School dismissal as a pandemic influenza response: When, where and for how long?
School dismissal as a pandemic influenza response: When, where and for how long?
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DOI：
10.1016/j.epidem.2019.100348
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发表时间：
2019-09-01
期刊：
影响因子：
3.8
通讯作者：
Uzicanin, Amra
中科院分区：
文献类型：
--
作者：
Germann, Timothy C.;Gao, Hongjiang;Uzicanin, Amra
我们在社区、地区和国家层面使用基于个人的计算机模拟模型来评估流感大流行期间协调一致的先发制人的学校解雇政策可能产生的影响。这些政策涉及三个关键决定：何时、多大的地理规模以及学校停课多长时间。我们的评估包括不确定性和敏感性分析，以及模型输出的不确定性，这些不确定性源于连续时间间隔的变异性和学校停课期间社会联系的推定修改。在疫苗普及之前的一段时间内，学校停课在推迟疫情高峰方面尤其有效，通常每多停课一周，学校停课就会推迟4-6天。假设监测能够正确和迅速地诊断出辖区内至少5%-10%的有症状的个人，市或县一级的解雇在给定的解雇持续时间内，除了这里考虑的最严重的大流行情景外，所有人的发病率都会得到最大程度的降低。对于最严重和传播最快(类似1918年)的大流行，应该考虑更广泛的(多个县)解雇，在这种情况下，可能有必要关闭数月，以充分推迟疫情高峰，以便实施疫苗。
We used individual-based computer simulation models at community, regional and national levels to evaluate the likely impact of coordinated pre-emptive school dismissal policies during an influenza pandemic. Such policies involve three key decisions: when, over what geographical scale, and how long to keep schools closed. Our evaluation includes uncertainty and sensitivity analyses, as well as model output uncertainties arising from variability in serial intervals and presumed modifications of social contacts during school dismissal periods. During the period before vaccines become widely available, school dismissals are particularly effective in delaying the epidemic peak, typically by 4-6 days for each additional week of dismissal. Assuming the surveillance is able to correctly and promptly diagnose at least 5-10% of symptomatic individuals within the jurisdiction, dismissals at the city or county level yield the greatest reduction in disease incidence for a given dismissal duration for all but the most severe pandemic scenarios considered here. Broader (multi-county) dismissals should be considered for the most severe and fast-spreading (1918-like) pandemics, in which multi-month closures may be necessary to delay the epidemic peak sufficiently to allow for vaccines to be implemented.