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School dismissal as a pandemic influenza response: When, where and for how long?

Journal Article · · Epidemics
 [1];  [2];  [3];  [4];  [2];  [2];  [2]
  1. Los Alamos National Laboratory (LANL), Los Alamos, NM (United States)
  2. Centers for Disease Control and Prevention (CDC), Atlanta, GA (United States)
  3. Centers for Disease Control and Prevention (CDC), Atlanta, GA (United States); Monash University, Victoria (Australia); IBM Health Modeling and Analytics Melbourne Research Laboratory, Melbourne, Victoria (Australia)
  4. Centers for Disease Control and Prevention (CDC), Atlanta, GA (United States); TRICARE/Defense Health Agency, Reston, VA (United States)
+ Show Author Affiliations

We used individual-based computer simulation models at community, regional and national levels to evaluate the likely impact of coordinated pre-emptive school dismissal policies during an influenza pandemic. Such policies involve three key decisions: when, over what geographical scale, and how long to keep schools closed. Our evaluation includes uncertainty and sensitivity analyses, as well as model output uncertainties arising from variability in serial intervals and presumed modifications of social contacts during school dismissal periods. During the period before vaccines become widely available, school dismissals are particularly effective in delaying the epidemic peak, typically by 4–6 days for each additional week of dismissal. Assuming the surveillance is able to correctly and promptly diagnose at least 5–10% of symptomatic individuals within the jurisdiction, dismissals at the city or county level yield the greatest reduction in disease incidence for a given dismissal duration for all but the most severe pandemic scenarios considered here. Broader (multi-county) dismissals should be considered for the most severe and fast-spreading (1918-like) pandemics, in which multi-month closures may be necessary to delay the epidemic peak sufficiently to allow for vaccines to be implemented.

Research Organization:
Los Alamos National Laboratory (LANL), Los Alamos, NM (United States)
Sponsoring Organization:
USDOE
Grant/Contract Number:
AC52-06NA25396
OSTI ID:
2469626
Journal Information:
Epidemics, Journal Name: Epidemics Vol. 28; ISSN 1755-4365
Publisher:
ElsevierCopyright Statement
Country of Publication:
United States
Language:
English

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Related Subjects

59 BASIC BIOLOGICAL SCIENCES
EpiCast
Infectious Diseases
Pandemic influenza
School dismissal
Stochastic individual-based model