The title of a recently released Yahoo! article is "School nurse shortage hampers swine flu response" and this has become a source of fear. That's why Nina Fekaris, a school nurse, is shown in the caption showing Ian Bak, a first grader, how to wash his hands properly. With swine flu spreading like wildfire and THE FEAR ASSOCIATED WITH IT spreading even faster, good personal hygiene is essential.

The first sentence is "As schools grapple (i.e. struggle) with a resurgence of swine flu, MANY DISTRICTS HAVE FEW OR NO NURSES to respond to outbreaks, leaving students more vulnerable to a virus that spreads easily in classrooms AND TAKES A HEAVIER TOLL ON CHILDREN AND YOUNG ADULTS" because the immune systems of these two groups of people are not yet fully developed. It can take its toll on kids with various breathing problems (e.g. asthma).

According to Jamie Hintzke, who has two kids in northern California's Pleasanton Unified School District, including a son with severe food allergies, "It's really irresponsible of the school district to not really provide medical oversight when kids are in school". "It's really irresponsible" is an expression of exasperation and anger. "I'm playing Russian roulette every single day he goes to school". OK, whoever has played or plays Russian roulette knows that the chances of losing are just as good as the chances of winning or perhaps greater. WE SHOULDN'T BE GAMBLING WITH CHILDREN'S HEALTH. The kid with severe food allergies is in the high-risk group of people likely to be infected with A-H1N1 because of his pre-existing medical condition.

However, here's the problem: "A 2008 survey by the National Association of School Nurses found that only 45 percent have their own full-time nurse, another 30 percent have a part-time nurse and a quarter don't have any nurses at all". This is indeed alarming.

"The average nurse-to-student ratio was one nurse for every 1151 students, but in 14 states, there was only one nurse for MORE THAN 2000 STUDENTS, according to the Nurses association".

"States with the highest ratios include Oregon with one nurse for every 3142 students, Michigan with one for every 4204 and Utah with one for every 4893". Many states in the Northwest (including Oregon and Utah) depend heavily on tourism and as we know, tourism has been slammed by this crisis. As far as Michigan is concerned, well that's where GM's headquarters are located (and as we know, GM is still trying to claw its way of bankruptcy, pay off its debts and balance its books for the first time in a long time).

"Only 12 states, MOSTLY IN THE NORTHEAST, met the 1-to-750 ratio recommended by the Centers for Disease Control and Prevention, the association found". These are obviously the states least affected by the global financial crunch.

"In Michigan, severe financial problems prompted the Pontiac School District to lay off five of its six nurses WHO PLAYED A KEY ROLE IN THE DISTRICT'S RESPONSE TO SWINE FLU LAST SPRING". And some people are still saying that there's no financial crisis or the financial crisis is over.

According to Susan Zacharski, THE DISTRICT'S only remaining nurse, "If swine flu is ANYTHING LIKE THE PREDICTION, schools without school nurses will be missing their front line of defense". If an entire school district only has one nurse now, it's obvious that the global financial crisis hasn't let up in terms of its intensity.

According to Nina Fekaris, a nurse in Oregon's Beaverton School District (4 schools, 4300 students), "We're asking so much more of UNTRAINED STAFF as far as providing medical management. IT'S PUTTING OUR KIDS AT RISK". Here's a dilemma: would you rather have untrained medical staff/nurses or no nurses at all? Both of these alternatives are EQUALLY BAD.

According to Robert Ellis, a first grade teacher at Washington Elementary School in Richmond, California, "WE REALLY DON'T KNOW what symptoms to look for, how to caution our kids or how to protect ourselves. I'M REALLY CONCERNED about it spreading in the classroom, how many kids will be impacted and the loss of education time". "I'm really concerned" and "We really don't know" is oftentimes a lethal combination.

Another significant sentence is: "So far, swine flu does not appear to be more dangerous than seasonal flu, which kills an average of 36000 Americans each year, BUT IT APPEARS TO BE MORE CONTAGIOUS AND HEALTH OFFICIALS ARE CONCERNED THAT IT COULD MUTATE AND BECOME DEADLIER".The advantage ("So far", swine flu is not as deadly as seasonal flu) IS MORE THAN OFFSET by the possibility that this virus COULD POTENTIALLY mutate.

According to Ben Horsely, spokesman for Utah's Granite School District, " It would be great to have a nurse in each school (especially in the face of an imminent pandemic). UNFORTUNATELY, WE DON'T HAVE THAT LUXURY". Many school districts simply don't have the cash to pay a full-time or even a part-time nurse.

The situation seems to be most dire "In California, where there was one nurse for every 2240 students last year, ROUGHLY HALF of the 1000 school districts do not have any nurses at all".

This includes the Berkley Unified School District (17 schools with 9000 students). According to spokesman Mark Coplan, Parents have called to say 'Is there a new policy to deal with H1N1?' We say, 'No, it's exactly the same as (what we would do for/to combat) seasonal flu'. We really want to treat this AS A NORMAL SITUATION". With all the fear that's going around that this virus could mutate into something far more deadly, this may not be possible.

Finally, Brenda Green, director of school health programs for the National School Boards Association was right on target with her assessment/comments/remarks: "What I'm concerned about is anyone thinking (that) THIS WON'T HAPPEN HERE. If there's no plan in place and people just act in an ad hoc way, THAT'S RISKY". This is better known as complacency and we must guard against this.