Limited School Closures Called Ineffective on Epidemics

New research shows limited school closures are ineffective and only significant, widespread school closures would have real impact on the spread of an epidemic and the strain placed on hospitals' ICUs.

Selective schools closures habr been considered as a means of reducing transmission between children and thus reducing the number of cases at the peak of an epidemic, but new research led by researchers at the University of Warwick shows limited school closures are ineffective. Only significant, widespread school closures would have real effect on the spread of a epidemic and the strain placed on hospitals' intensive care units.

"Influenza potentially places an extreme burden on local health services," said Dr. Thomas House from the University of Warwick's Mathematics Institute and the university's Complexity Science research group. "This was observed in both the 2009-10 swine-flu pandemic and this year's seasonal flu outbreak. Our work uses mathematical models to assess how school closures reduce the burden on particular hospitals. Although sustained national closures of schools can be very effective, they are costly and disruptive and can even prevent parents in the health service from responding to any epidemic. We find in the worst cases, that short duration, localized closures cannot fully prevent some hospitals exceeding capacity. This means, when facing the threat of a severe pandemic, a coordinated and possibly extended period of school closures may be necessary."

The researchers found that even with broadly optimistic assumptions about school closures, the proportion of hospitals above capacity in their ICUs cannot be brought to zero. The lowest value of 12 percent is reached when there is a coordinated closure of at least 30 percent of all English schools. In fact, if less optimistic (but more realistic) assumptions are made about the timing and selection of closures, there is no significant difference on the strain on ICUs until at least 50 percent of all schools are closed.

"Our work supports the decision not to close schools as a control measure during the 2009/10 swine flu pandemic," House said. "If a pandemic is serious enough to require measures like school closures, then they need to be well timed and large scale to have much effect."

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