Columbia University Pandemic Flu Response

There were three recognized influenza pandemics in the 20th century: in 1918-19, 1957 and 1968. The 1918 pandemic caused more than a half million deaths in the United States, and an estimated 50 million deaths worldwide, making it the greatest natural, public health disaster in history. The other pandemics, while much milder, were also responsible for significant illness and deaths.

Experts believe that an influenza pandemic may well occur at some point in the foreseeable future. It is impossible to predict the exact timing of the next pandemic, to know which influenza virus strain will be responsible, or to foretell the degree of severity.

As of September 2009, the World Health Organization (WHO) was coordinating the global response to an outbreak of human cases of swine Influenza A (H1N1) in the United States and internationally, and monitoring the corresponding threat of an influenza pandemic. In response to the outbreak, the WHO raised the worldwide pandemic alert level to Phase 6, which is characterized by confirmed person-to-person spread of a new influenza virus that is able to cause "community-level" outbreaks. The increase in the pandemic alert level corresponds with an increase in the likelihood of a pandemic.

The H1N1 flu is causing increasingly widespread, but notably mild illness in the United States and many other countries in the world. It is impossible to clearly predict whether the H1N1 virus will continue to cause only mild illness in most people or if it will become more virulent. The virus, therefore, is being closely monitored by public health authorities at the local, state and national levels.

The WHO also continues to monitor the global extent of avian Influenza A (H5N1), which does not currently pose a risk to U.S. residents and may or may not cause an influenza pandemic in the future. When an influenza pandemic does occur, it is expected that greater numbers of people will become ill - and remain ill for longer periods - than in normal influenza seasons.

The main defense against any strain of influenza is immunization. However, with currently available methods, it takes at least four to six months for a new influenza vaccine to be developed and produced in quantity. Therefore, it is likely that it would be several months after the appearance of a pandemic influenza strain before an effective vaccine would become available.

As of September 15, a vaccine has been approved to protect against the current H1N1 flu and expected to be available in the fall. 

In 2007, the U.S. Food and Drug Administration approved the first vaccine against the H5N1 flu virus in the event that the virus were to efficiently spread from person to person, resulting in the rapid spread of the disease across the globe.

While arrangements can be made to vaccinate students, staff and faculty in accordance with U.S. Public Health Service guidelines, colleges and universities must create advance response plans that do not rely on vaccine as a first measure.

Non-Pharmaceutical Measures

Both before and after a vaccine is available, the application of effective non-pharmaceutical measures is recommended. Measures that may be recommended include the following:

• Basic infection control measures of hand washing and cough etiquette 
• Social distancing to reduce contact (e.g., possible cancellation of large public gatherings and changing educational and workplace environments and schedules)
• Possible dismissal of students from school 
• Self-isolation and treatment of suspected cases 
• Voluntary home confinement of household members with confirmed or probable influenza and their caregivers until the sick person is well and can no longer spread infection (i.e., seven-10 days)

Impact on Higher Education

It is easy to imagine how universities might be affected significantly by a major influenza epidemic because of the diverse, global makeup of their campuses and the frequency of international travel among their students, faculty and staff. The impact on university operations might include:

• Unprecedented demands on student health services; the relocation of students in residence halls to accommodate the ill; 
• Establishment of social isolation sites to limit the spread of disease; severe reductions in the work force because of illness of faculty, staff and families; 
• Significant economic losses due to reduced productivity of the institution and unanticipated expenses.

During a pandemic, between one-third and one-half of the work force can be expected to be absent at any one time, due to illness of employees or their families.

The U.S. Centers for Disease Control and Prevention (CDC) recommends post-secondary institutions of higher education take steps that will protect its community members from a pandemic, such as the H1N1 flu. Columbia University is developing, and implementing as appropriate, effective systems to help communicate up-to-date information in the event of a pandemic or other emergency to students, faculty, staff and families.

For additional information, please see the Planning and Response section of this website.