for Pandemic Planning, the ACHA’s H1N1 site and the CDC’s page for higher education institutions.

In the news:

• Instutions’ plans for dealing with a potential outbreak of Swine Flu and their student education campaigns are discussed here, here, and here.
• The University of Oklahoma is experiencing a small outbreak of H1N1, but fortunately the cases are mild so far. One case has been confirmed at the University of Illinois-Springfield. The University of South Florida Polytechnic has two cases. H1N1 came to sorority rush at Louisiana State University; no word on whether H1N1 sung the songs properly.
• In Teaching the Quarantined, Inside HigherEd explores the problem of maintaining classes when sick students are cautioned to remain isolated for seven days. The Chronicle of Higher Educationhas an article on online teaching in times when face-to-face get-togethers are discouraged: In Case of Emergency, Break Tradition–Teach Online. The Chronicle article discusses other events (a flood, for example) that forced colleges and universities to change their delivery methods.
• Here’s a page of CDC Q&A on the H1N1 vaccine, which is supposed to be ready in the fall, perhaps by late October. On NPR, an expert spoke about the his vaccine distribution plan.
• Most Americans are not very worried about the impact of Swine Flu. Let’s hope our nonchalance doesn’t contribute to apathy, and that H1N1 turns out to be a blip on the collective consciousness by mid-2010.

Norb Dunkel is the Assistant Vice President and Director of Housing and Residence Education at the University of Florida. (Does anyone have a title that’s longer than that? Post to the comments!) Norb has generously provided the text of an announcement given to University of Florida housing professionals in preparation for H1N1 and students’ return to campus. They’ve also posted this on their website. Parents were provided the link in a pre-move-in e-mail.

Among the highlights:

• Tips on staying healthy: Sleep in, then eat pie.
  No wait. That’s not it. The tips are the usual: Cover coughs, wash hands, use hand sanitizers, get plenty of sleep, and eat well. (Which may include pie.)
• Tips on what to do if you become ill: Stay home; stay hydrated and avoid close contact with others. Self-isolate for at least 24 hours beyond when your fever breaks. You do not need to go to the student health center unless you develop severe symptoms: difficulty breathing, abdominal pain or pressure, sudden dizziness, confusion, persistent vomiting or flu symptoms that initially improve then worsen again, with an accompanying fever and cough.
• Tips on what to use for cleaning surfaces that may be contaminated, provided courtesy of the EPA.
• Some Q&As that parents or students are likely to  find useful.

University of Florida Flu Notice

This just in from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices: People 24 and under, since they seem to be more vulnerable to the H1N1 virus (AKA, Swine Flu) should receive the vaccination. Other priority groups are: pregnant women, health care employees, those who care for infants, and adults with chronic health issues or compromised immune systems. The CDC acknowledges that this could complicate the fall session on college campuses. The H1N1 vaccine is not yet available (clinical trials are ongoing) but the CDC says it can be administered on the same day as the seasonal flu vaccine.

Here’s the CDC’s interim instructions for higher education institutions; here is information about the pandemic in general, including the states that are hardest hit.