School closure as an influenza mitigation strategy: How variations in legal authority and plan criteria can alter the impact

Margaret A. Potter, Shawn T. Brown, Phillip C. Cooley, Patricia M. Sweeney, Tina B. Hershey, Sherrianne M. Gleason, Bruce Y. Lee, Christopher R. Keane, John Grefenstette, Donald S. Burke

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Article number977
JournalBMC public health
Volume12
Issue number1
DOIs
StatePublished - 2012
Externally publishedYes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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