Infectious disease experts say closures could reduce number of swine flu cases and buy time until vaccine is available

Ministers have been urged to rethink their policy of keeping schools open through the swine flu pandemic after research showed that a shutdown would curb the spread of infection and limit the number of deaths.

As Andy Burnham, the health secretary, announced that a flu helpline to take the pressure off GPs’ surgeries would go live this week, two infectious disease experts said school closures should be considered to reduce the number of cases and buy time until a vaccine is available.

Schools across Britain have now broken up for summer holidays and experts hope this will help to slow the spread of the virus. But there are fears that when classes resume in the autumn the number of cases will increase rapidly.

School closures would cause serious difficulties for working parents, lead to a 1% loss in GDP through absenteeism and see as many as 30% of NHS staff taking time off just when they are needed to treat patients.

In a study published in the Lancet, government adviser Prof Neil Ferguson and Dr Simon Cauchemez, both of the department of infectious disease epidemiology, Imperial College London, said “prolonged” closures could reduce the scale of the outbreak by 13-17% and at the pandemic’s peak the shutting of schools could bring down the number of cases by 38-45%.

“It is therefore hoped that closure of schools during the pandemic might break the chains of transmission, with the following potential benefits: reducing the total number of cases; slowing the epidemic to give more time for vaccine production; and reducing the incidence of cases at the peak of the epidemic, limiting both the stress on healthcare systems and peak absenteeism in the general population, and thus increasing community-wide resilience,” the researchers said.

Such a move would also raise the question of what should be done with millions of schoolchildren during a prolonged shutdown, they added. The authors said that governments in Europe and North America might have to take such a step after they studied the impact of school closures during flu epidemics in other countries stretching back to 1918.

They say that study of the 1918 flu outbreak in America and Australia indicates that shutting schools, in tandem with closing churches and improved hygiene, could have reduced the death toll by between 10% and 30%, and as much as 50% in some cities at the height of the outbreak.

About 100 schools closed after the start of the outbreak in May but soon reopened when official advice changed because swine flu was becoming so prevalent.

The chief medical officer, Sir Liam Donaldson, today responded coolly to the idea, when hew appeared on GMTV. “I think it would take a lot for us to move in that direction. It would be extremely disruptive to society. When would you open them again, given that flu might be around several months?

“If we look at what we did in the west Midlands for example, where we did very aggressively initially close schools, and treat people with Tamiflu who didn’t have symptoms but were contacts of cases, eventually it broke out of the box and spread more widely.”

Sir Liam said: “I think we will obviously keep all of these things under review as we do with any scientific advice, but at the moment I think it is unlikely.”

Ed Balls, schools secretary, said last night: “Now that the virus is established in the community, expert advice is that there is no longer a strong case for closing schools to contain the spread of infection. We will be monitoring the situation closely over the school holidays and will review the evidence in late August.”

The department’s emergency planning group, Cerg, is now solely concerned with orchestrating schools’ response to the spread of swine flu and updating ministers daily on the situation.

Prof Steve Field, chairman of the Royal College of General Practitioners, said ministers should keep open the possibility of school closures. “It’s something that shouldn’t be discounted if it’s the height of the pandemic,” he said. “It would depend on how the pandemic has developed. The Lancet study demonstrates that it would slow down the transmission of the virus and might cut the number of people who get serious illness and who die.”

Martin Ward, deputy general secretary of the Association of School and College Leaders, said schools could set up internet-based classrooms if there were long-term school closures. “But with the best will in the world they are not going to make the progress they would have if they had been in school,” he said.