JEFFERSON CITY — As the H1N1 virus spreads across the nation, Missouri's state employees are laying down plans to keep vital services such as jails and mental hospitals running effectively.
In Missouri's 21 prisons, the population is susceptible to the disease because of their close proximity to one another as well as their interaction with the outside world through guards and visitors.
The Missouri Department of Corrections plans to offer the H1N1 vaccine to high-risk employees and inmates once it becomes available, department spokeswoman Angie Morfeld said. Guards without compromised immune systems, however, will have to get the vaccine from their own health care provider.
Morfeld said the department has plans to keep all guard posts staffed during the pandemic but said she "can't talk about specific plans because of safety and security."
Inmates have access to on-site medical facilities and can be transported to a hospital if necessary, a move that takes more staff because inmates must be with an officer at all times. Morfeld said prisons are capable of housing all sick inmates separately from those that are healthy.
Psychiatric and developmental disability facilities face similar considerations because of their confined populations, said Lynn Carter, deputy director for the Department of Mental Health. Facilities may be forced to limit outings and reduce or restrict visitors if necessary to reduce residents exposure to infection.
She also said they will be relying on back-up, part-time employees to keep their psychiatric and developmental disability facilities staffed.
More than 7,000 employees staff the 17 state-run facilities, the inhabitants of which require certain levels of supervision.
The department is working to get vaccines for all their health care employees and high-risk residents, she said. As employees become sick, however, the department might have to ask for more overtime from employees and ask those working to cover additional duties.
Once employees who have fallen ill recover, they become ideal candidates to monitor those who are already sick, she said.
"They can work with the sick folks without the risk of contagion," Carter said. "They won't have to take all those protective measures."
Hospitals are also preparing for a surge of patients, but hospital officials are strongly encouraging H1N1 patients to go to their primary care provider before heading to the hospital, said Dave Dylan,Missouri Hospital Association spokesman.
"Most hospitals have some degree of vacancy in beds any given day, but the vast majority won't be sick enough to need hospitalization," Dylan said.
Dylan said the key to keeping a hospital appropriately staffed relies on doctors taking common sense procedures before they can be vaccinated.
"Most health care professionals are pretty savvy about hand washing because of the environment they work in," he said. "That's not to say they won't be exposed by sick family members, etc."
For Missouri's public schools, keeping students in class plays a hand in ensuring schools get funding.
"Schools are reimbursed or paid for every hour a child is present in school, so better attendance is better for the school district," said Jim Morris, the spokesman for the Department of Elementary and Secondary Education.
MU had 48 known H1N1 cases Friday, while a spokesman at Missouri State University said "a couple of dozen" students there were confirmed to have the virus.
Even with a lack of students, bus drivers and teachers, it's up to individual schools to shut down if they can't operate properly.
Schools have been known to shut down for some time during inclement weather, but shutting down for a disease is unusual. If a school has to close for a long period, the state legislature will occasionally step in and set new provisions for how much time has to be made up for that school for that year, Morris said.
"Unless the school shuts down, and then elected to make up those days later, the time that kids missed because of illness is simply time lost," Morris said.
The same is true at MSU, where administrators are asking faculty to work with students who have missed class because of illness.
"If five students are sick, we're not going to cancel class for the other 45," said Burnie Snodgrass, director of the MSU Taylor Health and Wellness Center.
Most universities are asking sick students to isolate themselves and inform professors of their illness.
At MU students have been asked to call ahead before going to the student health center and risking possibly exposing others to the disease.
Although there are currently no known cases of H1N1 at the University of Missouri-St. Louis, masks are already being handed out to those with symptoms, hand sanitizer has been placed next to entryways and elevators in the dormitories, and thermometers will soon be handed out to dorm-dwelling students, said Marie Mueller, clinic coordinator for UMSL and a nurse practitioner.
Mueller said the school plans to isolate the infected by separating them from their healthy roommate and bringing food up to the infected person.
All universities will have to wait until the vaccine is available to distribute it to students, likely in October or November.