Module 1b: First Case Presentations on Campus and in Region

As of September 1, several major U.S. cities are experiencing clusters of cases, including Seattle, San Francisco, Los Angeles, Chicago and New York City. The World Health Organization issues a Phase 6 Alert, which indicates there is a pandemic. 

On September 2, the Centers for Disease Control and Prevention indicates that a vaccine for this novel H7N9 influenza strain will not be available until January at the earliest. Seasonal flu vaccination will remain important, but it will not be effective against this strain. Furthermore, the novel H7N9 strain has resistance to antiviral oseltamivir (Tamiflu). Although this resistance reduces the effectiveness of Tamiflu, the Centers for Disease Control and Prevention says use of the antiviral is still recommended for treatment. It is recommending good hygiene practices (such as frequent hand-washing), frequent cleaning of surfaces, self-isolation when symptomatic, and preventive social distancing as measures to help limit the spread of the disease. For healthcare workers (or individuals with known, probable, or suspected flu-like symptoms), the Centers for Disease Control and Prevention recommends use of surgical masks. It has not recommended school closures at this time. 

On September 3, state officials contact our university to identify whether there are campus facilities that could be used for dispensing of mass care and/or isolation, if needed. 

Also on September 3, student housing resident advisors report that several students are refusing room assignments with international students from China. Parents (both domestic and international) are contacting our university seeking alternate housing arrangements. Similarly, some students are requesting changes to class schedules in order to avoid sharing classes with students from China. 

On September 4, a third-year undergraduate (Student B) reports to the university health center with a 103^o fever, muscle aches, sinus congestion, sore throat, and severe cough. He reports that his symptoms began September 2. He returned symptom-free from backpacking in China's region on August 29, when he flew into our city's airport. He lives in an off-campus apartment complex popular with our students. 

On September 5, three more students present at our university health center. All three have fevers of 102^o, muscle aches, congestion, and severe coughs. One is an international student who has chronic asthma. Two live in the same apartment complex as Student B. 

On September 5, the County Health Commission and the [insert state name] Department of Public Health announce two confirmed H7N9 cases in isolation at our local General Hospital.

1. Safety concerns for students, faculty and staff, and the logistics to ensure their safety.
2. More decisions need to be made about the university's operational status

1. What information do you release, and to whom, how, and with what goals do you release it?
2. Specifically, consider the following questions:
   1. Do you make emergency notifications regarding the sick students on your campus? At what point?
   2. How do you deal with negative attitudes expressed by some students toward international students from China
   3. How does your messaging about the situation and your delivery mechanisms differ for:
      1. Students?
      2. Faculty and staff?
      3. Parents (including parents of international students)?
      4. The surrounding community and the general public?