Navarro J Alexander, Kohl Katrin S, Cetron Martin S, Markel Howard
University of Michigan.
United States Centers for Disease Control and Prevention.
J Health Polit Policy Law. 2016 Jun;41(3):393-421. doi: 10.1215/03616878-3523958. Epub 2016 Feb 26.
Applying qualitative historical methods, we examined the consideration and implementation of school closures as a nonpharmaceutical intervention (NPI) in thirty US cities during the spring 2009 wave of the pA(H1N1) influenza pandemic. We gathered and performed close textual readings of official federal, state, and municipal government documents; media coverage; and academic publications. Lastly, we conducted oral history interviews with public health and education officials in our selected cities. We found that several local health departments pursued school closure plans independent of CDC guidance, that uncertainty of action and the rapidly evolving understanding of pA(H1N1) contributed to tension and pushback from the public, that the media and public perception played a significant role in the response to school closure decisions, and that there were some notable instances of interdepartmental communication breakdown. We conclude that health departments should continue to develop and fine-tune their action plans while also working to develop better communication methods with the public, and work more closely with education officials to better understand the complexities involved in closing schools. Lastly, state and local governments should work to resolve lingering issues of legal authority for school closures in times of public health crises.
运用定性历史研究方法,我们考察了在2009年春季甲型(H1N1)流感大流行期间,美国三十个城市将学校关闭作为一种非药物干预措施(NPI)的考量与实施情况。我们收集并仔细研读了联邦、州和市政府的官方文件、媒体报道以及学术出版物。最后,我们对所选城市的公共卫生和教育官员进行了口述历史访谈。我们发现,一些地方卫生部门在制定学校关闭计划时并未遵循疾病控制与预防中心(CDC)的指导方针;行动的不确定性以及对甲型(H1N1)流感不断演变的认识导致了公众的紧张情绪和抵制;媒体和公众认知在对学校关闭决策的应对中发挥了重要作用;而且存在一些部门间沟通不畅的显著事例。我们得出结论,卫生部门应继续制定并优化其行动计划,同时努力改进与公众的沟通方式,并与教育官员更紧密合作,以更好地理解关闭学校所涉及的复杂性。最后,州和地方政府应努力解决公共卫生危机期间学校关闭的法律权限方面的遗留问题。