Abstract
BackgroundSchool closure is a non-pharmaceutical intervention that was considered in many national pandemic plans developed prior to the start of the influenza A(H1N1)pdm09 pandemic, and received considerable attention during the event. Here, we retrospectively review and compare national and local experiences with school closures in several countries during the A(H1N1)pdm09 pandemic. Our intention is not to make a systematic review of country experiences; rather, it is to present the diversity of school closure experiences and provide examples from national and local perspectives.MethodsData were gathered during and following a meeting, organized by the European Centres for Disease Control, on school closures held in October 2010 in Stockholm, Sweden. A standard data collection form was developed and sent to all participants. The twelve participating countries and administrative regions (Bulgaria, China, France, Hong Kong Special Administrative Region (SAR), Italy, Japan, New Zealand, Serbia, South Africa, Thailand, United Kingdom, and United States) provided data.ResultsOur review highlights the very diverse national and local experiences on school closures during the A(H1N1)pdm09 pandemic. The processes including who was in charge of making recommendations and who was in charge of making the decision to close, the school-based control strategies, the extent of school closures, the public health tradition of responses and expectations on school closure varied greatly between countries. Our review also discusses the many challenges associated with the implementation of this intervention and makes recommendations for further practical work in this area.ConclusionsThe single most important factor to explain differences observed between countries may have been the different public health practises and public expectations concerning school closures and influenza in the selected countries.
Highlights
School closure is a non-pharmaceutical intervention that was considered in many national pandemic plans developed prior to the start of the influenza A(H1N1)pdm09 pandemic, and received considerable attention during the event
The epidemiology of the pandemic and use of school closures Early in the A(H1N1)pdm09 pandemic, it was clear from early data from the United States (US), Mexico and the United Kingdom (UK) that transmission was heavily focused in children [26,27,28,29], which was later confirmed from epidemiologic data from other countries as they became affected
While closing schools during the A(H1N1)pdm09 pandemic was expected to have an impact on transmission because of the age-specific immunity profile, it was unclear whether the potential benefits were worth the high economic and social costs
Summary
School closure is a non-pharmaceutical intervention that was considered in many national pandemic plans developed prior to the start of the influenza A(H1N1)pdm pandemic, and received considerable attention during the event. The use of school closures during influenza epidemics and pandemics as a non-pharmaceutical intervention (NPI) is a topic that has received considerable attention from policy makers, the public health research community, the public and the media. That review noted how the severity and impact of each pandemic is different and that the impact and relevance of school closure would, to a large extent, depend on the epidemiological and virologic characteristics of the pandemic strain, and the severity of disease [12]. Analyses of additional data collected during the A(H1N1)pdm pandemic have made it possible to further quantify the impact of closures so that literature assessing impact is substantial [7,8,9,10,11,13,14,15,16,17,18,19,20,21,22,23,24,25]
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