Michelle I. Slosberg ’12 first realized she was sick at the T station last Sunday.
“By the time I got to the bottom of the stairs I felt really, really tired. I was coughing, I had a fever, and it just got worse then on out.”
She called MIT Medical, described her symptoms, and was told to stay in her dorm. Three days of missed classes later, Slosberg is starting to feel better.
As most health experts predicted, the H1N1 virus or “swine flu” has made a comeback at campuses across the U.S., and MIT is no exception. Traffic into Medical’s Urgent Care has doubled, with up to 40 new cases of cold or flu symptoms each day. Posters cover the walls with sayings like, “Got a face? Don’t touch it” or “Avoid the flu! Wash your hands frequently.”
Most students who walk in with flu-like symptoms get the same message: “Please don’t go to class if you’re sick,” says David Diamond, Associate Medical Director at MIT Medical.
In an e-mail to all faculty, Daniel E. Hastings, Dean for Undergraduate Education; Steven R. Lerman, Dean for Graduate Education; Diamond; and Thomas A. Kochan, Faculty Chair, asked instructors to “be proactive” in telling students to stay home and discourage them from trying to “tough it out” and attend class sick.
Education is one of Medical’s most effective weapons against swine flu. Diamond meets weekly with the MIT Emergency Operations Center. He also spoke to deans, housemasters, and faculty.
Over the summer, MIT Medical tracked the American College Health Association and swine flu coverage from the southern hemisphere to estimate the virus’ potential threat this semester. Medical concluded that the H1N1 virus is no more aggressive than the seasonal flu.
In fact, students with the H1N1 virus seem to recover relatively sooner than those with the seasonal flu. Baker House alone has seen about 20 cases of Influenza-Like Illness, “and the number is changing every day,” according to Housemaster Guillermo Trotti.
“We are asking students that have flu symptoms to use the individual bathrooms, remain in their rooms, and use masks,” said Trotti. Many Baker roommates of sick students have opted to move into other rooms, although this is not required by either the dorm or MIT Medical.
“It’s a balance between responding responsibly without over-alarming the community,” Diamond said. “If we’re not careful, it’ll spread quickly and everyone will be sick all at once.” For now, Diamond refers to the H1N1 virus as the “flu with a lowercase ‘f.’”
One part of that balance comes with convincing students to get the flu vaccinations this fall. The vaccine for seasonal flu requires one shot and will be available in the following weeks. MIT Medical obtained 9,000 doses of the seasonal flu vaccine, 1,000 more than last year.
The H1N1 vaccine is a different story. It requires two shots received four weeks apart. MIT gets its first shipment of a limited number of doses in November, which it will administer to government-regulated priority groups first.
A version of the vaccine in Australia gives reason to believe that only one H1N1 shot is necessary, but it has not been approved in the U.S. MIT Medical still plans to administer the two shot vaccine to each patient.
In addition to suggesting that people get vaccines, the CDC offers common flu advice, such as frequent hand washing, adequate sleep, and a healthy diet.
“Every little piece may help a little bit,” said Dr. Diamond.
No Handshakes, No Kisses
Even if that changes accepted social standards.
This month in France, schools advised students to say goodbye to la bise, a friendly kiss on the cheek characteristic of French greetings, amid worries of spreading the virus.
Even handshakes are becoming a target of swine flu vigilance. The New England Women’s and Men’s Athletic Conference (NEWMAC), which oversees many of MIT’s sport competitions, encouraged schools last week to drop pre- or post-game handshakes between teams.
The recommendation applies for all sports except Volleyball, since the NCAA volleyball rule book requires handshakes after a game. An e-mail to MIT coaches and trainers suggested that “players should simply pass opposing players without making contact.”
In a preseason NEWMAC phone conference, Tom Cronan, Head Athletic Trainer at DAPER, noted that this news affects a very traditional part of sports.
“At the very least it’s good symbolism for our community given what we’re facing. People were really concerned with the sort of disrespect that that would demonstrate.”
Coaches are supposed to come to an agreement regarding handshakes before matches to avoid a potential awkward situation.
Even without handshakes, athletic events are still a good opportunity to spread the flu.
“That post-game huddle, any part of post-practice huddle or cooldown,” Cronan describes, are what bring teams, and infections, together.
“We still have a bunch of people in the rehab area for their post-practice cooldown, I’m not going to say ‘Oh spread out you guys!’ I don’t’ think we need to do that because hopefully the individual who might have flu-like symptoms isn’t coming here,” said Cronan.
In fact, the only place a student with flu-like symptoms should be is in his or her room, according to MIT Medical.
Sick? Get Breakfast in Bed.
Campus Dining has even started a meal delivery program for confirmed sick students to keep swine flu off the menu.
Richard Berlin, Director of Campus Dining, said the first delivery order was received on September 11, but more and more students have been placing orders in the past few days.
The program, Berlin says, was “designed to help all students,” whether they live in a dorm or FSILG, although most orders are coming from dorms with dining halls.
Dining wants to minimize the disruption that comes from having the flu, said Berlin.
After a student reports his or her illness to MIT Medical, a point of contact assigned to each dorm is notified, who then alerts the housemaster, house manager, Student Support Services, and Dining.
Orders may be placed online on the dining website or through e-mail by the sick student only if his or her illness is verified.
Breakfast, lunch, dinner, and a la carte items are delivered according to a certain schedule. Orders for breakfast, for example, must be processed the night before and are delivered usually to the dorm’s front desk between 8 a.m. and 10 a.m. A second student may then bring the food to the sick student’s room.
For dinner, students receive entrees from the Baker House Dining Hall menu on Fridays and Saturdays and the Next House Dining Hall menu for the rest of the week. House Dining Membership is recognized for dinner only.
Emerson College’s “Feeling Blue Meal” is a similar delivery program to help students get well without getting others sick.
Boston University, too, has a Special Meals Service for sick students. Last week, BU reported that two students with Influenza-Like Illness were sent home while a third was isolated to a private room.
According to the American College Health Association, Massachusetts institutions saw a 61 percent increase in attack rate last week, but the state’s 16 new college cases seem very little when compared to Washington, which showed 481 new cases, or Indiana, which showed 312 new cases last week and a 1094 percent increase in attack rate.
H1N1 arrived on college campuses earlier than the typical seasonal flu, but H1N1 tends to be a milder virus, with most H1N1-afflicted students recovering within a few days. MIT Medical is not testing patients for swine flu, according to CDC standard operating procedures, since the result would not necessarily affect the outcome of care.
Howard M. Heller, Chief of Medicine at MIT Medical, advises students to call MIT Medical first rather than simply walking in.
“First of all,” Heller said, “not everyone who’s sick needs to come in.”
Antivirals are only being administered to patients with medical conditions that could lead to serious medical complications.