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Proc Biol Sci. 2015 Nov 7;282(1818):20150814. doi: 10.1098/rspb.2015.0814.

Measured voluntary avoidance behaviour during the 2009 A/H1N1 epidemic.

Author information

1
Yale School of Forestry and Environmental Studies, Yale University, 195 Prospect Street, New Haven, CT 06511, USA College of Agriculture, California State University, Chico, Chico, CA 95926, USA jbayham@csuchico.edu.
2
Department of Economics, Arizona State University, Tempe, AZ 85287, USA.
3
Yale School of Forestry and Environmental Studies, Yale University, 195 Prospect Street, New Haven, CT 06511, USA.

Abstract

Managing infectious disease is among the foremost challenges for public health policy. Interpersonal contacts play a critical role in infectious disease transmission, and recent advances in epidemiological theory suggest a central role for adaptive human behaviour with respect to changing contact patterns. However, theoretical studies cannot answer the following question: are individual responses to disease of sufficient magnitude to shape epidemiological dynamics and infectious disease risk? We provide empirical evidence that Americans voluntarily reduced their time spent in public places during the 2009 A/H1N1 swine flu, and that these behavioural shifts were of a magnitude capable of reducing the total number of cases. We simulate 10 years of epidemics (2003-2012) based on mixing patterns derived from individual time-use data to show that the mixing patterns in 2009 yield the lowest number of total infections relative to if the epidemic had occurred in any of the other nine years. The World Health Organization and other public health bodies have emphasized an important role for 'distancing' or non-pharmaceutical interventions. Our empirical results suggest that neglect for voluntary avoidance behaviour in epidemic models may overestimate the public health benefits of public social distancing policies.

KEYWORDS:

A/H1N1; avoidance behaviour; social distancing

PMID:
26511046
PMCID:
PMC4650148
DOI:
10.1098/rspb.2015.0814
[Indexed for MEDLINE]
Free PMC Article

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