School officials, faculty, nurses and other health care workers are relying on thermometers, in-school vaccinations in some areas, extra rooms to sequester sick students and updates from county health departments to help them contain the H1N1 virus.

Schools throughout New York City began offering vaccinations the last week in October in a tiered program that includes more schools in the five boroughs each week.

The city will run free public H1N1 vaccination clinics on weekends in each borough for middle-level and high school students.

The vaccine is in a nasal spray version or a shot form.

The New York City school H1N1 vaccination program will cover approximately 1 million students and 1,342 schools, according to the city government Web site at
www.nycity.gov.

Other schools could also become inoculation centers. Some public schools across Long Island indicated to health officials in Nassau and Suffolk counties earlier this fall that they would be willing to be "point of dispensing" locations.

Not since the polio vaccination campaign of the 1950s have public schools been such a part of an immunization effort.

At many schools, teachers are working individually with students to complete work missed due to absences during the flu season by extending deadlines and providing time to make up missed work.

Nurses at some schools are checking temperatures before allowing students back in the school, and many are still scrambling for extra space to house ill students waiting to be picked up.

Current key findings from flu monitoring systems in New York, according to the state Health Department, for the week ending Oct. 31 are:

• The overall level of flu activity is high and appears to be increasing.
• The number of people hospitalized with flu is moderate and appears to be increasing.
• The total number of deaths associated with H1N1 flu reported in the state (outside of NYC) since Sept. 1 is 12.
• Total deaths associated with H1N1 flu reported in the state (outside of NYC) since April 24 is 38.

"While immunization efforts are important, it is equally critical that our members receive proper protection devices such as N95 masks, adequate supplies to properly clean workplaces and that employers update emergency plans," said NYSUT Vice President Kathleen Donahue, whose office oversees health issues for the union.

Despite high recorded absences at some schools, few schools have closed.

At East Greenbush Central School District in Rensselaer County, where hundreds of students have been absent due to illness, administrators posted an Oct. 28 letter from the County Department of Health advising schools to stay open as long as there is adequate staff. The letter noted that large outbreaks across the country have caused mild to severe illnesses, including some hospitalizations and even deaths.

"Most schools within Rensselaer County are experiencing a similar spike in activity.

Districts are reporting that both staff and students are showing signs and symptoms of the 2009 H1N1 influenza virus," the letter said. "Although schools are reporting an increase in absenteeism, they are being advised to remain open as long as there is adequate staff available to provide daily operation."

The district is reassuring parents that since classes resumed in September, cleaning and sanitizing of all commonly touched surfaces has increased; the district recently brought in additional staff to help.

According to Guthrie Birkhead, deputy commissioner of the state Health Department, in recent testimony before several Assembly committees, influenza activity related to H1N1 increased during September, beginning in the southern states where school starts in early August.

As of mid-October, New York's flu activity was already classified as widespread under the Centers for Disease Control's classification system, meaning that more than half the reporting jurisdictions indicated the presence of the flu.

Gov. David Paterson last month declared a state of emergency due to an increase in H1N1 cases across the state. His order increases the number of health care professionals who can give the vaccine. The list now includes dentists, pharmacists, podiatrists and midwives.