Swine Flu: Sanitise our minds instead, MoH

October 29, 2009 by Edmund Gall

After Influenza A/H1N1, aka swine flu, has been confirmed to have infected a worker or student, the rest of the employees and students are sometimes asked to remain at home for special sanitisation of the building(s) where the patient worked/studied.

We’ve seen this most recently at the South West Regional Health Authority.  These are the folks responsible for administering our health service in the south.  So we expect them to know what they’re about and to be exemplars of how one should respond.  But have they been exemplary?

Closure for special sanitisation started with the early school outbreaks, such as at Grant Memorial Presbyterian Primary School.  However, this only happened after parents openly complained and kept their children at home, despite the advice of the school’s principal.  Eventually, teachers joined the boycott and the school building was sanitised.  Depending on who you believe, students lost between 2 and 7 school days.

The Ministry of Health (MoH) had a policy for schools, which was distributed to schools and is available on its website.  However, even though it’s written in simple language, this policy doesn’t clearly address some of the concerns of the public.  For example, there is no clear advice on when to place buildings under quarantine, or at worse close the entire school.  The policy advises that those showing swine flu symptoms be removed from the premises immediately, advised to contact a healthcare professional for further guidance and not return to the school until either 7 days have passed or 24 hours after the symptoms have disappeared.

It doesn’t say what the rest of the folks in that class should do.  It’s this lack of clear advice that’s facilitated parents’ confusion, and though the policy makers have said it’s not advisable to close a school if there’s only one infection, they haven’t stated what benchmarks would trigger closure.

Things are especially aggravated with the recent deaths of persons confirmed to have been infected by swine flu.  Even here there is lack of clarity: two weeks have passed and we still don’t know whether they died due to swine flu or due to underlying health issues that were made worse by the swine flu infection.  It's only added to the paranoia surrounding swine flu: the public is equating swine flu infection with almost certain death.

Even though children are more at risk from being killed by leptospirosis than swine flu, the general paranoia has left parents inclined to keep their children at home until they are sure there is no risk.  When religious/community leaders also panic, it doesn't help at all.  The Sanatan Dharma Maha Sabha's General Secretary, Sat Maharaj, has called on all Hindu schools to close for three weeks, presumably until the vaccine is available.  However, as far as we know, the vaccine isn't going to be made available to all students: only those in the high risk groups.  So why close the schools?

In its policy, the MoH doesn't mention special sanitisation at all.  It asks schools to: “Ensure thorough daily cleaning of frequently-touched surfaces, such as desks, telephones, doorknobs, computer keyboards, toys and other shared education material, with appropriate disinfectant.”

So enquiring minds want to know: what’s involved in the special sanitisation that’s happened in schools and workplaces (like the SWRHA and the San Fernando Supreme Court)?  If schools and workplaces are being regularly cleaned, why shutdown for special sanitisation?  What makes it special?

Even government MPs aren’t too clear on how to behave.  One recently took his son to be tested, out of an “abundance of caution”, only to have the test return negative.  Since his son did not display some of the key symptoms required to make a confirmed diagnosis, he should’ve known there was no need to add to the panicked queues at our hospitals.  An “abundance of caution” is really a euphemism for ignorant panic (note: ‘ignorant’ in this context means ‘lack of knowledge’, as opposed to ‘ignant’, which means 'stupid', as in 'he behave real ignant!' ).

The lack of clarity has prompted some health professionals to speak out directly, such as Prof Courtenay Bartholomew’s request for the media to stop fuelling the panic.  If the MoH improves its policy and communicates it regularly to health professionals, the media, Ministry of Education and other stakeholders who represent the majority of the public (NPTA, TTUTA, chambers of commerce), then we may have less confusion.

When it comes to swine flu, if the MoH sanitises our minds of the myths, there won’t be a need for special sanitisation of buildings.

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