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Simulating school closure policies for cost effective pandemic decision making
Ozgur M Araz1, Paul Damien, David A Paltiel
1College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA. ozgur.araz@unmc.edu
BMC Public Health
|June 21, 2012
Summary
School closures can mitigate pandemics but impact society. Optimal strategies depend on pandemic severity, balancing early triggers with closure duration for cost-effectiveness.
Area of Science:
- Epidemiology
- Public Health
- Health Economics
Background:
- School closures were inconsistently used globally during the 2009 H1N1 influenza pandemic.
- These closures have significant negative economic and social consequences.
Purpose of the Study:
- To estimate the epidemiological and cost-effectiveness of school closure strategies.
- To evaluate various closure and reopening strategies under uncertainty.
Main Methods:
- Utilized a decision analytic approach combined with an influenza transmission mathematical model.
- Assessed strategies based on school-aged prevalence (SAP) thresholds and closure durations.
- Incorporated uncertainty in disease transmissibility and severity.
Main Results:
- Cost-effectiveness varied significantly with pandemic severity and willingness to pay per QALY.
- For severe pandemics, early closure (0.5% SAP) and long duration (24 weeks) were optimal.
- Milder pandemics favored early closure with shorter durations (12 weeks or variable).
Conclusions:
- Early estimation of pandemic severity is crucial for effective public health decision-making.
- Tailored school closure strategies are essential for pandemic response.
- Findings guide policymakers in optimizing school closure interventions.
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