CoChat
Sign Up
Cited by 113Influenza Virus Research StudiesHealth Systems, Economic Evaluations, Quality of LifeMathematical and Theoretical Epidemiology and Ecology Models

The DOI matches its Crossref record; 38 of the 39 references it cites were found in a registry or an index.

Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost?: a computational simulation of Pennsylvania

Open access
Brown, Shawn T, Tai, Julie HY, Bailey, Rachel R, Cooley, Philip C, Wheaton, William D, Potter, Margaret A, Voorhees, Ronald E, LeJeune, Megan, Grefenstette, John J, Burke, Donald S, McGlone, Sarah M, Lee, Bruce Y·2011·BMC Public Health
DOI 10.1186/1471-2458-11-353PMC PMC3119163
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: During the 2009 H1N1 influenza epidemic, policy makers debated over whether, when, and how long to close schools. While closing schools could have reduced influenza transmission thereby preventing cases, deaths, and health care costs, it may also have incurred substantial costs from increased childcare needs and lost productivity by teachers and other school employees. METHODS: A combination of agent-based and Monte Carlo economic simulation modeling was used to determine the cost-benefit of closing schools (vs. not closing schools) for different durations (range: 1 to 8 weeks) and symptomatic case incidence triggers (range: 1 to 30) for the state of Pennsylvania during the 2009 H1N1 epidemic. Different scenarios varied the basic reproductive rate (R(0)) from 1.2, 1.6, to 2.0 and used case-hospitalization and case-fatality rates from the 2009 epidemic. Additional analyses determined the cost per influenza case averted of implementing school closure. RESULTS: For all scenarios explored, closing schools resulted in substantially higher net costs than not closing schools. For R(0) = 1.2, 1.6, and 2.0 epidemics, closing schools for 8 weeks would have resulted in median net costs of $21.0 billion (95% Range: $8.0 - $45.3 billion). The median cost per influenza case averted would have been $14,185 ($5,423 - $30,565) for R(0) = 1.2, $25,253 ($9,501 - $53,461) for R(0) = 1.6, and $23,483 ($8,870 - $50,926) for R(0) = 2.0. CONCLUSIONS: Our study suggests that closing schools during the 2009 H1N1 epidemic could have resulted in substantial costs to society as the potential costs of lost productivity and childcare could have far outweighed the cost savings in preventing influenza cases.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/1471-2458-11-353

Cites

38 of 38 references verified0 citation errors · 0 not checkable

Statistics

Figures

Figure 1 The location and size of Pennsylvania schools.
Figure 1 The location and size of Pennsylvania schools.CC BY · PubMed Central
Figure 2 Percent of selected populations infected for school-aged children, persons not going to school, and the total population in the state of Pennsylvania for the three R0's explored.
Figure 2 Percent of selected populations infected for school-aged children, persons not going to school, and the total population in the state of Pennsylvania for the three R0's explored.CC BY · PubMed Central
Figure 3 Estimated cost of disease due to influenza for school closure policies of varying length for the three R0's explored in the state of Pennsylvania (See Equation (2) in text). Error bars give the 5% and 95% distributions.
Figure 3 Estimated cost of disease due to influenza for school closure policies of varying length for the three R0's explored in the state of Pennsylvania (See Equation (2) in text). Error bars give the 5% and 95% distributions.CC BY · PubMed Central
Figure 4 Estimated costs due to school closure for policies of varying length for the three R0's explored in the state of Pennsylvania (See Equation (3) in text). Error bars give the 5% and 95% distributions.
Figure 4 Estimated costs due to school closure for policies of varying length for the three R0's explored in the state of Pennsylvania (See Equation (3) in text). Error bars give the 5% and 95% distributions.CC BY · PubMed Central
Figure 5 Estimated total overall costs for school closure policies of varying length for the three R0's explored in the state of Pennsylvania. Error bars give the 5% and 95% distributions.
Figure 5 Estimated total overall costs for school closure policies of varying length for the three R0's explored in the state of Pennsylvania. Error bars give the 5% and 95% distributions.CC BY · PubMed Central
Figure 6 Median net cost for school closure policies of varying length for the three R0's explored in the state of Pennsylvania. Error bars give the 5% and 95% distributions.
Figure 6 Median net cost for school closure policies of varying length for the three R0's explored in the state of Pennsylvania. Error bars give the 5% and 95% distributions.CC BY · PubMed Central
Figure 7 Median net cost for school closure policies of varying length and case fatality rate (CFR). Error bars give the 5% and 95% distributions.
Figure 7 Median net cost for school closure policies of varying length and case fatality rate (CFR). Error bars give the 5% and 95% distributions.CC BY · PubMed Central

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Research works printed but not linked: 3

  1. Centers for Disease Control and Prevention: Interim Pre-Pandemic planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States. Volume 2010. 2009
  2. American Medical Association: Socioeconomics of Medical Practice. Volume 69. Edited by: Gonzales M. Chicago, Il. 1997, American Medical Association, 107-
  3. Centers for Medicare and Services: In Services USDoHH, ed. 2009

Cited by

Sorted by citations

See all 113

Related

See all

Metadata

Authors
Brown, S. T., Tai, J. H., Bailey, R. R., Cooley, P. C., Wheaton, W. D., Potter, M. A., Voorhees, R. E., LeJeune, M., Grefenstette, J. J., Burke, D. S., McGlone, S. M., & Lee, B. Y.
Affiliations
  • University of Pittsburgh (US)
  • RTI International (US)
Corresponding author
Brown, Shawn T
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2011-05-20
Volume
11
Issue
1
Pages
353-353
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/1471-2458-11-353
PMC
PMC3119163
OpenAlex
W1994172949
Cited by
111
References
39
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 6 · 2021: 11 · 2020: 11 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 9 · 2015: 8 · 2014: 15 · 2013: 14 · 2012: 13
FWCI
10.36
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • D-Scholarship@Pitt (University of Pittsburgh) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Johns Hopkins University
  • National Institutes of Health (5u54gm088491-10)
  • Centers for Disease Control and Prevention (1P01TP000304-03)
  • National Institute of General Medical Sciences (1U54GM088491-01-09)
  • U.S. National Library of Medicine (R01LM009132)
Topics
  • Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Physical Sciences › Mathematics › Applied Mathematics › Mathematical and Theoretical Epidemiology and Ecology Models
Keywords
school closures, 2009 H1N1 influenza, pandemic influenza, cost-benefit analysis, basic reproduction number, productivity loss, childcare costs, influenza transmission, Pennsylvania
MeSH terms
Adolescent, Adult, Aged, Child, Child, Preschool, Disease Outbreaks, Humans, Infant, Influenza, Human, Middle Aged, Monte Carlo Method, Pennsylvania, Schools, Models, Statistical, Models, Econometric, Influenza A Virus, H1N1 Subtype, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review