Kids and the Flu: October/November 2009

Fear of a H1N1 flu pandemic this fall has state lawmakers reviewing emergency planning regulations for child-care providers and schools.

This is no small concern. Every weekday, 67 million children attend schools and more than 325,000 licensed child-care facilities in the United States. Yet only seven states—Alabama, Arkansas, Hawaii, New Hampshire, Maryland, Massachusetts and Vermont—require child-care facilities to have a comprehensive written plan addressing evacuation, reunification and accommodating children with special needs during an emergency.

“Every legislator and all state and local officials have a fundamental responsibility to protect our most precious resource, our children,” says Senator Richard Moore of Massachusetts. “If we can enact laws and policies to protect pets in time of disaster—and we have—surely we can do as much for our children.”

On average, according to the U.S. Department of Health and Human Services, states have “many major gaps” in their influenza plans, specifically in school closure policies and efforts to contain the spread of the flu in the community once an outbreak occurs.

Treatments, antidotes and research to help disaster survivors and victims of illnesses have focused on the needs of adults. But adult models may not be adaptable to children, who have unique anatomic, physiologic, immunologic, developmental and psychological considerations that potentially affect their vulnerability to injury and response in a disaster. Emergency responders, medical professionals and health care institutions need the expertise and training to ensure optimal care for children.

“From health and mental health, to education, child care and nutrition, states and their partners play a vital role in providing disaster services to children,” says Nevada Assemblywoman Sheila Leslie, who is a member of the National Commission on Children and Disasters.

It is examining a wide range of issues to ensure children are a greater priority in disaster planning. The commission is preparing a report to the president and Congress, expected in October, but Leslie says it will have relevance for states as well.

As lawmakers retool their emergency plans, Leslie suggests conducting oversight hearings to explore answers to these questions:

• Should the state, if it doesn’t already, require a comprehensive disaster plan for child-care operators, after-school programs and summer camps? Should that plan include pandemics?
• How prepared are schools to address the academic and emotional needs of students after a disaster, including pandemics?
• What about the stockpile of medical countermeasures in the state? Are there pediatric medical countermeasures available? Are emergency rooms staffed with pediatric-trained doctors and nurses?
• How will the state spend its allocation of federal supplemental H1N1 funds? Is the focus of hospital and public health planning on children?

Legislation usually includes some of these key elements:
 

• Establishing child-care license requirements that ensure emergency preparedness, response and recovery plans that include a pandemic.
• Encouraging cooperation among local and state emergency managers.
• Teaching basic preparedness to kids.
• Supporting “psychological first aid” training for teachers, parents and children.
• Supporting the academic and mental health needs of children after a disaster.

Community involvement in any plan is essential to its success. Public health experts advise that lawmakers, teachers and health care professionals highlight the need for parents to create a family disaster plan and to review the disaster plan for their child’s school or child-care facility. They also suggest that schools, child care personnel and parents have accurate H1N1 information.