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The next 'pandemic playbook' needs to prioritize the needs of children-and a clear roadmap for opening schools

Branch-Elliman, Westyn
Fisher, Lloyd
Doron, Shira
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Journal Article
Publication Date
2023-04-26
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Abstract

The national influenza pandemic response plan includes short-term school closures as an infection mitigation measure, based on modeling data regarding the role of pediatric populations and schools as drivers of disease spread. Modeled estimates regarding the role of children and their in-school contacts as drivers of community transmission of endemic respiratory viruses were used in part to justify prolonged school closures throughout the United States. However, disease transmission models extrapolated from endemic pathogens to novel ones may underestimate the degree to which spread is driven by population immunity and overestimate the impact of school closures as a means of reducing child contacts, particularly in the longer-term. These errors, in turn, may have caused incorrect estimations about the potential benefits of closing schools on a society level while simultaneously failing to account for the significant harms of long-term educational disruption. Pandemic response plans need to be updated to include nuances regarding drivers of transmission such as pathogen type, population immunity, and contact patterns, and disease severity in different groups. Expected duration of impact also needs to be considered, recognizing that effectiveness of different interventions, particularly those focused on limiting social interactions, are short-lived. Additionally, future iterations should include risk-benefit assessments. Interventions that are particularly harmful to certain groups, such as school closures are on children, should be de-emphasized and time limited. Finally, pandemic responses should include ongoing and continuous policy re-evaluation and should include a clear plan for de-implementation and de-escalation.

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Branch-Elliman W, Fisher L, Doron S. The next 'pandemic playbook' needs to prioritize the needs of children-and a clear roadmap for opening schools. Antimicrob Steward Healthc Epidemiol. 2023 Apr 26;3(1):e82. doi: 10.1017/ash.2023.154. PMID: 37179759; PMCID: PMC10173290.

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DOI
10.1017/ash.2023.154
PubMed ID
37179759
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© US Department of Veterans Affairs, 2023. This is a work of the US Government and is not subject to copyright protection within the United States. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:// creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.Attribution 4.0 International