A Tale of Many Cities: A Contemporary Historical Study of the Implementation of School Closures during the 2009 pA(H1N1) Influenza Pandemic

If Long-Term Suppression is not Possible, how do we Minimize Mortality for Infectious Disease Outbreaks?

OBJECTIVE

For any emerging pathogen, the preferred approach is to drive it to extinction with non-pharmaceutical interventions (NPI) or suppress its spread until effective drugs or vaccines are available. However, this might not always be possible. If containment is infeasible, the best people can hope for is pathogen transmission until population level immunity is achieved, with as little morbidity and mortality as possible.

METHODS

A simple computational model was used to explore how people should choose NPI in a non-containment scenario to minimize mortality if mortality risk differs by age.

RESULTS

Results show that strong NPI might be worse overall if they cannot be sustained compared to weaker NPI of the same duration. It was also shown that targeting NPI at different age groups can lead to similar reductions in the total number of infected, but can have strong differences regarding the reduction in mortality.

CONCLUSIONS

Strong NPI that can be sustained until drugs or vaccines become available are always preferred for preventing infection and mortality. However, if people encounter a worst-case scenario where interventions cannot be sustained, allowing some infections to occur in lower-risk groups might lead to an overall greater reduction in mortality than trying to protect everyone equally.

School Closures in the United States and Severe Respiratory Illnesses in Children: A Normalized Nationwide Sample

OBJECTIVES

To determine the association between nationwide school closures and prevalence of common admission diagnoses in the pediatric critical care unit.

DESIGN

Retrospective cohort study.

SETTING

National database evaluation using the Virtual Pediatric Systems LLC database.

PATIENTS

All patients admitted to the PICU in 81 contributing hospitals in the United States.

MEASUREMENTS AND MAIN RESULTS

Diagnosis categories were determined for all 110,418 patients admitted during the 20-week study period in each year (2018, 2019, and 2020). Admission data were normalized relative to statewide school closure dates for each patient using geographic data. The "before school closure" epoch was defined as 8 weeks prior to school closure, and the "after school closure" epoch was defined as 12 weeks following school closure. For each diagnosis, admission ratios for each study day were calculated by dividing 2020 admissions by 2018-2019 admissions. The 10 most common diagnosis categories were examined. Significant changes in admission ratios were identified for bronchiolitis, pneumonia, and asthma. These changes occurred at 2, 8, and 35 days following school closure, respectively. PICU admissions decreased by 82% for bronchiolitis, 76% for pneumonia, and 76% for asthma. Nonrespiratory diseases such as diabetic ketoacidosis, status epilepticus, traumatic injury, and poisoning/ingestion did not show significant changes following school closure.

CONCLUSIONS

School closures are associated with a dramatic reduction in the prevalence of severe respiratory disease requiring PICU admission. School closure may be an effective tool to mitigate future pandemics but should be balanced with potential academic, economic, mental health, and social consequences.

Building community at distance: a datathon during COVID-19

Purpose

This paper aims to use the experience of an in-person event that was forced to go virtual in the wake of COVID-19 as an entryway into a discussion on the broader implications around transitioning events online. It gives both practical recommendation to event organizers as well as broader reflections on the role of digital libraries during the COVID-19 pandemic and beyond.

Design/methodology/approach

The authors draw on their personal experiences with the datathon, as well as a comprehensive review of literature. The authors provide a candid assessment of what approaches worked and which ones did not.

Findings

A series of best practices are provided, including factors for assessing whether an event can be run online; the mixture of synchronous versus asynchronous content; and important technical questions around delivery. Focusing on a detailed case study of the shift of the physical team-building exercise, the authors note how cloud-based platforms were able to successfully assemble teams and jumpstart online collaboration. The existing decision to use cloud-based infrastructure facilitated the event’s transition as well. The authors use these examples to provide some broader insights on meaningful content delivery during the COVID-19 pandemic.

Originality/value

Moving an event online during a novel pandemic is part of a broader shift within the digital libraries’ community. This paper thus provides a useful professional resource for others exploring this shift, as well as those exploring new program delivery in the post-pandemic period (both due to an emphasis on climate reduction as well as reduced travel budgets in a potential period of financial austerity).

Pandemic COVID-19 Joins History's Pandemic Legion

With great apprehension, the world is now watching the birth of a novel pandemic already causing tremendous suffering, death, and disruption of normal life. Uncertainty and dread are exacerbated by the belief that what we are experiencing is new and mysterious. However, deadly pandemics and disease emergences are not new phenomena: they have been challenging human existence throughout recorded history. Some have killed sizeable percentages of humanity, but humans have always searched for, and often found, ways of mitigating their deadly effects.

With great apprehension, the world is now watching the birth of a novel pandemic already causing tremendous suffering, death, and disruption of normal life. Uncertainty and dread are exacerbated by the belief that what we are experiencing is new and mysterious. However, deadly pandemics and disease emergences are not new phenomena: they have been challenging human existence throughout recorded history. Some have killed sizeable percentages of humanity, but humans have always searched for, and often found, ways of mitigating their deadly effects. We here review the ancient and modern histories of such diseases, discuss factors associated with their emergences, and attempt to identify lessons that will help us meet the current challenge.