Model-based comprehensive analysis of school closure policies for mitigating influenza epidemics and pandemics
File(s)journal.pcbi.1004681.PDF (2.4 MB)
Published version
Author(s)
Fumanellil, L
Ajelli, M
Merler, S
Ferguson, NM
Cauchemez, S
Type
Journal Article
Abstract
School closure policies are among the non-pharmaceutical measures taken into consideration to mitigate influenza epidemics and pandemics spread. However, a systematic review of the effectiveness of alternative closure policies has yet to emerge. Here we perform a model-based analysis of four types of school closure, ranging from the nationwide closure of all schools at the same time to reactive gradual closure, starting from class-by-class, then grades and finally the whole school. We consider policies based on triggers that are feasible to monitor, such as school absenteeism and national ILI surveillance system. We found that, under specific constraints on the average number of weeks lost per student, reactive school-by-school, gradual, and county-wide closure give comparable outcomes in terms of optimal infection attack rate reduction, peak incidence reduction or peak delay. Optimal implementations generally require short closures of one week each; this duration is long enough to break the transmission chain without leading to unnecessarily long periods of class interruption. Moreover, we found that gradual and county closures may be slightly more easily applicable in practice as they are less sensitive to the value of the excess absenteeism threshold triggering the start of the intervention. These findings suggest that policy makers could consider school closure policies more diffusely as response strategy to influenza epidemics and pandemics, and the fact that some countries already have some experience of gradual or regional closures for seasonal influenza outbreaks demonstrates that logistic and feasibility challenges of school closure strategies can be to some extent overcome.
Date Issued
2016-01-21
Date Acceptance
2015-11-27
Citation
Plos Computational Biology, 2016, 12 (1)
ISSN
1553-7358
Publisher
Public Library of Science
Journal / Book Title
Plos Computational Biology
Volume
12
Issue
1
Copyright Statement
© 2016 Fumanelli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Subjects
Science & Technology
Life Sciences & Biomedicine
Biochemical Research Methods
Mathematical & Computational Biology
Biochemistry & Molecular Biology
UNITED-STATES
RESPIRATORY DROPLET
INFECTIOUS-DISEASES
MIXING PATTERNS
TRANSMISSION
INTERVENTIONS
STRATEGIES
FERRETS
IMPACT
VIRUS
Absenteeism
Computational Biology
Computer Simulation
Humans
Influenza, Human
Models, Biological
Pandemics
Schools
Students
Bioinformatics
06 Biological Sciences
08 Information And Computing Sciences
01 Mathematical Sciences
Publication Status
Published
Article Number
e1004681
Date Publish Online
2016-01-21