May 06, 2009
When Gov. Martin O'Malley shuttered five schools in Maryland last week after the discovery of several suspected cases of the swine flu, the closures seemed prudent given how little was known about the virulence of the disease and its ability to spread.
Most of what we did know was ominous: It was a strain that had never appeared before in humans, it struck healthy, young adults, it appeared nearly simultaneously in countries around the world, and it was already responsible for more than 20 deaths in Mexico and one in the United States. (A second U.S. death was announced Tuesday.) Within a week of the first alarms, the federal Centers for Disease Control and Prevention issued guidelines urging state health officials to guard against a mass outbreak of unknown severity by closing schools where there was even a single suspected case of the illness.
That's what Maryland did, and as a result, by Tuesday morning, the state had more closed schools (six) than confirmed cases of the flu (four).
But the country breathed a collective sigh of relief Tuesday afternoon when the CDC issued a revised guideline permitting schools to reopen, which Maryland promptly followed. Most cases in the U.S. have been relatively mild, according to the agency, which compared the severity and spread of H1N1 to ordinary seasonal influenza. On its web site, the CDC recommended keeping schools open in all but the most egregious circumstances, while continuing to urge people with flu-like symptoms to stay at home at least seven days so they don't infect others.
Was the first response to the appearance of this new illness an overreaction? In hindsight, it certainly appears that way: We don't normally rush to close schools even during the normal flu season, and except for the unfortunate deaths of a Mexican toddler visiting relatives in Texas and this week of a woman in that state, there were no fatalities in this country and relatively few cases of people who required hospitalization. At the same time, parents suddenly confronted with what to do with youngsters kept home from school for a week understandably felt inconvenienced by what turned out to be a false alarm.
But the incident was also a vivid reminder of how quickly a genuine public health crisis might develop, and the pressures that national and local officials would face in dealing with it. The H1N1 virus could have turned into a Katrina-type disaster on a national scale; the CDC and state officials were determined to avoid another calamity like that, and their response showed they were up to the task. Fortunately, things turned out a lot better than feared this time, but we can't always count on that happening.
