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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/12163

Title: Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic
Authors: House, Thomas
Baguelin, Marc
Van Hoek, Albert Jan
White, Peter J.
Sadique, Zia
Eames, Ken
Read, Jonathan M.
HENS, Niel
Melegaro, Alessia
Edmunds, W. John
Keeling, Matt J.
Issue Date: 2011
Publisher: ROYAL SOC
Citation: PROCEEDINGS OF THE ROYAL SOCIETY B-BIOLOGICAL SCIENCES, 278(1719). p. 2753-2760
Abstract: Despite the fact that the 2009 H1N1 pandemic influenza strain was less severe than had been feared, both seasonal epidemics of influenza-like-illness and future influenza pandemics have the potential to place a serious burden on health services. The closure of schools has been postulated as a means of reducing transmission between children and hence reducing the number of cases at the peak of an epidemic; this is supported by the marked reduction in cases during school holidays observed across the world during the 2009 pandemic. However, a national policy of long-duration school closures could have severe economic costs. Reactive short-duration closure of schools in regions where health services are close to capacity offers a potential compromise, but it is unclear over what spatial scale and time frame closures would need to be made to be effective. Here, using detailed geographical information for England, we assess how localized school closures could alleviate the burden on hospital intensive care units (ICUs) that are reaching capacity. We show that, for a range of epidemiologically plausible assumptions, considerable local coordination of school closures is needed to achieve a substantial reduction in the number of hospitals where capacity is exceeded at the peak of the epidemic. The heterogeneity in demand per hospital ICU bed means that even widespread school closures are unlikely to have an impact on whether demand will exceed capacity for many hospitals. These results support the UK decision not to use localized school closures as a control mechanism, but have far wider international public-health implications. The spatial heterogeneities in both population density and hospital capacity that give rise to our results exist in many developed countries, while our model assumptions are sufficiently general to cover a wide range of pathogens. This leads us to believe that when a pandemic has severe implications for ICU capacity, only widespread school closures (with their associated costs and organizational challenges) are sufficient to mitigate the burden on the worst-affected hospitals.
Notes: [House, T; Keeling, MJ] Univ Warwick, Warwick Math Inst, Coventry CV4 7AL, W Midlands, England [Keeling, MJ] Univ Warwick, Sch Life Sci, Coventry CV4 7AL, W Midlands, England [Baguelin, M; Van Hoek, AJ; Edmunds, WJ] Hlth Protect Agcy, Immunisat Dept, London NW9 5EQ, England [White, PJ] Hlth Protect Agcy, Modelling & Econ Unit, London NW9 5EQ, England [White, PJ] Imperial Coll Fac Med, Dept Infect Dis Epidemiol, MRC Ctr Outbreak Anal & Modelling, London W2 1PG, England [Sadique, Z] Univ London London Sch Hyg & Trop Med, Hlth Serv Res Unit, London WC1E 7HT, England [Baguelin, M; Eames, K; Edmunds, WJ] Univ London London Sch Hyg & Trop Med, Infect Dis Epidemiol Unit, London WC1E 7HT, England [Read, JM] Univ Liverpool, Inst Infect & Global Hlth, Neston CH64 7TE, England [Hens, N] Hasselt Univ, Interuniv Inst Biostat & Stat Bioinformat, B-3590 Diepenbeek, Belgium [Hens, N] Univ Antwerp, Vaccine & Infect Dis Inst, Ctr Hlth Econ Res & Modelling Infect Dis, Antwerp, Belgium [Hens, N] Univ Antwerp, Vaccine & Infect Dis Inst, Ctr Evaluat Vaccinat, Antwerp, Belgium [Melegaro, A] Bocconi Univ, DONDENA Ctr Res Social Dynam, I-20136 Milan, Italy
URI: http://hdl.handle.net/1942/12163
DOI: 10.1098/rspb.2010.2688
ISI #: 000293733600008
ISSN: 0962-8452
Category: A1
Type: Journal Contribution
Validation: ecoom, 2012
Appears in Collections: Research publications

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