Social distancing measures minimize influenza transmission by reducing contact between susceptible and infectious individuals, and include school closures, travel restrictions, and restrictions on mass gatherings. Here we review the recent literature to evaluate the effectiveness of this approach as a pandemic prevention measure.
School Closures: Mathematical simulations provide evidence that school closures can reduce influenza transmission in an ideal setting. What is less clear is if these effects are still evident when key assumptions are only partially met. Empirical evidence from the last pandemic suggests that school closures reduce community transmission; however, few studies systematically compare community transmission in areas with and without this intervention. Furthermore, school closures are likely not effective during severe pandemics (high R0) and not economically or socially acceptable during mild pandemics (low R0). As a result, widespread proactive school closures are likely not an effective prevention measure during an influenza pandemic.
Travel Restrictions and Border Control: Stringent travel restrictions and border control may briefly delay imminent pandemics; however, these approaches are neither economically nor socially feasible except in unique settings (e.g. small island).
Mass Gathering Restrictions: There is no recent evidence outlining the effectiveness of mass gathering prohibition. While such approaches should logically reduce influenza transmission, they are not socially acceptable in most situations, especially for religious gatherings. Resources should instead be dedicated to case identification and patient treatment and isolation.