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Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic

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Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic. / 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.

In: Proceedings of the Royal Society B: Biological Sciences, Vol. 278, No. 1719, 22.09.2011, p. 2753-2760.

Research output: Contribution to journalJournal article

Harvard

House, T, Baguelin, M, Van Hoek, AJ, White, PJ, Sadique, Z, Eames, K, Read, JM, Hens, N, Melegaro, A, Edmunds, WJ & Keeling, MJ 2011, 'Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic', Proceedings of the Royal Society B: Biological Sciences, vol. 278, no. 1719, pp. 2753-2760. https://doi.org/10.1098/rspb.2010.2688

APA

House, T., Baguelin, M., Van Hoek, A. J., White, P. J., Sadique, Z., Eames, K., Read, J. M., Hens, N., Melegaro, A., Edmunds, W. J., & Keeling, M. J. (2011). Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic. Proceedings of the Royal Society B: Biological Sciences, 278(1719), 2753-2760. https://doi.org/10.1098/rspb.2010.2688

Vancouver

House T, Baguelin M, Van Hoek AJ, White PJ, Sadique Z, Eames K et al. Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic. Proceedings of the Royal Society B: Biological Sciences. 2011 Sep 22;278(1719):2753-2760. https://doi.org/10.1098/rspb.2010.2688

Author

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. / Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic. In: Proceedings of the Royal Society B: Biological Sciences. 2011 ; Vol. 278, No. 1719. pp. 2753-2760.

Bibtex

@article{03064e7e9e7c4b918e5fc5aeb3647eea,
title = "Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic",
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.",
keywords = "Adolescent, Adult, Aged, Basic Reproduction Number, Child, Child, Preschool, Critical Care, Disease Transmission, Infectious, Great Britain, Health Services Needs and Demand, Hospitalization, Humans, Influenza A Virus, H1N1 Subtype, Influenza, Human, Intensive Care Units, Middle Aged, Models, Biological, Pandemics, Schools, Young Adult",
author = "Thomas House and Marc Baguelin and {Van Hoek}, {Albert Jan} and White, {Peter J.} and Zia Sadique and Ken Eames and Read, {Jonathan M.} and Niel Hens and Alessia Melegaro and Edmunds, {W. John} and Keeling, {Matt J.}",
note = "This journal is Copyright 2011 The Royal Society",
year = "2011",
month = sep
day = "22",
doi = "10.1098/rspb.2010.2688",
language = "English",
volume = "278",
pages = "2753--2760",
journal = "Proceedings of the Royal Society B: Biological Sciences",
issn = "0962-8452",
publisher = "Royal Society of Chemistry Publishing",
number = "1719",

}

RIS

TY - JOUR

T1 - Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic

AU - House, Thomas

AU - Baguelin, Marc

AU - Van Hoek, Albert Jan

AU - White, Peter J.

AU - Sadique, Zia

AU - Eames, Ken

AU - Read, Jonathan M.

AU - Hens, Niel

AU - Melegaro, Alessia

AU - Edmunds, W. John

AU - Keeling, Matt J.

N1 - This journal is Copyright 2011 The Royal Society

PY - 2011/9/22

Y1 - 2011/9/22

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Aged

KW - Basic Reproduction Number

KW - Child

KW - Child, Preschool

KW - Critical Care

KW - Disease Transmission, Infectious

KW - Great Britain

KW - Health Services Needs and Demand

KW - Hospitalization

KW - Humans

KW - Influenza A Virus, H1N1 Subtype

KW - Influenza, Human

KW - Intensive Care Units

KW - Middle Aged

KW - Models, Biological

KW - Pandemics

KW - Schools

KW - Young Adult

U2 - 10.1098/rspb.2010.2688

DO - 10.1098/rspb.2010.2688

M3 - Journal article

C2 - 21288945

VL - 278

SP - 2753

EP - 2760

JO - Proceedings of the Royal Society B: Biological Sciences

JF - Proceedings of the Royal Society B: Biological Sciences

SN - 0962-8452

IS - 1719

ER -