A Blog by Jonathan Low


Mar 12, 2020

The Reason Travel Bans Cannot Stop the Spread of Viral Infections Like Covid-19

The virus is carried by people who are often asymptomatic, meaning that even if they are screened they may not show they have it.

Past experience shows such bans are almost always imposed too late, as is the case now. The UK exemption (where the President owns a golf resort and whose Prime Minister is his ideological soulmate) renders the ban useless because it already has a higher percentage of its population infected than does the US. The reality is that Covid 19 is already in the US, and spreading. JL

Laura McGann reports in Vox, and Mara Pillinger reports in Foreign Policy, image by Benoit Tessier, Reuters:

In past epidemics, governments have also imposed trade restrictions. Such restrictions are ineffective and economically costly for all. They also have insidious downsides: incentivizing countries to conceal outbreaks, hindering response efforts, infringing human rights, and fueling xenophobia. In practice, travel restrictions prove ineffective because they are imposed too late or because people circumvent them. The big threat isn’t the virus coming to the United States. It’s already here. "Germs don't respect borders. Most of Europe has = or < cases than US. Travel bans won't make US safer."
Vox Americans generally expect that when regularly scheduled programming is interrupted to cut to the president sitting in the Oval Office, they will hear an important, sober, and universal message — a message almost always of unity, often a call for shared responsibility and even sacrifice.
President Trump just used the powerful symbol of his office to attempt to divide us.
Seated behind his desk in the White House Wednesday, Trump looked into the camera and warned Americans of an enemy who has infiltrated our borders. We are at war, he said, with a “foreign virus.”
It’s a tactic meant to distract from what his administration has and hasn’t done, in this case to combat the coronavirus pandemic. “This is the most aggressive and comprehensive effort to confront a foreign virus in modern history,” Trump said of his administration’s work.
The pandemic, of course, isn’t a spy. It’s not an infiltrator. It’s a health crisis that’s been long predicted. The way we’ll fight it is through mechanisms like social distancing, a technique that requires clear, direct information so everyone knows it’s important to participate and how to do so. It’s a shared responsibility. We are in this together.
That is not the language of the Trump era. Trump rode into office on a message of division, of fear and hate and xenophobia. He announced his campaign in 2015 by smearing Mexicans. Even his inaugural address was laced with dark notes. “From this day forward,” he said during his address, “it’s going to be only America first.” Xenophobia isn’t a bug in the system for him; it’s a feature.
Throughout his time in office, again and again, he’s rallied his supporters through fear of outsiders — whether it was fear of travelers from Muslim-majority countries or asylum seekers at the US-Mexico border. He’s portrayed foreigners as filthy and derided others’ homelands as “shithole countries.”
Now, faced with explaining his government’s response to an outbreak that’s getting worse, he’s relying on the same tropes.
On Wednesday night, when he should have been calling on Americans to come together, he attempted to make us afraid of all of Europe. “To keep new cases from entering our shores, we will be suspending all travel from Europe to the United States for the next 30 days,” Trump said (excluding the UK for some reason).
This isn’t the first time in history a leader has stoked fears among the public by linking outsiders to germs, of course. It’s been part of many dark chapters in world history. Researchers have documented the repeated, often unfounded fears of connections between germs and immigrants throughout the 20th century. In a moment of crisis, it’s particularly jarring and dangerous.
In this case, though perhaps predictable, it is especially dubious.
Experts pointed out that full-scale travel bans haven’t been effective. Italy, the hardest-hit country in Europe, was the first European country to ban travel to and from China, where the outbreak originated, and it didn’t help.
Trump plans travel restrictions to Europe @StateDept level 3 warning. How enforced? Quarantine returning citizens? @POTUS conflates closed border & response To be clear, germs don't respect borders. Most of Europe has = or < cases than US. Travel bans won't make US safer

And Trump’s big announcement ignores the fact that the virus is already in the United States, spreading locally. The big threat isn’t the virus coming to the United States. It’s already here.
“A large number of new clusters in the United States were seeded by travelers from Europe,” Trump said — without explaining how the virus is spreading now or even highlighting some of the best science-based measures to test for it or stop it from spreading.
Medical experts reacted critically to Trump’s ban by pointing out that it ignores the work that really needs to be done, such as testing to assess the full scale of the crisis and mass communication with the public about how to prevent the spread.
The US President has banned all travel from Europe for 30 days, excluding UK.

This is a distraction:
- US has local transmission already
- we’re struggling to even conduct surveillance to know our burden
- ignores vital mitigation steps we know we need to do now

Trump did tell Americans to cover their mouths and noses when they cough or sneeze. He did finally say it was best to stay home if you are sick.
But his message wasn’t the sober, direct statement Americans might expect from the president in the Oval Office. More worrisome, maybe a xenophobic speech designed to distract is what we we actually should have expected.
Foreign Policy
When the World Health Organization (WHO) declared the coronavirus epidemic “a public health emergency of international concern” (PHEIC), more than 70 countries responded by imposing travel restrictions against China. Global health experts overwhelmingly decry travel and trade restrictions as bad policy and irresponsible violations of international law. Yet governments continue to implement them, even though scientific evidence—and economic self-interest—advises otherwise. If experts can’t reliably prevent such restrictions, they must take steps to mitigating their most harmful effects.
Travel and trade restrictions take various forms. With this coronavirus, governments are warning citizens not travel to China, and instructing those already there to leaveclosing borders and banning flightsbarring visitors who have recently been to China from entering the country; and implementing mandatory quarantines for returning residents. In past epidemics, governments have also imposed trade restrictions, such as bans on importing pork during the 2009 swine flu pandemic. Such restrictions are ineffective and economically costly for all sides. Initial estimates are that U.S. travel restrictions against China will cost the U.S. economy $10.3 billion. They also have more insidious downsides: incentivizing countries to conceal outbreaks, hindering response efforts, infringing on human rights, and fueling the spread of xenophobia.
In calmer times, governments recognize that trade and travel restrictions are highly problematic. In 2005, after the SARS epidemic, WHO member states adopted a revised International Health Regulations (IHR), the international legal framework that governs how countries prepare for and respond to outbreaks. A core purpose of the new framework is to “avoid unnecessary interference with international traffic and trade” by empowering WHO to make recommendations about whether restrictions are necessary. Countries committed not to impose “more restrictive” measures than WHO recommends (without providing scientific justification).
Since then, WHO has declared six PHEICs, each time advising that trade and travel restrictions were unwarranted. Yet in half those cases—H1N1 in 2009, Ebola in 2014, and the ongoing coronavirus outbreak—countries ignored WHO’s recommendations and imposed large-scale restrictions anyway. (There were fewer restrictions imposed in response to 2019 Ebola epidemic, which has remained largely confined to the Democratic Republic of the Congo; and none for Zika, which is transmitted by mosquitoes, or polio, which a vaccine can prevent.)
Unfortunately, governments’ behavior demonstrates that PHEIC declarations are more likely to provoke travel restrictions than to prevent them. (The restraint of the administration of then U.S. President Barack Obama during the 2014 Ebola epidemic stands out as a rare exception.) A principle of good leadership and public health practice is to meet people where they are. In this spirit, we need to recognize why policymakers keep opting for travel restrictions and why their reasoning might be difficult to overcome.
For one thing, the combination of common sense and fear generates strong public support for travel restrictions. Coronavirus travels in people, so in theory, anything that reduces the movement of people should help reduce the spread of the virus. In practice, travel restrictions prove ineffective because they are imposed too late or because people circumvent them. Perversely, the timing problem may simply drive policymakers to impose restrictions more quickly. And people frequently evade general immigration restrictions too, yet this does not persuade governments to dispense with visas or border checks.
Modeling studies show that travel restrictions might slow, but cannot prevent, an epidemic.
Modeling studies show that travel restrictions might slow, but cannot prevent, an epidemic.
 However, policymakers may well decide that slowing it is better than not slowing it. (Even the authors of one such study demonstrating that the Hubei quarantine is unlikely to be effective are unwilling to give up on travel restrictions entirely. They conclude by advising that to “possibly succeed, substantial, even draconian measures that limit population mobility should be seriously and immediately considered.”)
Another reason policymakers gravitate towards travel restrictions is the lack of politically viable alternatives. In the face of a pandemic threat, governments are under substantial pressure. They must be seen to take proactive, robust steps to protect their citizens or else they pay a price. From a public-health standpoint, encouraging people to wash their hands and cough into their elbows is good policy. But politically, it’s insufficient to instill public confidence in health authorities; more dramatic action is needed. This kind of security theater can be dangerous—but the absence of security theater can be dangerous too. Apparent inaction (or insufficient action) erodes trust in public health authorities, which undermines response efforts. Pragmatically, policymakers may be damned if they do and damned if they don’t.
Efforts to prevent trade and travel restrictions often refer to governments’ obligation to comply with the IHR, a binding international treaty. But this argument misses key dynamics that strain the reach of the IHR. The first is the role of the private sector. During this coronavirus epidemic, the private sector has effectively imposed its own set of trade and travel restrictions. Numerous airlines have halted flights to China due to lack of demand or because pilots refuse to fly. Retailers such as Starbucks and Apple have closed their stores, while multinational firms have suspended employee travel. The repercussions of these measures will be every bit as severe—if not more so—as restrictions imposed by governments. Yet the private sector is not bound by the IHR. And as WHO Director-General Tedros Adhanom Ghebreyesus acknowledged, “it will be very difficult” for WHO to convince companies to act against their perceived business interests.
Second, the IHR focus on international travel and travel restrictions. But during this coronavirus epidemic, the most significant travel bans have been imposed within China, by the Chinese government. China has quarantined over 50 million people, suspended interprovincial buses, closed tourist destinations, and ordered travel agencies to halt tours abroad. Macau’s casinos are dark. Hong Kong has closed most border crossings and is quarantining visitors from the mainland. The fact that China is implementing travel restrictions on its own citizens—and WHO is not challenging those restrictions—makes it difficult to convince policymakers in other countries not follow suit.


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