Avian. Flu@edu: with so many people living in such close quarters, colleges and universities "act like giant petri dishes" in which a virus can grow and mutate. The paradox of some pandemics is that they are more likely to kill the healthiest among us

Risk & Insurance, April 15, 2006 by Susan Gurevitz

Like a Rorschach inkblot test, merely mention college students and our first thoughts are of boisterous parties, out-of-control drinking and a "what, me worry?" attitude. Who would suspect that this healthy, invincible age group would also be the primary target of the avian flu, ominously poised on the horizon?

"The 1918 flu attacked younger people," says Alan Bova, risk management director at Cornell University in Ithaca, N.Y., and author of a white paper on the official pandemic response by the University Risk Management and Insurance Association trade group

People as young as 15 and up to age 40--not the usual vulnerable flu population--made up the bulk of the 675,000 people killed in the United States by the 1918 Spanish flu, the last major flu pandemic.

"It was not the flu itself but the body's powerful overreaction to the flu that wracked those with strong immune systems more than those with weak ones.... Paradoxically, the Spanish flu caused the healthiest humans' own immune reactions to kill them," Bova writes in the URMIA report. The avian flu that has already sickened more than 184 people in Asia, Europe and Africa is predicted to be even more deadly.

Exacerbating the situation, college campuses act like giant petri dishes, with students living so close to each other in dorms, sitting in classrooms and eating in dining halls.

"It's the movement, the visitors, the close proximity, so much coming and going from sports teams, admissions tours, visiting scholars and so many other activities," says Janice Abraham, president and CEO of United Educators. Other complicating factors include student and faculty international travel and a campus accessible to the surrounding community. "Thinking about this has got to be on everybody's radar screens," she says.

Maybe it's not on everybody's screens yet, but a number of higher-education insurance brokers, university health officials and risk management people are dusting off any kind of emergency preparedness plans and business continuity strategies they have so they won't be left at the starting gate when the first U.S. cases are reported.

"The big question is how fast can they get their arms around this," says James Graves, vice president for Marsh Risk Consulting in Dallas. "There needs to be a huge sense of urgency for the education industry, especially with what they're seeing on the news. The nature of the universities makes them more vulnerable."

That's why A.J. Gallagher Risk Management Services' Higher Education Group in January convened a blue-ribbon group of risk managers and public health and Centers for Disease Control and Prevention officials to hammer out a 50-page document titled the "Blueprint for Pandemic Flu Preparedness Planning for Colleges and Universities," which Gallagher is distributing to its clients.

"Our goal is to provide a benchmark list that institutions should consider," says John E. Watson, executive director, Higher Education Practice Group in Gallagher's Glendale, Calif., office. "Like prior to Sept. 11, 2001, no one ever thought a high-rise office tower could be destroyed, but now that that has happened, people now have to acknowledge that it can occur," he explains. "The same can be said for Katrina and Rita. This (the avian flu) could also be a catastrophic issue," he says.

The Gallagher blueprint sketches out scenarios of what could happen should a pandemic occur, and then gives an extensive preparedness checklist that schools can follow to set up their own disaster plans. Presented in an outline format, the exhaustive lists of risk assessments, monitoring and campus considerations probably cover most every operation, situation, facility and issue that could surface in an emergency.

Watson acknowledges that it could take as long as an entire academic year to completely refine such a comprehensive emergency plan, "but if you aggressively attack it right now, there's enough in the outline format so in the fall (2006), you'll be able to take advantage of the timing, when all (new students, faculty and staff) are receptive to hearing about new knowledge and information," Watson says.

By the fall, it's quite possible that parents of new students may already start asking about the school's pandemic plan, along with the typical safety questions. In fact, last September students and faculty members at Carnegie Mellon University already started asking for Tamiflu, the six-year-old antiviral prescription drug that's expected to be effective against the current strain of avian flu, but is in short supply.

Apparently at Carnegie Mellon--where international students make up 25 percent of the entire student body--they were even ahead of most public acknowledgement that there was any perceived problem at all.

"I started checking with other schools and went on the listserv to see if anyone else was planning for this because the bird flu overseas was in the media, and very few were even thinking about it," recalls Dr. Anita Barkin, director of the Carnegie Mellon University Student Health Service.