First, close all the schools

One of the first things a government should do if a global flu pandemic begins - even before it hits your country - is to close all the schools. So writes Tyler Cowen in a new George Mason University working paper, Avian Flu: What Should Be Done (PDF).

Once a pandemic breaks out abroad, we should shut the schools immediately. This will limit the ability of children to pass the flu to each other in close, regular settings. We should assume that the flu is coming to the United States or has arrived, rather than remaining in denial, or believing that a quarantine will keep it out. We should not wait for the first wave of U.S. human cases to close the schools and day care centers. So far it appears that children are a group especially vulnerable to current H5N1 strains. If need be, some of the schoolwork could be posted on-line and taught in a virtual manner.

Difficult questions arise when both parents must work for reasons of income or because they supply essential medical or economic services.  ...Nonetheless these significant inconveniences are not worth the potential loss of thousands of children’s lives through the school system. Children, of course, also pick up flu strains at school and bring the diseases back home. They are potential spreaders nonpareil, and we should limit this transmission mechanism before it gets well underway.

I'm not sure I'd move that soon. one of the lessons fom the SARS crisis, surely, is the need to avoid  public panic. Likewise his opposition to quarantine is contentious. Nonetheless, most of the policy recommendations appear economically sensible, with a certain libertarian streak: "pro-intellectual property, pro-decentralization, and skeptical of quarantine and centralized stockpiles", as he puts it. Tyler particularly emphasises the need for local preparedness:

The single most important thing we can do for a pandemic - whether avian flu or not - is to have well-prepared local health care systems. ...Realize that the federal government will be largely powerless in the worst stages of a pandemic and make appropriate local plans.

You may also wish to read his Marginal Revolution post, where he invites comments.

Comments

[Edward Hugh]

I agree with you New Economist. One of the problems he doesn't seem to twig is that this won't be a hurricane: ie it won't just pass. If you don't have immunity then you will remain vulnerable. Either you need the vaccine, or you need to have the flu, hopefully in a more moderate version of the mutation. I think simply staying away from school for a couple of weeks won't do it.

Obviously there are different types of advice here for the different risk categories, people need to be informed and act accordingly. I think it is difficult to SARS in the sense that Sars was hard to spread.

If you want a giggle, take a look at my "Denationalise Tamiflu Now!" over at a Few Euros More.

[Richard Pearson Sr]

We do it with animals, why not quarentine people arriving from high risk areas or at least giving them the flu vacine unless they have proof of having already had the shot?

[Edward Hugh]

"why not quarentine people arriving from high risk areas or at least giving them the flu vacine unless they have proof of having already had the shot?"

The problem is Richard that the high risk areas will be all our major cities - the big nodes - and we could be talking of weeks, if not a couple of months while the thing passes. So putting everything locktight is going to be virtually impossible.

Also, we need to be clear: there is no vaccine (yet). Tamiflu is *not* a viral specific vaccine, it is a generic palliative. And there are on-costs to taking it since there are known side-effects (even if not necessarily the ones claimed for Japan). Having the appropriate vaccine will need time after the strain breaks loose, and manufacturing and distributing it will need time. Meantime the flu will go the rounds, this is why the WHO take it as read that if the thing breaks lose it *will* become a pandemic. So some of us are just going to have to take our chances.

Obviously building 'fire breaks' in the initial instances will be important, precisely to try and stop it taking hold, but most of this will likely take place in Asia.

High risk people (rather than areas) is another issue. People over 65, and young children need to be protected first, plus others with medical conditions which increase the risk. So on these grounds closing nursery, and possibly primary schools might be a good idea. I think we have to rely on agencies like the WHO to spell this out for us when the time comes (if it comes).