Officials weigh pros, cons of school closings

• Copyright © 2009 by the American Academy of Pediatrics

The worldwide outbreak of novel influenza A (H1N1) virus (swine flu) has prompted health officials to take a careful look at national policies to mitigate disease, such as school closings, which are complicated by health, social and economic implications.

During past pandemic influenza outbreaks around the world, long-term school closings may have broken (or at least slowed) the spread of the disease, when the children were kept apart outside of school. School closings also had a positive effect on the total number of cases (especially during peak attack times) and limited the stress on hospitals, health care systems and other key services in communities.

It is important for parents, school administrators and local public health officials to prepare now for how they will handle an influenza outbreak in their area. Pediatricians will play integral roles in this decision-making process in their communities. The key to success is planning ahead.

Without a clear picture of the impact of school closure, all families with children must plan how to balance work responsibilities with child care duties; think about what they will do for child care if their child’s school or child care center closes; consider how their children can be learning when schools are closed; keep promoting healthy behaviors to protect their children from getting sick in the first place; and stay educated on flu activity and its severity within their local community.

Any decision on school closure should take into account the severity of the pandemic. Closing schools can have negative effects such as the difficulty in continuing to teach children outside of school; loss of nutritional programs (e.g., free breakfast and lunch for children of needy families); absence from the workforce, possibly not paid, for parents looking after their own children; some children being left to care for themselves; and key health care workers taking time off from work to care for their own children.

School closings also may need to be combined with other interventions such as using antiviral drugs, giving vaccines, banning mass gatherings and closing selected workplaces.

Close monitoring and ongoing research will lead to more information on the best practices to increase vaccination rates while decreasing both pandemic and seasonal influenza disease.

The effects of closing schools and other public policy decisions during a pandemic cannot be fully determined in advance. With all the uncertainty of a pandemic, people may change their health-related behaviors in ways that are difficult to predict.