Wong Zoie Shui-Yee, Goldsman David, Tsui Kwok-Leung
School of Public Health and Community Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America.
PLoS One. 2016 Jan 28;11(1):e0147052. doi: 10.1371/journal.pone.0147052. eCollection 2016.
School closures as a means of containing the spread of disease have received considerable attention from the public health community. Although they have been implemented during previous pandemics, the epidemiological and economic effects of the closure of individual schools remain unclear.
This study used data from the 2009 H1N1 pandemic in Hong Kong to develop a simulation model of an influenza pandemic with a localised population structure to provide scientific justifications for and economic evaluations of individual-level school closure strategies.
The estimated cost of the study's baseline scenario was USD330 million. We found that the individual school closure strategies that involved all types of schools and those that used a lower threshold to trigger school closures had the best performance. The best scenario resulted in an 80% decrease in the number of cases (i.e., prevention of about 830,000 cases), and the cost per case prevented by this intervention was USD1,145; thus, the total cost was USD1.28 billion.
This study predicts the effects of individual school closure strategies on the 2009 H1N1 pandemic in Hong Kong. Further research could determine optimal strategies that combine various system-wide and district-wide school closures with individual school triggers across types of schools. The effects of different closure triggers at different phases of a pandemic should also be examined.
学校关闭作为控制疾病传播的一种手段，已受到公共卫生界的广泛关注。尽管在以往的大流行期间也曾实施过学校关闭措施，但个别学校关闭的流行病学和经济影响仍不明确。
本研究利用香港2009年甲型H1N1流感大流行的数据，建立了一个具有局部人口结构的流感大流行模拟模型，为个体层面的学校关闭策略提供科学依据和经济评估。
该研究基线情景的估计成本为3.3亿美元。我们发现，涉及所有类型学校的个别学校关闭策略以及采用较低触发阈值来关闭学校的策略表现最佳。最佳情景下病例数减少了80%（即预防了约83万例病例），该干预措施预防每例病例的成本为1145美元；因此，总成本为12.8亿美元。
本研究预测了个别学校关闭策略对香港2009年甲型H1N1流感大流行的影响。进一步的研究可以确定最佳策略，即将各种全系统和全地区的学校关闭与不同类型学校的个别学校触发因素相结合。还应研究在大流行的不同阶段不同关闭触发因素的影响。
