Omicron wave: how to make travel restrictions this time around

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Possible future measures identified by the White House include more aggressive pre-arrival testing and a self-quarantine system for international arrivals. These are tools that could help make travel restrictions more effective in potentially slowing the spread of the virus from international arrival, health experts say. They also argue that blanket national bans are a blunt tool and that wider distribution of vaccines in low-income countries and respect for mask wear and social distancing remain more effective in responding to the virus.

Travel bans may work to contain viruses such as Ebola, where infected people show symptoms of illness, but not for the coronavirus, which typically has asymptomatic carriers, said Ingrid Katz, infectious disease physician and director of faculty associated with Harvard Global Health Institute.

Katz called Biden’s travel ban “theater” because it allows US citizens and residents, as well as other countries where Omicron operates, to enter the country without needing to quarantine at arrival, which could allow the spread of the variant.

But the proposal the White House is expected to announce soon should make the restrictions more serious – and more science-compliant.

The White House now wants anyone arriving in the country to be tested one day before travel, instead of three days under current rules. The CDC recommends that all passengers get tested 3-5 days after travel and unvaccinated travelers should self-quarantine.

The CDC is already expanding a testing program for “specific international arrivals” at four of the busiest international airports in the United States – JFK, San Francisco, Newark and Atlanta – its director Rochelle Walensky told reporters on Tuesday.

These measures are light compared to the ceilings on arrivals and quarantine measures in hotels put in place by many countries during the pandemic.

Countries like Taiwan, Hong Kong and New Zealand continue to maintain strict hotel quarantine rules, ranging from seven to 21 days, applied to all arrivals. The goal is to isolate all positive cases before carriers can spread them in the community, without completely closing a border.

From the first weeks of the pandemic, health experts warned that the key to slowing the spread of Covid-19 was to universally practice safe behaviors, such as social distancing and wearing a mask in public. The Trump administration – and many other governments – have nevertheless been tempted to look to bans on travelers from China and Europe to show they are taking decisive action.

While the restrictions have helped some countries minimize and sometimes eliminate the virus, these successes were only possible when strict quarantine regimes were in place – an option the United States never pursued.

Since Covid vaccines became available from December 2020, the advice from pandemic experts has been clear: No one is safe until everyone is safe.

The governments of rich countries have mostly ignored the specialists. They prioritized purchasing vaccines for their national populations – admittedly a responsibility of any government – but also purchased most of the vaccines available in 2021. This denied the 55 members of the African Union the opportunity to ‘buy their own doses, the head of the African Vaccine Procurement Task Force, Strive Masiyiwa told POLITICO. The UN-supported COVAX vaccination facility also failed to meet its delivery targets.

Although experts have warned that new variants will continue to emerge, governments have continued to rely on travel restrictions as a method to contain the spread of the virus across borders – from outright bans by some travelers to Tough arrivals ceilings and mandatory hotel quarantine systems – rather than dealing with the root problem: the lack of people vaccinated.

Africa remains the least vaccinated region in the world, with around 7 percent of its 1.3 billion people fully vaccinated, while North America has vaccinated around 55 percent of its population, according to Our World in Data .

With more than 50 countries banning travelers from southern Africa, pandemic specialists immediately backed down. They point out that there is no definitive answer on Omicron’s country of origin, and that since travel bans usually come with exceptions for citizens of a given country, these Gaps are sufficient to ensure that a variant will travel to any country operating such a system.

South African President Cyril Ramaphosa added to this chorus of complaints, calling the restrictions “scientifically unjustified” and suggesting that his country is blamed for doing what China has not done: quickly and transparently share information. new information about the virus.

Previous blanket restrictions tore families and relationships apart and shut down entire industries related to tourism and education.

In the United States, that included travelers from 26 European countries locked out for 18 months. In April, the United Nations Human Rights Committee ruled that Australia’s strict cap on total arrivals – sometimes as low as 1,500 people per week – effectively barred thousands of its citizens from return home, which he said is illegal under international law.

Travel bans set in recent days by more than 50 countries, enforced against arrivals from southern Africa, may in fact make it more difficult to respond to the outbreak caused by Omicron in the region, according to health experts.

Test materials, drugs, vaccines and personal protective equipment are typically carried on passenger flights, which are now significantly reduced. “If commercial aircraft [are] not to steal 75% of our cargo is lost ”, tweeted Tulio de Oliveira, the director of the Center for Epidemic Response & Innovation in South Africa and one of the top experts working on variants.

There are ways to make travel restrictions more effective by trying to slow the spread of Omicron.

The World Health Organization backed the mitigation measures – including strict passenger screening – on Tuesday, but insisted “blanket travel bans will not prevent international spread” while noting ” that they place a heavy burden on life and livelihoods “.

Any screening must be proportional to the risk, temporary “and applied with respect for the dignity, human rights and fundamental freedoms of travelers,” the WHO said in its statement.

Airport owners agree, of course. Luis Felipe de Oliveira, head of the Airports Council International, said that “total travel bans and border closures are not a permanent solution as variants emerge,” and said governments should instead be coordinate to implement “pragmatic and risk-based measures based on science.”

As the tourism industry focuses on its direct business interest in staying open, health experts take a broader view. Travel restrictions should be integrated into a comprehensive approach to public health, which includes large-scale testing and quarantine, said Jennifer Kates, senior vice president and director of global health and HIV policy at the Kaiser Family. Foundation.

The UK, for example, now requires everyone to take a PCR test within two days of arriving in the country and self-isolate until they test negative.

Belgium – which has seen a recent dramatic spike in Covid cases and evidence of community spread of the Omicron variant – now requires on-arrival testing for citizens and visitors to designated hot spots. The goal is to minimize instances where a person catches or incubates the virus between their test and flight, and to allow contact tracing of any cases that initially slip through their net.

Any future U.S. restrictions should apply to everyone, including U.S. citizens and residents permitted to reenter the country. If these aren’t in place, the bans will give people a false sense of security, Kates said. “These are hard measurements to do, of course,” she admitted.

The United States has fought against restrictions and mitigation efforts. It has never enforced a strict quarantine like many other countries, and it has struggled to speed up rapid tests.

Regulatory challenges and lack of early federal investment, along with unpredictability of demand and mixed messages have all been part of the reasons the US still doesn’t have cheap rapid tests like the UK. and Germany, according to a KFF report. The Biden administration committed at least $ 3 billion this fall to increase the supply of rapid tests, but the increase did not come in time for Omicron’s arrival.

Travel bans should be used sparingly, given their potential to discourage data sharing and cooperation, if pre-travel and post-travel testing protocols and mask-wearing during travel are implemented, Charles said. B. Holmes, director of the Georgetown Center for Innovation in Global Health and former State Department chief medical officer during the Obama-Biden administration.

“Globally, we need to be able to integrate these protocols into our lives and our societies. It’s not just for travel, but it can be for events and other areas, ”he said.

“It’s kind of a cost to doing business in society in 2021.”

In the end, the most effective policy to minimize the effects of the new variants will remain generalized vaccination. “New variants will continue to threaten the world if we continue not to invest in last mile vaccine delivery” in low-income countries, said Ritu Sharma, vice president of CARE.

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