Skip to main content
Top
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

School practices to promote social distancing in K-12 schools: review of influenza pandemic policies and practices

Authors: Lori Uscher-Pines, Heather L. Schwartz, Faruque Ahmed, Yenlik Zheteyeva, Erika Meza, Garrett Baker, Amra Uzicanin

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

Background

During an evolving influenza pandemic, community mitigation strategies, such as social distancing, can slow down virus transmission in schools and surrounding communities. To date, research on school practices to promote social distancing in primary and secondary schools has focused on prolonged school closure, with little attention paid to the identification and feasibility of other more sustainable interventions. To develop a list and typology of school practices that have been proposed and/or implemented in an influenza pandemic and to uncover any barriers identified, lessons learned from their use, and documented impacts.

Methods

We conducted a review of the peer-reviewed and grey literature on social distancing interventions in schools other than school closure. We also collected state government guidance documents directed to local education agencies or schools to assess state policies regarding social distancing. We collected standardized information from each document using an abstraction form and generated descriptive statistics on common plan elements.

Results

The document review revealed limited literature on school practices to promote social distancing, as well as limited incorporation of school practices to promote social distancing into state government guidance documents. Among the 38 states that had guidance documents that met inclusion criteria, fewer than half (42%) mentioned a single school practice to promote social distancing, and none provided any substantive detail about the policies or practices needed to enact them. The most frequently identified school practices were cancelling or postponing after-school activities, canceling classes or activities with a high rate of mixing/contact that occur within the school day, and reducing mixing during transport.

Conclusion

Little information is available to schools to develop policies and procedures on social distancing. Additional research and guidance are needed to assess the feasibility and effectiveness of school practices to promote social distancing.
Literature
1.
go back to reference Qualls N, Levitt A, Kanade N, et al. Community mitigation guidelines to prevent pandemic influenza - United States, 2017. MMWR Recommendations and reports : Morbidity and mortality weekly report Recommendations and reports. 2017;66(1):1–34.CrossRefPubMedPubMedCentral Qualls N, Levitt A, Kanade N, et al. Community mitigation guidelines to prevent pandemic influenza - United States, 2017. MMWR Recommendations and reports : Morbidity and mortality weekly report Recommendations and reports. 2017;66(1):1–34.CrossRefPubMedPubMedCentral
2.
go back to reference Earn DJ, He D, Loeb MB, Fonseca K, Lee BE, Dushoff J. Effects of school closure on incidence of pandemic influenza in Alberta, Canada. Ann Intern Med. 2012;156(3):173–81.CrossRefPubMed Earn DJ, He D, Loeb MB, Fonseca K, Lee BE, Dushoff J. Effects of school closure on incidence of pandemic influenza in Alberta, Canada. Ann Intern Med. 2012;156(3):173–81.CrossRefPubMed
3.
go back to reference Bootsma MC, Ferguson NM. The effect of public health measures on the 1918 influenza pandemic in U.S. cities. Proc Natl Acad Sci U S A. 2007;104(18):7588–93.CrossRefPubMedPubMedCentral Bootsma MC, Ferguson NM. The effect of public health measures on the 1918 influenza pandemic in U.S. cities. Proc Natl Acad Sci U S A. 2007;104(18):7588–93.CrossRefPubMedPubMedCentral
5.
go back to reference Glatman-Freedman A, Portelli I, Jacobs SK, et al. Attack rates assessment of the 2009 pandemic H1N1 influenza a in children and their contacts: a systematic review and meta-analysis. PLoS One. 2012;7(11):e50228.CrossRefPubMedPubMedCentral Glatman-Freedman A, Portelli I, Jacobs SK, et al. Attack rates assessment of the 2009 pandemic H1N1 influenza a in children and their contacts: a systematic review and meta-analysis. PLoS One. 2012;7(11):e50228.CrossRefPubMedPubMedCentral
6.
go back to reference Cox CM, Blanton L, Dhara R, Brammer L, Finelli L. 2009 pandemic influenza a (H1N1) deaths among children--United States, 2009-2010. Clin Infect Dis. 2011;52(Suppl 1):S69–74.CrossRefPubMed Cox CM, Blanton L, Dhara R, Brammer L, Finelli L. 2009 pandemic influenza a (H1N1) deaths among children--United States, 2009-2010. Clin Infect Dis. 2011;52(Suppl 1):S69–74.CrossRefPubMed
7.
go back to reference Centers for Disease Control and Prevention. 2017 community strategy for pandemic influenza mitigation in the United States: pre-pandemic planning guidelines for the use of nonpharmaceutical interventions. MMWR. 2017. Centers for Disease Control and Prevention. 2017 community strategy for pandemic influenza mitigation in the United States: pre-pandemic planning guidelines for the use of nonpharmaceutical interventions. MMWR. 2017.
8.
go back to reference Chao DL, Halloran ME, Longini IM Jr. School opening dates predict pandemic influenza a(H1N1) outbreaks in the United States. J Infect Dis. 2010;202(6):877–80.CrossRefPubMedPubMedCentral Chao DL, Halloran ME, Longini IM Jr. School opening dates predict pandemic influenza a(H1N1) outbreaks in the United States. J Infect Dis. 2010;202(6):877–80.CrossRefPubMedPubMedCentral
10.
go back to reference Jackson C, Mangtani P, Hawker J, Olowokure B, Vynnycky E. The effects of school closures on influenza outbreaks and pandemics: systematic review of simulation studies. PLoS One. 2014;9(5):e97297.CrossRefPubMedPubMedCentral Jackson C, Mangtani P, Hawker J, Olowokure B, Vynnycky E. The effects of school closures on influenza outbreaks and pandemics: systematic review of simulation studies. PLoS One. 2014;9(5):e97297.CrossRefPubMedPubMedCentral
11.
go back to reference Jackson C, Vynnycky E, Hawker J, Olowokure B, Mangtani P. School closures and influenza: systematic review of epidemiological studies. BMJ Open. 2013;3(2) Jackson C, Vynnycky E, Hawker J, Olowokure B, Mangtani P. School closures and influenza: systematic review of epidemiological studies. BMJ Open. 2013;3(2)
12.
go back to reference Rashid H, Ridda I, King C, et al. Evidence compendium and advice on social distancing and other related measures for response to an influenza pandemic. Paediatr Respir Rev. 2015;16(2):119–26.PubMed Rashid H, Ridda I, King C, et al. Evidence compendium and advice on social distancing and other related measures for response to an influenza pandemic. Paediatr Respir Rev. 2015;16(2):119–26.PubMed
13.
go back to reference McGiboney G, Fretwell Q. Pandemic Planning for Schools. In. American School Board Journal. Jun2007, Vol 194 Issue 6, p46–47. 2p. 1 Color Photograph.. Vol 1942007:46–47. McGiboney G, Fretwell Q. Pandemic Planning for Schools. In. American School Board Journal. Jun2007, Vol 194 Issue 6, p46–47. 2p. 1 Color Photograph.. Vol 1942007:46–47.
14.
go back to reference Ash K. E-Learning's Potential Scrutinized In Flu Crisis. In: Education Week, vol. 282009. p. 1–13. Ash K. E-Learning's Potential Scrutinized In Flu Crisis. In: Education Week, vol. 282009. p. 1–13.
15.
go back to reference Shi J, Njai R, Wells E, et al. 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(4):e94290.CrossRefPubMedPubMedCentral Shi J, Njai R, Wells E, et al. 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(4):e94290.CrossRefPubMedPubMedCentral
16.
go back to reference Miller JR, Short VL, Wu HM, et al. Use of nonpharmaceutical interventions to reduce transmission of 2009 pandemic influenza a (pH1N1) in Pennsylvania public schools. J. Sch. Health. 2013;83(4):281–9.CrossRefPubMed Miller JR, Short VL, Wu HM, et al. Use of nonpharmaceutical interventions to reduce transmission of 2009 pandemic influenza a (pH1N1) in Pennsylvania public schools. J. Sch. Health. 2013;83(4):281–9.CrossRefPubMed
17.
go back to reference Nasrullah M, Breiding MJ, Smith W, et al. Response to 2009 pandemic influenza a H1N1 among public schools of Georgia, United States--fall 2009. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2012;16(5):e382–90.CrossRef Nasrullah M, Breiding MJ, Smith W, et al. Response to 2009 pandemic influenza a H1N1 among public schools of Georgia, United States--fall 2009. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2012;16(5):e382–90.CrossRef
18.
go back to reference Rebmann T, Elliott MB, Swick Z, Reddick D. US school morbidity and mortality, mandatory vaccination, institution closure, and interventions implemented during the 2009 influenza a H1N1 pandemic. Biosecurity and bioterrorism : biodefense strategy, practice, and science. 2013;11(1):41–8.CrossRef Rebmann T, Elliott MB, Swick Z, Reddick D. US school morbidity and mortality, mandatory vaccination, institution closure, and interventions implemented during the 2009 influenza a H1N1 pandemic. Biosecurity and bioterrorism : biodefense strategy, practice, and science. 2013;11(1):41–8.CrossRef
19.
go back to reference Dooyema CA, Copeland D, Sinclair JR, et al. Factors influencing school closure and dismissal decisions: influenza a (H1N1), Michigan 2009. J. Sch. Health. 2014;84(1):56–62.CrossRefPubMed Dooyema CA, Copeland D, Sinclair JR, et al. Factors influencing school closure and dismissal decisions: influenza a (H1N1), Michigan 2009. J. Sch. Health. 2014;84(1):56–62.CrossRefPubMed
31.
go back to reference Adalja AA, Crooke PS, Hotchkiss JR. Influenza transmission in preschools: modulation by contact landscapes and interventions. Mathematical modelling of natural phenomena. 2010;5(3):3–14.CrossRefPubMedPubMedCentral Adalja AA, Crooke PS, Hotchkiss JR. Influenza transmission in preschools: modulation by contact landscapes and interventions. Mathematical modelling of natural phenomena. 2010;5(3):3–14.CrossRefPubMedPubMedCentral
32.
go back to reference Fumanelli L, Ajelli M, Merler S, Ferguson NM, Cauchemez S. Model-based comprehensive analysis of school closure policies for mitigating influenza epidemics and pandemics. PLoS Comput Biol. 2016;12(1):e1004681.CrossRefPubMedPubMedCentral Fumanelli L, Ajelli M, Merler S, Ferguson NM, Cauchemez S. Model-based comprehensive analysis of school closure policies for mitigating influenza epidemics and pandemics. PLoS Comput Biol. 2016;12(1):e1004681.CrossRefPubMedPubMedCentral
33.
34.
go back to reference Lofgren E, Rogers J, Senese M. Pandemic preparedness strategies for school systems: is closure really the only way? Ann Zool Fenn. 2008;45(5):449–58.CrossRef Lofgren E, Rogers J, Senese M. Pandemic preparedness strategies for school systems: is closure really the only way? Ann Zool Fenn. 2008;45(5):449–58.CrossRef
35.
go back to reference Cooley P, Bartsch S, Brown S, Wheaton W, Wagener D, Lee B. Weekends as social distancing and their effect on the spread of influenza. Computational and Mathematical Organization Theory. 2016;22(1) Cooley P, Bartsch S, Brown S, Wheaton W, Wagener D, Lee B. Weekends as social distancing and their effect on the spread of influenza. Computational and Mathematical Organization Theory. 2016;22(1)
36.
go back to reference Guidance for K-12 Administrators' Responses to Influenza. In: Education Digest, vol. 752009. p. 8–12. Guidance for K-12 Administrators' Responses to Influenza. In: Education Digest, vol. 752009. p. 8–12.
37.
38.
go back to reference Sugisaki K, Seki N, Tanabe N, et al. Effective school actions for mitigating seasonal influenza outbreaks in Niigata, Japan. PLoS One. 2013;8(9):e74716.CrossRefPubMedPubMedCentral Sugisaki K, Seki N, Tanabe N, et al. Effective school actions for mitigating seasonal influenza outbreaks in Niigata, Japan. PLoS One. 2013;8(9):e74716.CrossRefPubMedPubMedCentral
43.
go back to reference California Department of Education. Pandemic Flu Checklist for Local Educational Agencies in California 2014. Accessed 3–1-17. California Department of Education. Pandemic Flu Checklist for Local Educational Agencies in California 2014. Accessed 3–1-17.
75.
go back to reference West Virginia Department of Education. WVDE Pandemic Influenza Plan. Accessed 3-1-17. West Virginia Department of Education. WVDE Pandemic Influenza Plan. Accessed 3-1-17.
76.
go back to reference Wisconsin Department of Public Instruction. School District Influenza Plan. 2009; Accessed 3-1-17. Wisconsin Department of Public Instruction. School District Influenza Plan. 2009; Accessed 3-1-17.
Metadata
Title
School practices to promote social distancing in K-12 schools: review of influenza pandemic policies and practices
Authors
Lori Uscher-Pines
Heather L. Schwartz
Faruque Ahmed
Yenlik Zheteyeva
Erika Meza
Garrett Baker
Amra Uzicanin
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5302-3

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue