Restricting the freedom of movement is an inefficient way of tackling epidemics
12.3.2020
Coronavirus is not anymore a distant threat on the other side of the planet as the epidemic has conquered Northern Italy. An intuitive solution would be abolishing Schengen and closing the borders, but what does the research say?
In fact, many extensive studies show that travelling restrictions are an inefficient way of preventing the spreading of diseases. For example, the World Health Organisation WHO has done an extensive systematic review[1] on the subject. It shows that travelling bans have little effect on the magnitude of worldwide pandemics because they decrease the attack rate by less than 0.02 per cent. The systematic review is done only on influenza virus but the review can be compared with the current coronavirus case as the R0 values of the viruses do not differ hugely. The R0 value describes how many people on average catch the disease from an infected. Additionally, both the influenza viruses and the coronavirus are transmitted by droplets.
Travelling bans do actually only slow down the emergence of epidemics as the WHO systematic review shows. According to it a 90.0 per cent flight ban to all affected countries postpones the emergence of a worldwide influenza pandemic only by 3 – 4 weeks. Even a 99.9 per cent flight ban to all affected countries cannot prevent a pandemic but only defer it, by four month. The time estimate depends on the influenza virus, its R0 value and many external factors.
A similar 99.9 per cent total flight ban to a single country delays its influenza epidemic peak approximately by two months. The time period varies depending on the country, its location and other external factors. For example, if a country has a long border with a country with an epidemic, the effectiveness of a flight ban is naturally near to zero. Travelling bans have minimal effects also on urban areas.
According to the WHO systematic review, the effectiveness of travel restrictions is especially low if the R0 value is over 1.9. For the current coronavirus SARS-CoV-2 it is 2.2.
The reason for the inefficiency of the method is probably the fact that only one case is needed from which an epidemic can spread if spreading is not prevented properly. In fact, according to a study done by the researchers Ka Chun Chong ja Benny Chung Ying Zee[2], a more efficient way of tackling epidemics would be to act inside a country by getting proper treatment for the patients as soon as possible. In order to eradicate epidemics, countries should be more efficient in diagnosing patients, finding people who were near them and providing proper care for the infected.
Despite the research information, many countries use inefficient methods by restricting the freedom of movement more than the WHO guides. The closing of borders makes namely an expression that the government has taken the situation seriously.
However, the closing of borders has significant negative effects on economics. The EU economics is based on the mobility of people and goods. Actually, the restriction of freedom of movement could cause more deaths than save as medicine and knowledge could not reach the people in need.
The sense of proportion should always be kept in mind. Epidemics are real health threats against which actions must be taken. However, JEF Helsinki demands that overkills and inefficient actions should not be used as they only spend public money. As Mika Salminen, the manager of the National Institute for Health and Welfare of Finland (THL), has commented on the subject, we should take actions known to be effective and not just the showy ones.
References:
1. Mateus A., Otete H., Beck C., Dolan G., & Nguyen-Van-Tam J. Effectiveness of travel restrictions in the rapid containment of human influenza: a systematic review. WHO[Internet] 2014 Jan. [cited 2020 March] Available from: https://www.who.int/bulletin/volumes/92/12/14-135590/en/
2. Chong KC., & Ying Zee BC. Modeling the impact of air, sea, and land travel restrictions supplemented by other interventions on the emergence of a new influenza pandemic virus. NCBI[Internet] 2012 Nov. [cited 2020 March] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577649/
For further information:
Denis Shemyakin, Chair
041 505 6185
denis.shemyakin@jefhelsinki.com
Satu Westerholm, Secretary
040 036 6658
satu.westerholm@jefhelsinki.com
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