TY - JOUR
T1 - School closure as an influenza mitigation strategy
T2 - How variations in legal authority and plan criteria can alter the impact
AU - Potter, Margaret A.
AU - Brown, Shawn T.
AU - Cooley, Phillip C.
AU - Sweeney, Patricia M.
AU - Hershey, Tina B.
AU - Gleason, Sherrianne M.
AU - Lee, Bruce Y.
AU - Keane, Christopher R.
AU - Grefenstette, John
AU - Burke, Donald S.
N1 - Funding Information:
This work was supported by the National Institute of General Medical Sciences MIDAS grant 1U54GM088491-01. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This work was funded through the Center for Public Health Practice by the Centers for Disease Control and Prevention (cooperative agreement 5P01TP000304). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.
PY - 2012
Y1 - 2012
N2 - Background: States' pandemic influenza plans and school closure statutes are intended to guide state and local officials, but most faced a great deal of uncertainty during the 2009 influenza H1N1 epidemic. Questions remained about whether, when, and for how long to close schools and about which agencies and officials had legal authority over school closures. Methods. This study began with analysis of states' school-closure statutes and pandemic influenza plans to identify the variations among them. An agent-based model of one state was used to represent as constants a population's demographics, commuting patterns, work and school attendance, and community mixing patterns while repeated simulations explored the effects of variations in school closure authority, duration, closure thresholds, and reopening criteria. Results: The results show no basis on which to justify statewide rather than school-specific or community-specific authority for school closures. Nor do these simulations offer evidence to require school closures promptly at the earliest stage of an epidemic. More important are criteria based on monitoring of local case incidence and on authority to sustain closure periods sufficiently to achieve epidemic mitigation. Conclusions: This agent-based simulation suggests several ways to improve statutes and influenza plans. First, school closure should remain available to state and local authorities as an influenza mitigation strategy. Second, influenza plans need not necessarily specify the threshold for school closures but should clearly define provisions for early and ongoing local monitoring. Finally, school closure authority may be exercised at the statewide or local level, so long as decisions are informed by monitoring incidence in local communities and schools.
AB - Background: States' pandemic influenza plans and school closure statutes are intended to guide state and local officials, but most faced a great deal of uncertainty during the 2009 influenza H1N1 epidemic. Questions remained about whether, when, and for how long to close schools and about which agencies and officials had legal authority over school closures. Methods. This study began with analysis of states' school-closure statutes and pandemic influenza plans to identify the variations among them. An agent-based model of one state was used to represent as constants a population's demographics, commuting patterns, work and school attendance, and community mixing patterns while repeated simulations explored the effects of variations in school closure authority, duration, closure thresholds, and reopening criteria. Results: The results show no basis on which to justify statewide rather than school-specific or community-specific authority for school closures. Nor do these simulations offer evidence to require school closures promptly at the earliest stage of an epidemic. More important are criteria based on monitoring of local case incidence and on authority to sustain closure periods sufficiently to achieve epidemic mitigation. Conclusions: This agent-based simulation suggests several ways to improve statutes and influenza plans. First, school closure should remain available to state and local authorities as an influenza mitigation strategy. Second, influenza plans need not necessarily specify the threshold for school closures but should clearly define provisions for early and ongoing local monitoring. Finally, school closure authority may be exercised at the statewide or local level, so long as decisions are informed by monitoring incidence in local communities and schools.
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U2 - 10.1186/1471-2458-12-977
DO - 10.1186/1471-2458-12-977
M3 - Article
C2 - 23148556
AN - SCOPUS:84868684257
SN - 1471-2458
VL - 12
JO - BMC public health
JF - BMC public health
IS - 1
M1 - 977
ER -