1
|
Zheteyeva Y, Rainey JJ, Gao H, Jacobson EU, Adhikari BB, Shi J, Mpofu JJ, Bhavnani D, Dobbs T, Uzicanin A. Unintended costs and consequences of school closures implemented in preparation for Hurricane Isaac in Harrison County School District, Mississippi, August-September 2012. PLoS One 2017; 12:e0184326. [PMID: 29091717 PMCID: PMC5665504 DOI: 10.1371/journal.pone.0184326] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 08/22/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION School closures, while an effective measure against the spread of disease during a pandemic, may carry unintended social and economic consequences for students and families. We evaluated these costs and consequences following a 4-day school closure in Mississippi's Harrison County School District (HCSD). METHODS In a survey of all households with students enrolled in HCSD, we collected information on difficulties related to the school closure, including interruption of employment and pay, loss of access to subsidized school meals, and arrangement of alternative childcare. We analyzed this information in the context of certain demographic characteristics of the survey respondents and households, such as race, level of education, and income. We also estimated the average number of lost work days and documented the childcare alternatives chosen by households affected by the school closure. RESULTS We received 2,229 (28.4%) completed surveys from an estimated 7,851 households eligible to participate. About half (1,082 [48.5%]) of the households experienced at least some difficulty during the closure, primarily in three areas: uncertainty about duration of the closure, lost income, and the effort of arranging alternate childcare. Adults working outside the home, particularly the major wage earner in the household, were more likely to suffer lost income while schools were closed, an effect mitigated by paid leave benefits. Difficulty arranging childcare was reported most frequently by respondents with lower levels of education and households with younger children. Beyond the top three concerns expressed by households in HCSD, the survey also shed light on the issue of food insecurity when subsidized school meals are not available. Reported by 17.9% of households participating in the subsidized school lunch program, difficulty providing meals during the closure was associated with higher numbers of dependent children, selection of "other" as the race of the household respondent, and lower levels of education. CONCLUSION To help prevent undue financial hardship in families of school children, public health authorities and school administrators should provide recommendations for childcare alternatives and paid leave or remote work options during prolonged school closures, particularly to households in which all adults work outside of the home.
Collapse
Affiliation(s)
- Yenlik Zheteyeva
- Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeanette J. Rainey
- Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hongjiang Gao
- Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Evin U. Jacobson
- Office of Public Health Preparedness and Response, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Bishwa B. Adhikari
- Division of Preparedness and Emerging Infections, National Center for Emerging & Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jianrong Shi
- Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jonetta J. Mpofu
- Division of Reproductive Health, Chronic Disease Prevention and Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Office of Workforce and Career Development, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Darlene Bhavnani
- Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Council of State and Territorial Epidemiologists Applied Epidemiology Fellowship, Atlanta, GA, United States of America
| | - Thomas Dobbs
- Mississippi State Department of Health, Jackson, Mississippi, United States of America
| | - Amra Uzicanin
- Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| |
Collapse
|
2
|
Navarro JA, Kohl KS, Cetron MS, Markel H. A Tale of Many Cities: A Contemporary Historical Study of the Implementation of School Closures during the 2009 pA(H1N1) Influenza Pandemic. JOURNAL OF HEALTH POLITICS, POLICY AND LAW 2016; 41:393-421. [PMID: 26921384 PMCID: PMC5595096 DOI: 10.1215/03616878-3523958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
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.
Collapse
|
3
|
Shi J, Njai R, Wells E, Collins J, Wilkins M, Dooyema C, Sinclair J, Gao H, Rainey JJ. Knowledge, attitudes, and practices of nonpharmaceutical interventions following school dismissals during the 2009 Influenza A H1N1 pandemic in Michigan, United States. PLoS One 2014; 9:e94290. [PMID: 24747300 PMCID: PMC3991575 DOI: 10.1371/journal.pone.0094290] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 03/14/2014] [Indexed: 11/19/2022] Open
Abstract
Background Many schools throughout the United States reported an increase in dismissals due to the 2009 influenza A H1N1 pandemic (pH1N1). During the fall months of 2009, more than 567 school dismissals were reported from the state of Michigan. In December 2009, the Michigan Department of Community Health, in collaboration with the United States Centers for Disease Control and Prevention, conducted a survey to describe the knowledge, attitudes, and practices (KAPs) of households with school-aged children and classroom teachers regarding the recommended use of nonpharmaceutical interventions (NPIs) to slow the spread of influenza. Methods A random sample of eight elementary schools (kindergarten through 5th grade) was selected from each of the eight public health preparedness regions in the state. Within each selected school, a single classroom was randomly identified from each grade (K-5), and household caregivers of the classroom students and their respective teachers were asked to participate in the survey. Results In total, 26% (2,188/8,280) of household caregivers and 45% (163/360) of teachers from 48 schools (of the 64 sampled) responded to the survey. Of the 48 participating schools, 27% (13) experienced a school dismissal during the 2009 fall term. Eighty-seven percent (1,806/2,082) of caregivers and 80% (122/152) of teachers thought that the 2009 influenza A H1N1 pandemic was severe, and >90% of both groups indicated that they told their children/students to use NPIs, such as washing hands more often and covering coughs with tissues, to prevent infection with influenza. Conclusions Knowledge and instruction on the use of NPIs appeared to be high among household caregivers and teachers responding to the survey. Nevertheless, public health officials should continue to explain the public health rationale for NPIs to reduce pandemic influenza. Ensuring this information is communicated to household caregivers and teachers through trusted sources is essential.
Collapse
Affiliation(s)
- Jianrong Shi
- Eagle Medical Services, San Antonio, Texas, United States of America
- * E-mail:
| | - Rashid Njai
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Atlanta, Georgia, United States of America
| | - Eden Wells
- University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Jim Collins
- Michigan Department of Community Health, Bureau of Epidemiology, Lansing, Michigan, United States of America
| | - Melinda Wilkins
- Michigan State University Program in Public Health, East Lansing, Michigan, United States of America
| | - Carrie Dooyema
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Atlanta, Georgia, United States of America
| | - Julie Sinclair
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Atlanta, Georgia, United States of America
| | - Hongjiang Gao
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Atlanta, Georgia, United States of America
| | - Jeanette J. Rainey
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Global Migration and Quarantine, Atlanta, Georgia, United States of America
| |
Collapse
|
4
|
Cauchemez S, Van Kerkhove MD, Archer BN, Cetron M, Cowling BJ, Grove P, Hunt D, Kojouharova M, Kon P, Ungchusak K, Oshitani H, Pugliese A, Rizzo C, Saour G, Sunagawa T, Uzicanin A, Wachtel C, Weisfuse I, Yu H, Nicoll A. School closures during the 2009 influenza pandemic: national and local experiences. BMC Infect Dis 2014; 14:207. [PMID: 24739814 PMCID: PMC4021091 DOI: 10.1186/1471-2334-14-207] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 03/18/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND School closure is a non-pharmaceutical intervention that was considered in many national pandemic plans developed prior to the start of the influenza A(H1N1)pdm09 pandemic, and received considerable attention during the event. Here, we retrospectively review and compare national and local experiences with school closures in several countries during the A(H1N1)pdm09 pandemic. Our intention is not to make a systematic review of country experiences; rather, it is to present the diversity of school closure experiences and provide examples from national and local perspectives. METHODS Data were gathered during and following a meeting, organized by the European Centres for Disease Control, on school closures held in October 2010 in Stockholm, Sweden. A standard data collection form was developed and sent to all participants. The twelve participating countries and administrative regions (Bulgaria, China, France, Hong Kong Special Administrative Region (SAR), Italy, Japan, New Zealand, Serbia, South Africa, Thailand, United Kingdom, and United States) provided data. RESULTS Our review highlights the very diverse national and local experiences on school closures during the A(H1N1)pdm09 pandemic. The processes including who was in charge of making recommendations and who was in charge of making the decision to close, the school-based control strategies, the extent of school closures, the public health tradition of responses and expectations on school closure varied greatly between countries. Our review also discusses the many challenges associated with the implementation of this intervention and makes recommendations for further practical work in this area. CONCLUSIONS The single most important factor to explain differences observed between countries may have been the different public health practises and public expectations concerning school closures and influenza in the selected countries.
Collapse
Affiliation(s)
- Simon Cauchemez
- Department of Infectious Disease Epidemiology, MRC Centre for Outbreak Analysis and Modelling, School of Public Health, Imperial College, London, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Effective school actions for mitigating seasonal influenza outbreaks in Niigata, Japan. PLoS One 2013; 8:e74716. [PMID: 24040329 PMCID: PMC3769291 DOI: 10.1371/journal.pone.0074716] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 08/03/2013] [Indexed: 11/19/2022] Open
Abstract
Background Japan has implemented various school actions during seasonal influenza outbreaks since the 1950's under the School Health Law. However, the effective duration, extent, and timing of closures remain unresolved. Materials and Methods We conducted a retrospective study on the relationship between elementary class closures and influenza outbreak control during four consecutive influenza seasons from the 2004-2005 to 2007-2008 school years in Joetsu, Niigata, Japan. Among a total of 1,061 classes of 72 schools, 624 cases of influenza outbreaks were documented among 61 schools. Results Class closures were carried out in a total of 62 cases in response to influenza outbreak, which was defined as a student absentee rate of greater than 10% due to influenza or influenza-like illness. Of these cases, two-day class closures were conducted the day after reaching a 10% student absentee rate in 28 cases and other types of closures were initiated in 34 cases. A markedly higher number of outbreak cases ended within one week for two-day class closures compared to the other types of closures (82.1% vs. 20.6%, respectively). The significant association between two-day class closures and interruption of an outbreak within one week was confirmed using a multivariable model adjusted for the season, grade, day of the week of an outbreak start, and absentee rate on the day of an outbreak start (OR, 3.18; 95% CI, 1.12–9.07; p = 0.030). Conclusions Our results suggest that a two-day class closure carried out the day after reaching a 10% absentee rate is an effective approach for mitigating influenza outbreaks in elementary schools.
Collapse
|
6
|
Cohen NJ, Callahan DB, Gonzalez V, Balaban V, Wang RT, Pordell P, Beato R, Oyervides O, Huang WT, Massoudi MS. Respiratory illness in households of school-dismissed students during pandemic (H1N1) 2009. Emerg Infect Dis 2012; 17:1756-7. [PMID: 21888814 PMCID: PMC3322060 DOI: 10.3201/eid1709.101589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|