Economic cost and health care workforce effects of school closures in the U.S

School closure is an important component of U.S. pandemic flu mitigation strategy. The benefit is a reduction in epidemic severity through reduction in school-age contacts. However, school closure involves two types of cost. First is the direct economic impact of the worker absenteeism generated by school closures. Second, many of the relevant absentees will be health care workers themselves, which will adversely affect the delivery of vaccine and other emergency services. Neither of these costs has been estimated in detail for the United States. We offer detailed estimates, and improve on the methodologies thus far employed in the non-U.S. literature. We give estimates of both the direct economic and health care impacts for school closure durations of 2, 4, 8, and 12 weeks under a range of assumptions. We find that closing all schools in the U.S. for four weeks could cost between 10 and 47 billion dollars (0.1-0.3% of GDP) and lead to a reduction of 6% to 19% in key health care personnel. These should be considered conservative (i.e., low) economic estimates in that earnings rather than total compensation are used to calculate costs. We also provide per student costs, so regionally heterogeneous policies can be evaluated. These estimates permit the epidemiological benefits of school closure to be compared to the costs at multiple scales and over many durations -- AbstractHoward Lempel, Ross A. Hammond, Joshua M. Epstein."September 30, 2009."Available in PDF from the Brookings Institution website (www.brookings.edu) ; viewed 09/30/09Includes bibliographical referencesThis work was supported by: The Models of Infectious Disease Agent Study (MIDAS), under Award Number U01GM070708 from the National Institutes of General Medical Sciences; The University of Pittsburgh Public Health Adaptive Systems (PHASYS) project, under Cooperative Agreement Number 1P01TP000304-01 from the Centers for Disease Control and Prevention; and The Johns Hopkins Medical School Center on Preparedness and Catastrophic Event Response (PACER), under Award Number N00014-06-1-0991 from the Office of Naval Research. Epstein's work is also supported by an NIH Director's Pioneer Award, Number DP1OD003874 from the Office of the Director, National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of General Medical Sciences, the National Institutes of Health, the Centers for Disease Control and Prevention, the Office of Naval Research, or the Office of the Director, National Institutes of Healt