Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost?: a computational simulation of Pennsylvania
<p>Abstract</p> <p>Background</p> <p>During the 2009 H1N1 influenza epidemic, policy makers debated over whether, when, and how long to close schools. While closing schools could have reduced influenza transmission thereby preventing cases, deaths, and health care costs...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2011-05-01
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| Series: | BMC Public Health |
| Online Access: | http://www.biomedcentral.com/1471-2458/11/353 |
| _version_ | 1811318324290650112 |
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| author | Voorhees Ronald E Potter Margaret A Wheaton William D Cooley Philip C Bailey Rachel R Tai Julie HY Brown Shawn T LeJeune Megan Grefenstette John J Burke Donald S McGlone Sarah M Lee Bruce Y |
| author_facet | Voorhees Ronald E Potter Margaret A Wheaton William D Cooley Philip C Bailey Rachel R Tai Julie HY Brown Shawn T LeJeune Megan Grefenstette John J Burke Donald S McGlone Sarah M Lee Bruce Y |
| author_sort | Voorhees Ronald E |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>During the 2009 H1N1 influenza epidemic, policy makers debated over whether, when, and how long to close schools. While closing schools could have reduced influenza transmission thereby preventing cases, deaths, and health care costs, it may also have incurred substantial costs from increased childcare needs and lost productivity by teachers and other school employees.</p> <p>Methods</p> <p>A combination of agent-based and Monte Carlo economic simulation modeling was used to determine the cost-benefit of closing schools (vs. not closing schools) for different durations (range: 1 to 8 weeks) and symptomatic case incidence triggers (range: 1 to 30) for the state of Pennsylvania during the 2009 H1N1 epidemic. Different scenarios varied the basic reproductive rate (R<sub>0</sub>) from 1.2, 1.6, to 2.0 and used case-hospitalization and case-fatality rates from the 2009 epidemic. Additional analyses determined the cost per influenza case averted of implementing school closure.</p> <p>Results</p> <p>For all scenarios explored, closing schools resulted in substantially higher net costs than not closing schools. For R<sub>0 </sub>= 1.2, 1.6, and 2.0 epidemics, closing schools for 8 weeks would have resulted in median net costs of $21.0 billion (95% Range: $8.0 - $45.3 billion). The median cost per influenza case averted would have been $14,185 ($5,423 - $30,565) for R<sub>0 </sub>= 1.2, $25,253 ($9,501 - $53,461) for R<sub>0 </sub>= 1.6, and $23,483 ($8,870 - $50,926) for R<sub>0 </sub>= 2.0.</p> <p>Conclusions</p> <p>Our study suggests that closing schools during the 2009 H1N1 epidemic could have resulted in substantial costs to society as the potential costs of lost productivity and childcare could have far outweighed the cost savings in preventing influenza cases.</p> |
| first_indexed | 2024-04-13T12:23:38Z |
| format | Article |
| id | doaj.art-bd55d5ecfba94b539fc84f92ac0c6819 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-13T12:23:38Z |
| publishDate | 2011-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-bd55d5ecfba94b539fc84f92ac0c68192022-12-22T02:47:05ZengBMCBMC Public Health1471-24582011-05-0111135310.1186/1471-2458-11-353Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost?: a computational simulation of PennsylvaniaVoorhees Ronald EPotter Margaret AWheaton William DCooley Philip CBailey Rachel RTai Julie HYBrown Shawn TLeJeune MeganGrefenstette John JBurke Donald SMcGlone Sarah MLee Bruce Y<p>Abstract</p> <p>Background</p> <p>During the 2009 H1N1 influenza epidemic, policy makers debated over whether, when, and how long to close schools. While closing schools could have reduced influenza transmission thereby preventing cases, deaths, and health care costs, it may also have incurred substantial costs from increased childcare needs and lost productivity by teachers and other school employees.</p> <p>Methods</p> <p>A combination of agent-based and Monte Carlo economic simulation modeling was used to determine the cost-benefit of closing schools (vs. not closing schools) for different durations (range: 1 to 8 weeks) and symptomatic case incidence triggers (range: 1 to 30) for the state of Pennsylvania during the 2009 H1N1 epidemic. Different scenarios varied the basic reproductive rate (R<sub>0</sub>) from 1.2, 1.6, to 2.0 and used case-hospitalization and case-fatality rates from the 2009 epidemic. Additional analyses determined the cost per influenza case averted of implementing school closure.</p> <p>Results</p> <p>For all scenarios explored, closing schools resulted in substantially higher net costs than not closing schools. For R<sub>0 </sub>= 1.2, 1.6, and 2.0 epidemics, closing schools for 8 weeks would have resulted in median net costs of $21.0 billion (95% Range: $8.0 - $45.3 billion). The median cost per influenza case averted would have been $14,185 ($5,423 - $30,565) for R<sub>0 </sub>= 1.2, $25,253 ($9,501 - $53,461) for R<sub>0 </sub>= 1.6, and $23,483 ($8,870 - $50,926) for R<sub>0 </sub>= 2.0.</p> <p>Conclusions</p> <p>Our study suggests that closing schools during the 2009 H1N1 epidemic could have resulted in substantial costs to society as the potential costs of lost productivity and childcare could have far outweighed the cost savings in preventing influenza cases.</p>http://www.biomedcentral.com/1471-2458/11/353 |
| spellingShingle | Voorhees Ronald E Potter Margaret A Wheaton William D Cooley Philip C Bailey Rachel R Tai Julie HY Brown Shawn T LeJeune Megan Grefenstette John J Burke Donald S McGlone Sarah M Lee Bruce Y Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost?: a computational simulation of Pennsylvania BMC Public Health |
| title | Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost?: a computational simulation of Pennsylvania |
| title_full | Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost?: a computational simulation of Pennsylvania |
| title_fullStr | Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost?: a computational simulation of Pennsylvania |
| title_full_unstemmed | Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost?: a computational simulation of Pennsylvania |
| title_short | Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost?: a computational simulation of Pennsylvania |
| title_sort | would school closure for the 2009 h1n1 influenza epidemic have been worth the cost a computational simulation of pennsylvania |
| url | http://www.biomedcentral.com/1471-2458/11/353 |
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