Grounded: Travel bans and the nCoV outbreak

In Manila, about hundreds of overseas Filipino workers, bound mostly for China’s special administrative regions of Hong Kong and Macau, were stranded Monday, following the temporary travel ban. (File photo by Cristina Arayata)

MANILA — The 2019 novel coronavirus (2019-nCoV) has infected more than 20,000 people worldwide, with most cases from China. As of Tuesday, its death toll climbed to 427 with two deaths from outside the country of origin, one each from Hong Kong and the Philippines.

The World Health Organization (WHO), the authority that supervises global health concerns, has recommended against any travel or trade restrictions. However, since the United States imposed a ban on flights from China, other countries have followed suit.

With governments around the world racing against time to contain the virus through measures, including the closure of their borders, questions were raised as to the stand of the WHO on the matter.

Tarik Jašarević, WHO spokesperson, said in a press interview in late January that “travel restrictions may intuitively seem like the right thing to do, (but) this is not something that WHO usually recommends.”

“This is because of the social disruption they cause and the intensive use of resources required,” Jašarević added.

WHO Director-General Tedros Adhanom Ghebreyesus said, “travel restrictions can cause more harm than good by hindering info-sharing, medical supply chains, and harming economies.”

Experts say travel and trade restrictions make it more difficult to track cases and their contacts, and disrupt the medical supply chain, potentially fueling shortages of drugs and medical supplies in areas hit hardest by the outbreak.

These also send a punitive message, which could contribute to discrimination and stereotyping against Chinese nationals.

What went before?

Amid the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003, Canada imposed a quarantine on some 25,000 residents in the greater Toronto area where millions were screened at the airports.

“The pilot thermal scanner project screened about 2.4 million passengers. Only 832 required further assessment, and again none were found to have SARS.

In other countries, the yields for airport screening measures were similarly low,” read an excerpt from the report titled Learning from SARS: Renewal of Public Health in Canada.

A 2006 study published in the Proceedings of the National Academy of Sciences used a mathematical simulation to predict how travel restrictions might affect the spread of avian flu in the United States if the virus evolved to pass easily between humans.

The study concluded that restricting travel was ineffective.

“Our simulations demonstrate that, in a highly mobile population, restricting travel after an outbreak is detected is likely to delay slightly the time course of the outbreak without impacting the eventual number ill,” the authors wrote.

The study continued to note that the action is expensive and it is nearly impossible to seal off the borders of a country. “People will inevitably move — even indirectly from the countries that are quarantined,” it added.

“Travel bans typically don’t work because if people want to travel, they find a way to do so,” said Steven Hoffman, director of the Global Strategy Lab and a professor of global health at York University.

“That actually undermines the public-health response because it makes it harder to track cases in an outbreak,” he added.

In Manila, about hundreds of overseas Filipino workers, bound mostly for China’s special administrative regions of Hong Kong and Macau, were stranded Monday, following the temporary travel ban.

Public pressure

Catherine Worsnop, a health expert who studies international cooperation during global health emergencies at the University of Maryland in the US, said: “travel bans as a response to an outbreak make it more challenging.”

“From a public health perspective, there is limited effectiveness. And then there are a host of other reasons why they can actually be counterproductive,” she added.

On Saturday, #OustDuterte has trended on Twitter with comments that the “government has a relaxed approach to the novel coronavirus scare.”

President Rodrigo Duterte on Sunday banned travel from the city of Wuhan, the epicenter of the outbreak, and soon expanded it to also ban foreign travelers to and from mainland China, Hong Kong, and Macau. Some countries, such as the Bahamas, Mongolia, and Singapore, have banned all travel from China.

“People want their government to do something when these outbreaks are happening, and adopting a border restriction is a visible policy that people think works,” Worsnop said.

Any effort and money spent crafting and enforcing travel and trade restrictions also take away already-stretched resources from public health measures that have been proven to be far more effective, the expert said.

Those measures include providing assistance to countries with weaker health systems, accelerating the development of a vaccine or rapid diagnostic test, and communicating with the public about when and how to seek care, she added.

Government efforts

WHO representative to the Philippines, Dr. Rabindra Abeyasinghe, however, has commended the government’s efforts to prevent the spread of the 2019-nCoV across the country.

“We are satisfied so far with the measures being implemented by the government of the Philippines,” Abeyasinghe said in a Laging Handa press briefing in Malacañang on Monday.

“WHO commends their actions taken by the Philippine Government to strengthen its preparedness, to build capacity to detect cases,” he added.

On January 29, Health Secretary Francisco Duque III bared that the Philippines has its own capability to detect 2019-nCoV within 48 hours.

Duque said the Japanese counterpart of the Philippines’ Research Institute for Tropical Medicine (RITM) gave the RNA (ribonucleic acid) primer to be used for confirmatory testing of the virus.

With this development, the turnaround time will be cut by 50 percent since the acquisition of the primer would eliminate the need to consult Australian experts.

1. Interior Secretary Eduardo Año has also ordered all barangays nationwide to form Barangay Health Emergency Response Teams (BHERTs) to help the government address the crisis brought about by the 2019-nCoV within their respective communities. He said each barangay must be adequately informed about the disease and prepared to adopt protocols in containing it.