Reactive school closure weakens the network of social interactions and reduces the spread of influenza
Reactive school closure weakens the network of social interactions and reduces the spread of influenza
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DOI：
10.1073/pnas.1821298116
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发表时间：
2019-07-02
影响因子：
11.1
通讯作者：
Ajelli, Marco
中科院分区：
文献类型：
--
作者：
Litvinova, Maria;Liu, Quan-Hui;Ajelli, Marco
关闭学校政策被认为是缓解季节性流感和大流行性流感的最有希望的非药物干预措施之一。然而，其有效性仍有争议，主要是由于缺乏关于人口在政策执行期间行为的经验证据。在2015年至2016年俄罗斯流感季节期间，我们进行了一项基于日记的接触调查，以估计在实施反应性学校关闭策略之前和期间的社会互动模式。我们开发了一个创新的混合调查建模框架，以估计人类社会互动的时变网络。通过将该网络与感染传播模型相结合，我们减少了学校关闭政策对缓解流感传播影响的不确定性。当学校关闭政策到位时，我们测量到学生（每天14.2对6.5次接触）和工人（每天11.2对8.7次接触）的接触次数大幅减少。这一减少并没有被学生与非家庭亲属之间的接触数量的增加所抵消。模型模拟表明，基于监测学生旷课率的逐步反应性学校关闭政策能够减轻流感传播。我们估计，如果没有实施应对策略，2015年至2016年流感季节的发病率将增加33%。我们的研究揭示了在实施反应性学校关闭期间人口的社会混合模式，并为未来学校关闭政策的成本效益分析提供了关键工具。
School-closure policies are considered one of the most promising nonpharmaceutical interventions for mitigating seasonal and pandemic influenza. However, their effectiveness is still debated, primarily due to the lack of empirical evidence about the behavior of the population during the implementation of the policy. Over the course of the 2015 to 2016 influenza season in Russia, we performed a diary-based contact survey to estimate the patterns of social interactions before and during the implementation of reactive school-closure strategies. We develop an innovative hybrid survey-modeling framework to estimate the time-varying network of human social interactions. By integrating this network with an infection transmission model, we reduce the uncertainty surrounding the impact of school-closure policies in mitigating the spread of influenza. When the school-closure policy is in place, we measure a significant reduction in the number of contacts made by students (14.2 vs. 6.5 contacts per day) and workers (11.2 vs. 8.7 contacts per day). This reduction is not offset by the measured increase in the number of contacts between students and nonhousehold relatives. Model simulations suggest that gradual reactive school-closure policies based on monitoring student absenteeism rates are capable of mitigating influenza spread. We estimate that without the implemented reactive strategies the attack rate of the 2015 to 2016 influenza season would have been 33% larger. Our study sheds light on the social mixing patterns of the population during the implementation of reactive school closures and provides key instruments for future cost-effectiveness analyses of school-closure policies.