# Health outcomes and costs of community mitigation strategies for an influenza pandemic in the United States

 Title: Health outcomes and costs of community mitigation strategies for an influenza pandemic in the United States Author: Perlroth, Daniella J.; Glass, Robert J.; Davey, Victoria J.; Cannon, Daniel; Garber, Alan M; Owens, Douglas K. Note: Order does not necessarily reflect citation order of authors. Citation: Perlroth, Daniella J., Robert J. Glass, Victoria J. Davey, Daniel Cannon, Alan M. Garber, and Douglas K. Owens. 2010. Health outcomes and costs of community mitigation strategies for an influenza pandemic in the United States. Clinical Infectious Diseases 50, 2:165-174. Access Status: Full text of the requested work is not available in DASH at this time (“dark deposit”). For more information on dark deposits, see our FAQ. Full Text & Related Files: Health Outcomes and Costs_0.pdf (2.235Mb; PDF) Abstract: Background The optimal community-level approach to control pandemic influenza is unknown. Methods We estimated the health outcomes and costs of combinations of 4 social distancing strategies and 2 antiviral medication strategies to mitigate an influenza pandemic for a demographically typical US community. We used a social network, agent-based model to estimate strategy effectiveness and an economic model to estimate health resource use and costs. We used data from the literature to estimate clinical outcomes and health care utilization. Results At 1% influenza mortality, moderate infectivity ($$R_o$$ of 2.1 or greater), and 60% population compliance, the preferred strategy is adult and child social distancing, school closure, and antiviral treatment and prophylaxis. This strategy reduces the prevalence of cases in the population from 35% to 10%, averts 2480 cases per 10,000 population, costs $2700 per case averted, and costs$31,300 per quality-adjusted life-year gained, compared with the same strategy without school closure. The addition of school closure to adult and child social distancing and antiviral treatment and prophylaxis, if available, is not cost-effective for viral strains with low infectivity ($$R_o$$ of 1.6 and below) and low case fatality rates (below 1%). High population compliance lowers costs to society substantially when the pandemic strain is severe ($$R_o$$ of 2.1 or greater). Conclusions Multilayered mitigation strategies that include adult and child social distancing, use of antivirals, and school closure are cost-effective for a moderate to severe pandemic. Choice of strategy should be driven by the severity of the pandemic, as defined by the case fatality rate and infectivity. Published Version: 10.1086/649867 Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:11595665 Downloads of this work: