NEW YORK – At St. Francis Preparatory School this fall, the auditorium will double as a sick room. New York City might make students wash their hands several times a day. There will be a unit on H1N1 in health class.
In the weeks after the H1N1 outbreak that began at the Queens parochial school, New York City became a viral epicenter and focus of the nation's fears of the illness, sickening as many as 1 million, killing 47 people and closing dozens of public and private schools.
While educators and health officials decide how best to ward off a stronger strain of the virus in the fall, St. Francis Assistant Principal Patrick McLaughlin said his students may have already learned from experience to be vigilant.
He already noticed the changes: Sharing water bottles at school suddenly became a major transgression. And in 25 years of teaching health class, McLaughlin had never seen students get so excited about communicable diseases.
"I don't want them to come to school being afraid," McLaughlin says, standing by neat rows of empty classroom chairs. "But I do want that awareness ... that knowledge, that it's out there. It could come back. Be ready for it."
No one wants to call the city's outbreak a blessing, but the spring's out-of-season flu invasion did provide a peculiar kind of gift. Now New York City's Health Department and schools are trying to take advantage of the lead time — preparing for a fall season that is expected to be even worse.
The details of the city's H1N1 plan are still being finalized by a Health Department panel.
And like St. Francis Prep, the city's public schools are largely waiting to follow the lead of the agency, which hopes to have its recommendations by the first day of school, said Health Commissioner Dr. Thomas Farley.
The wait for a plan is taking too long for Cathy Cahn, Parent-Teachers' Association president at P.S. 205, who says Mitchell Weiner, the assistant principal who became the city's first H1N1 fatality, was a friend.
"How easily that could happen in any building," she said. "I would like to know: How are we going to keep our kids healthy?"
Weiner's family has since filed court papers saying they plan to sue the city, claiming it was negligent in its response to the outbreak and that schools established no procedures for coping with the illness. The mayor has said the city did nothing wrong.
Farley warned the fall will likely be worse than the surprise round of illnesses in the spring. But with any luck, the new flu season will simply be a matter of more people sick — not more people sicker than anyone was before.
"Most people can recover on their own, alone at home," Farley said. "And then they should stay home so they don't spread the infection to others."
There are signs that students have already learned lessons the hard way about spreading the virus.
Like many of her classmates at St. Francis, Abby Opam's early brush with H1N1 likely left her immune to any fall outbreak — but the experience has changed how she's looking at her first year of college at New York University.
"Instead of going there for a few hours during the school day, you're going to be surrounded by kids all the time, living in a dorm," she said.
"I'm being more careful to not, like, share drinks or, you know, get too touchy with people — especially with so many new people from different parts of the country."
Federal officials have said the nation's schools should only close as a last resort this year. Closings at dozens of schools last year kept thousands of children at home; officials worried about the burden on working parents who had to arrange impromptu child care or stay home with their kids.
Previously, those struck ill were advised to stay home for a week after their fever broke. But this school year, children will be told they can return to school 24 hours after their fever is gone and they're feeling better.
St. Francis Prep is planning a health assembly for its 2,700 students at the start of the year to impart the basics: Wash your hands. Don't share drinks and utensils. If you get sick, stay home.
School officials are determined not to repeat the scene of feverish students lined up by the dozen in hallways outside the school nurse's office, coughing on healthy students who were walking from class to class. So the school's auditorium has been assigned special status as a sick room.
Officials are still contemplating whether enough vaccination shots are available for all the city's schoolchildren. If so, Farley says, the Health Department would prefer that family doctors handle students' inoculations, although flu clinics in schools are also a possibility.
Schools might also institute routine checks, Farley said, asking students whether they are experiencing fever or respiratory symptoms, then putting them in a designated room until they can be picked up by their parents.
The panel that's determining the finer points of city policy even considered requiring students to wash their hands several times a day, said Dr. Isaac Weisfuse, the city's flu coordinator who is heading up the team. But the measure hasn't been adopted yet because the panel wants to give schools discretion to choose policies that work best for them, he said.
At St. Francis, where fluorescent corridor lights reflect brightly off the newly waxed and buffed hallways, administrators are waiting to start a fresh year. They're prepared with extra equipment this time around. After the chaos of last year, the school received donated sterilization equipment, and the school nurse bought touch-forehead thermometers to make mass triage easier.
And McLaughlin, the assistant principal, has at least one virus-related development to look forward to. He's planning an entire unit in health class based around H1N1.