The Lancet. Closure of schools during an influenza pandemic

[Giuseppe]

Abstract. Closure of schools during an influenza pandemic (The Lancet, edited)

Review

The Lancet Infectious Diseases, Volume 9, Issue 8, Pages 473 - 481, August 2009
doi:10.1016/S1473-3099(09)70176-8

Closure of schools during an influenza pandemic

[Original Summary: LINK. EDITED.]

Dr Simon Cauchemez PhD a , Prof Neil M Ferguson FMedSci a, Claude Wachtel PhD b, Anders Tegnell MD c, Guillaume Saour d, Ben Duncan LLM e, Prof Angus Nicoll MB ChB e f


Summary

In response to WHO raising the influenza pandemic alert level from phase five to phase six, health officials around the world are carefully reviewing pandemic mitigation protocols. School closure (also called class dismissal in North America) is a non-pharmaceutical intervention that is commonly suggested for mitigating influenza pandemics. Health officials taking the decision to close schools must weigh the potential health benefits of reducing transmission and thus case numbers against high economic and social costs, difficult ethical issues, and the possible disruption of key services such as health care. Also, if schools are expected to close as a deliberate policy option, or just because of high levels of staff absenteeism, it is important to plan to mitigate the negative features of closure. In this context, there is still debate about if, when, and how school closure policy should be used. In this Review, we take a multidisciplinary and holistic perspective and review the multiple aspects of school closure as a public health policy. Implications for the mitigation of the swine-origin influenza A H1N1 pandemic are also discussed.

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[mixin]

Re: The Lancet. Closure of schools during an influenza pandemic

From the review:

Those two datasets suggest that, in an optimistic scenario, closure of schools during a pandemic might have some effect on the total number of cases (maybe a 15% reduction), but cause larger reductions (around 40%) in peak attack rates. However, this reduction will be substantially undermined if children are not sufficiently isolated or if the policy is not well implemented.

A few of the topics:
Epidemiological evidence on health effect
School closure in Hong Kong in March, 2008
School holidays in France, 1984–2006
School closure in the France during the 1957 pandemic
1918 influenza pandemic in US and Australian cities
Severe acute respiratory syndrome in Hong Kong in 2003
Social and economic effects of school closure
Implementation, communication, and interoperability

 

[tropical]

Re: The Lancet. Closure of schools during an influenza pandemic

#1: policy
"Health officials taking the decision to close schools must weigh the potential health benefits of reducing transmission and thus case numbers against high economic and social costs, difficult ethical issues ..."


WRONG.

"Health officials taking the decision to close schools must weigh the potential health benefits ONLY.

 

[Thornton]

Re: The Lancet. Closure of schools during an influenza pandemic

I hope to see a wider range of options and more tools for problem solving. For example instead of total closure of schools or open for normal business, how about a liberal and accomodating policy of assisting sick or at risk students to stay at home and get help with school assignments via the web, phones calls texting with friends etc. This way we may see the schools running at 70 per cent capacity for most of the year but maintaining more normal learning and social environments to psychologically support the community.
JT

 

[Lizw]

Re: The Lancet. Closure of schools during an influenza pandemic

I hope to see a wider range of options and more tools for problem solving. For example instead of total closure of schools or open for normal business, how about a liberal and accomodating policy of assisting sick or at risk students to stay at home and get help with school assignments via the web, phones calls texting with friends etc. This way we may see the schools running at 70 per cent capacity for most of the year but maintaining more normal learning and social environments to psychologically support the community.
JT

Schools get their federal funding based on attendance--the physical body of the student sitting in a physical chair in a physical classroom--so good as this option is, it may not be feasible everywhere. There is some percentage of non-attending students a school can have--students that are taught at home by a visiting teacher. That option is often used for someone who has had a major illness or accident and is physically unable to attend for a prolonged period, but is expected to return. I don't know what percentage of non-attending students a school can have, or whether it's the same everywhere, but I'll bet it's a heck of a lot less than it would need to be to accommodate a realistic number of students. Policies can be changed, of course, but some of the rules on funding are set in legislative concrete.

 

[Lizw]

Re: The Lancet. Closure of schools during an influenza pandemic

Well, well, looks like someone else is thinking along the same lines as Dr. Thornton. This is from the H1N1 Influenza Preparedness Summit, linked to by Hawkeye at http://www.flutrackers.com/forum/showthread.php?t=116902

Also look to develop web-based technology to have continuing education in a period of prolonged school closure; need to look at other means besides online learning, since not everyone has access to high speed internet at home. Perhaps, television/video lectures, etc., and develop units of instruction explaining communicable diseases, etc. to young children.

I really hope they will act on this, as it could provide alternate learning sources for a lot of kids who don't do well in the traditional public school setting, but whose parents aren't equipped to teach them at home. And also, of course, keep them out of school but still learning when they're at risk of being infected, or of infecting others.