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Dear Editor:
University of Toronto began planning in the spring of 2009 to mitigate the impact of a possible H1N1 outbreak. As it was expected that individuals suffering from flu-like symptoms may be told by Public Health or by their physicians not to visit a physician's office, the university determined that it would not require a medical certificate for absences due to suspected H1N1. In lieu of a medical certificate or doctor's note, a process was put in place through the student registrarial system (ROSI) whereby students were directed to make a declaration of illness. For the purposes of the declaration, symptoms of H1N1 flu were defined to include fever, runny nose, coughing, sore throat, fatigue, nausea/vomiting, and diarrhea. The declaration included a statement that the student understood that making a false declaration would constitute academic misconduct. All 77,826 students were advised of the H1N1 declaration mechanism and had access to the system beginning the first day of classes in September 2009.
The data were extracted from the student registrarial system in a manner whereby no record could be directly attributable to an individual student. As the source data are in a DB2 database, SQL was used to extract and summarize the data. Data...