scholarly journals The impact of unplanned school closure on children’s social contact: Rapid evidence review

2020 ◽  
Author(s):  
Samantha Brooks ◽  
Louise Smith ◽  
Rebecca Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  

Background Emergency school closures are often used as public health interventions during infectious disease outbreaks in an attempt to minimise the spread of infection. However, if children continue to mix with others outside the home during the closures, these measures are unlikely to be effective. ObjectivesThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsWe searched four databases from inception to February 2020 for relevant literature. Main findings were extracted. Results3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures but contact was still common. All studies reported children leaving the house or being looked after by non-household members. There was some evidence that older child age and parental disagreement with closure were predictive of children leaving the house, and mixed evidence regarding the relationship between infection status and leaving the home. Parental agreement with closure was generally high, but some parents disagreed due to perceived low risk of infection and practical issues regarding childcare and financial impact. ConclusionsEvidence suggests that many children continue to leave the house and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

Author(s):  
Samantha K. Brooks ◽  
Louise E. Smith ◽  
Rebecca K. Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  

AbstractBackgroundEmergency school closures are often used as public health interventions during infectious disease outbreaks in an attempt to minimise the spread of infection. However, if children continue to mix with others outside the home during the closures, these measures are unlikely to be effective.ObjectivesThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsWe searched four databases from inception to February 2020 for relevant literature. Main findings were extracted.Results3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures but contact was still common. All studies reported children leaving the house or being looked after by non-household members. There was some evidence that older child age and parental disagreement with closure were predictive of children leaving the house, and mixed evidence regarding the relationship between infection status and leaving the home. Parental agreement with closure was generally high, but some parents disagreed due to perceived low risk of infection and practical issues regarding childcare and financial impact.ConclusionsEvidence suggests that many children continue to leave the house and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.


2020 ◽  
Vol 25 (13) ◽  
Author(s):  
Samantha K Brooks ◽  
Louise E Smith ◽  
Rebecca K Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  

Background Emergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. However, if children continue mixing with others outside the home during closures, the effect of these measures may be limited. Aim This review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures. Methods In February 2020, we searched four databases, MEDLINE, PsycInfo, Embase and Web of Science, from inception to 5 February 2020 for papers published in English or Italian in peer-reviewed journals reporting on primary research exploring children’s social activities during unplanned school closures. Main findings were extracted. Results A total of 3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures, but contact remained common. All studies reported children leaving the home or being cared for by non-household members. There was some evidence that older child age (two studies) and parental disagreement (two studies) with closure were predictive of children leaving the home, and mixed evidence regarding the relationship between infection status and such. Parental agreement with closure was generally high, but some disagreed because of perceived low risk of infection and issues regarding childcare and financial impact. Conclusion Evidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.


2006 ◽  
Vol 274 (1611) ◽  
pp. 833-837 ◽  
Author(s):  
Andreas Handel ◽  
Ira M Longini ◽  
Rustom Antia

Effective control of infectious disease outbreaks is an important public health goal. In a number of recent studies, it has been shown how different intervention measures like travel restrictions, school closures, treatment and prophylaxis might allow us to control outbreaks of diseases, such as SARS, pandemic influenza and others. In these studies, control of a single outbreak is considered. It is, however, not clear how one should handle a situation where multiple outbreaks are likely to occur. Here, we identify the best control strategy for such a situation. We further discuss ways in which such a strategy can be implemented to achieve additional public health objectives.


2019 ◽  
Vol 374 (1776) ◽  
pp. 20180265 ◽  
Author(s):  
Olumayowa Kajero ◽  
Victor Del Rio Vilas ◽  
James L. N. Wood ◽  
Giovanni Lo Iacono

Public health practitioners require measures to evaluate how vulnerable populations are to diseases, especially for zoonoses (i.e. diseases transmitted from animals to humans) given their pandemic potential. These measures would be valuable to support strategic and operational decision making and allocation of resources. Although vulnerability is well defined for natural hazards, for public health threats the concept remains undetermined. Here, we develop new methodologies to: (i) quantify the impact of zoonotic diseases and the capacity of countries to cope with these diseases, and (ii) combine these two measures (impact and capacity) into one overall vulnerability indicator. The adaptive capacity is calculated from estimations of disease mortality, although the method can be adapted for diseases with no or low mortality but high morbidity. As an example, we focused on the vulnerability of Nigeria and Sierra Leone to Lassa Fever and Ebola. We develop a simple analytical form that can be used to estimate vulnerability scores for different spatial units of interest, e.g. countries or regions. We show how some populations can be highly vulnerable despite low impact threats. We finally outline future research to more comprehensively inform vulnerability with the incorporation of relevant factors depicting local heterogeneities (e.g. bio-physical and socio-economic factors). This article is part of the theme issue ‘Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control’. This theme issue is linked with the earlier issue ‘Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes’.


2021 ◽  
Author(s):  
Ann Liljas ◽  
Lenke Morath ◽  
Bo Burström ◽  
Pär Schön ◽  
Janne Agerholm

Abstract Background: Infectious disease outbreaks are common in care homes, often with substantial impact on the rates of infection and mortality of the residents, who primarily are older people vulnerable to infections. There is growing evidence that organisational characteristics of staff and facility might play a role in infection outbreaks however such evidence have not previously been systematically reviewed. Therefore, this systematic review aims to examine the impact of facility and staff characteristics on the risk of infectious disease outbreaks in care homes.Methods: Five databases were searched. Studies considered for inclusion were of any design reporting on an outbreak of any infectious disease in one or more care homes providing care for primarily older people with original data on: facility size, facility location (urban/rural), facility design, use of temporary hired staff, staff compartmentalizing, residence of staff, and/or nursing aides hours per resident. Retrieved studies were screened, assessed for quality, and analysed employing a narrative synthesis.Results: Sixteen studies (8 cohort studies, 6 cross-sectional studies, 2 case-control) were included from the search which generated 10,424 unique records. COVID-19 was the most commonly reported cause of outbreak (n=11). The other studies focused on influenza, respiratory and gastrointestinal outbreaks. Most studies reported on the impact of facility size (n=11) followed by facility design (n=4), use of temporary hired staff (n=3), facility location (n=2), staff compartmentalizing (n=2), nurse aides hours (n=2) and residence of staff (n=1). Findings suggest that urban location and larger facility size may be associated with greater risks of an infectious outbreak. Additionally, the risk of a larger outbreak seems lower in larger facilities. Whilst staff compartmentalizing may be associated with lower risk of an outbreak, staff residing in highly infected areas may be associated with greater risk of outbreak. The influence of facility design, use of temporary staff, and nurse aides hours remains unclear.Conclusions: This systematic review suggests that larger facilities have greater risks of infectious outbreaks, yet the risk of a larger outbreak seems lower in larger facilities. Due to lack of robust findings the impact of facility and staff characteristics on infectious outbreaks remain largely unknown.PROSPERO: CRD42020213585


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jennifer B. Nuzzo ◽  
Diane Meyer ◽  
Michael Snyder ◽  
Sanjana J. Ravi ◽  
Ana Lapascu ◽  
...  

Abstract Background The 2014–2016 Ebola outbreak was a wake-up call regarding the critical importance of resilient health systems. Fragile health systems can become overwhelmed during public health crises, further exacerbating the human, economic, and political toll. Important work has been done to describe the general attributes of a health system resilient to these crises, and the next step will be to identify the specific capacities that health systems need to develop and maintain to achieve resiliency. Methods We conducted a scoping review of the literature to identify recurring themes and capacities needed for health system resiliency to infectious disease outbreaks and natural hazards and any existing implementation frameworks that highlight these capacities. We also sought to identify the overlap of the identified themes and capacities with those highlighted in the World Health Organization’s Joint External Evaluation. Sources of evidence included PubMed, Web of Science, OAIster, and the websites of relevant major public health organizations. Results We identified 16 themes of health system resilience, including: the need to develop plans for altered standards of care during emergencies, the need to develop plans for post-event recovery, and a commitment to quality improvement. Most of the literature described the general attributes of a resilient health system; no implementation frameworks were identified that could translate these elements into specific capacities that health system actors can employ to improve resilience to outbreaks and natural hazards in a variety of settings. Conclusions An implementation-oriented health system resilience framework could help translate the important components of a health system identified in this review into specific capacities that actors in the health system could work to develop to improve resilience to public health crises. However, there remains a need to further refine the concept of resilience so that health systems can simultaneously achieve sustainable transformations in healthcare practice and health service delivery as well as improve their preparedness for emergencies.


2020 ◽  
Vol 50 (15) ◽  
pp. 2498-2513
Author(s):  
Jing-Li Yue ◽  
Wei Yan ◽  
Yan-Kun Sun ◽  
Kai Yuan ◽  
Si-Zhen Su ◽  
...  

AbstractThe upsurge in the number of people affected by the COVID-19 is likely to lead to increased rates of emotional trauma and mental illnesses. This article systematically reviewed the available data on the benefits of interventions to reduce adverse mental health sequelae of infectious disease outbreaks, and to offer guidance for mental health service responses to infectious disease pandemic. PubMed, Web of Science, Embase, PsycINFO, WHO Global Research Database on infectious disease, and the preprint server medRxiv were searched. Of 4278 reports identified, 32 were included in this review. Most articles of psychological interventions were implemented to address the impact of COVID-19 pandemic, followed by Ebola, SARS, and MERS for multiple vulnerable populations. Increasing mental health literacy of the public is vital to prevent the mental health crisis under the COVID-19 pandemic. Group-based cognitive behavioral therapy, psychological first aid, community-based psychosocial arts program, and other culturally adapted interventions were reported as being effective against the mental health impacts of COVID-19, Ebola, and SARS. Culturally-adapted, cost-effective, and accessible strategies integrated into the public health emergency response and established medical systems at the local and national levels are likely to be an effective option to enhance mental health response capacity for the current and for future infectious disease outbreaks. Tele-mental healthcare services were key central components of stepped care for both infectious disease outbreak management and routine support; however, the usefulness and limitations of remote health delivery should also be recognized.


2020 ◽  
Vol 46 (7) ◽  
pp. 427-431 ◽  
Author(s):  
Michael J Parker ◽  
Christophe Fraser ◽  
Lucie Abeler-Dörner ◽  
David Bonsall

In this paper we discuss ethical implications of the use of mobile phone apps in the control of the COVID-19 pandemic. Contact tracing is a well-established feature of public health practice during infectious disease outbreaks and epidemics. However, the high proportion of pre-symptomatic transmission in COVID-19 means that standard contact tracing methods are too slow to stop the progression of infection through the population. To address this problem, many countries around the world have deployed or are developing mobile phone apps capable of supporting instantaneous contact tracing. Informed by the on-going mapping of ‘proximity events’ these apps are intended both to inform public health policy and to provide alerts to individuals who have been in contact with a person with the infection. The proposed use of mobile phone data for ‘intelligent physical distancing’ in such contexts raises a number of important ethical questions. In our paper, we outline some ethical considerations that need to be addressed in any deployment of this kind of approach as part of a multidimensional public health response. We also, briefly, explore the implications for its use in future infectious disease outbreaks.


Author(s):  
Huailiang Wu ◽  
Jian Huang ◽  
Casper J. P. Zhang ◽  
Zonglin He ◽  
Wai-Kit Ming

AbstractBackgroundA novel coronavirus disease (COVID-19) outbreak due to SARS-CoV-2 infection occurred in China in late-December 2019. Facemask wearing is considered as one of the most cost-effective and important measures to prevent the transmission of SARS-CoV-2, but it became a social concern due to the recent global facemask shortage. China is the major facemask producer in the world, contributing to 50% of global production. However, even full productivity (20 million facemasks per day) does not seem to meet the need of a population of 1.4 billion in China.MethodsPolicy review using government websites and shortage analysis using mathematical modelling based on data obtained from the National Health Commission (NHC), the Ministry of Industry and Information Technology (MIIT), the Center for Disease Control and Prevention (CDC) of the People’s Republic of China, and Wuhan Bureau of Statistics.FindingsSupplies of facemasks in the whole of China would have been sufficient for both healthcare workers and the general population if the COVID-19 outbreak only occurred in Wuhan city or Hubei province. However, if the outbreak occurred in the whole of China, facemask supplies in China could last for 5 days if under the existing public health measures and a shortage of 853 million facemasks is expected by 30 Apr 2020. Assuming a gradually decreased import volume, we estimated that dramatic increase in productivity (42.7 times of the usual level) is needed to mitigate the facemask crisis by the end of April.InterpretationIn light of the COVID-19 outbreak in China, a shortage of facemasks and other medical resources can considerably compromise the efficacy of public health measures. Effective public health measures should also consider the adequacy and affordability of medical resources. Global collaboration should be strengthened to prevent the development of a global pandemic from a regional epidemic via easing the medical resources crisis in the affected countries.Research in contextEvidence before this studyWe searched PubMed and Web of Science for articles in English, between 1 Jan 1980, and 1 Jan 2020, using the search terms 1) (infection OR infectious disease* OR outbreaks) AND (modelling); and 2) (mask* OR facemask* OR medical resource*) AND (infection OR infectious disease* OR outbreaks). Most relevant studies identified were performed to predict diseases spread and to determine the original infection source of previous epidemics like SARS and H7N9. However, few studies focused on the medical resources crisis during the outbreaks.Added value of this studyTo the best of our knowledge, this is the first study to investigate the facemask shortage during the novel coronavirus pneumonia (COVID-19) outbreak in China. We have summarized in detail the management strategies implemented by the Chinese governments during the outbreaks. By considering three scenarios for the outbreak development, we simulated the facemasks availability from late-December 2019 to late-April 2020 and estimated the duration of sufficient facemask supplies. Our findings showed that if the COVID-19 outbreak occurred only in Wuhan city or Hubei province, facemask shortage would not appear with the existing public health measures. However, if the outbreak occurred in the whole of China, a shortage of facemask could be substantial assuming no alternative public health measures.Implications of all the available evidenceOur findings provide insight into the public health measures to confront medical resources crisis during infectious disease outbreaks. Effective public health measures should consider the adequacy and affordability of existing medical resources. Governments across the world should revisit their emergency plans for controlling infectious disease outbreaks by taking into account the supply of and demand for the medical resource. Global collaboration should be strengthened to prevent the development of a global pandemic from a regional epidemic via easing the medical resources crisis in the affected countries.


Author(s):  
Andreas Handel ◽  
Joel C. Miller ◽  
Yang Ge ◽  
Isaac Chun-Hai Fung

As COVID-19 continues to spread, public health interventions are crucial to minimize its impact. The most desirable goal is to drive the pathogen quickly to extinction. This generally involves applying interventions as strongly as possible, which worked for SARS, but so far has failed for COVID-19. If fast eradication is not achievable, the next best goal is to delay the spread and minimize cases and burden on the health care system until suitable drugs or vaccines are available. This suppression approach also calls for strong interventions, potentially applied for a long time.


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