Border closures won't do much to stop Omicron, expert says, and could be counterproductive
President Biden’s decision late last week to ban travel from eight southern African countries is unlikely to curb the spread of the Omicron coronavirus variant, an epidemiologist warns, and could even be counterproductive.
“While it feels attractive to do a travel ban because it shows action and power and protecting our borders, it actually doesn’t really have a lot of public health impact,” Dr. Stefan Baral, an associate professor in the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health, told Yahoo News.
Baral, who is also the director of the school’s Key Populations Program, travels regularly to South Africa for research where he focuses on the distribution and control of diseases in a human rights context. And he said that people rushing to travel in advance of a ban could lead to superspreader events at airports.
“One of the things that happens [with border bans] is that people rush to the airport ... when they have that 48-hour grace period,” he said, noting similar rushes last year due to border closures.
“Those are superspreading events that caused a significant amount of seeding across the United States because people hurried back. You also don’t create an environment where people want to report their symptoms because they don’t really even know what happens to them if they report that they’re not feeling well.”
The Omicron variant, which early evidence suggests could evade some preexisting immunity, was first identified on Nov. 23 in South Africa, where less than 25 percent of the population is fully vaccinated. While not much is known about the variant just yet, South Africa’s health minister, Joe Phaahla, said he believes Omicron is behind a steady rise in infection rates across the country.
In response to the variant’s detection, the U.S. banned travel from South Africa, Botswana, Zimbabwe, Namibia, Lesotho, Eswatini, Mozambique and Malawi — all countries in the southern region of the continent — as “a precautionary measure until we have more information,” Biden said last Friday.
Other countries have enacted similar measures. In the United Kingdom, 10 countries in the southern part of Africa have been added to the “red list,” which stops short of banning travelers from them from entering the country but labels them high risk. Visitors from red list nations are required to take additional COVID-19 tests and quarantine for 10 days after arrival.
A number of European Union countries have banned travel from southern Africa. Japan, Israel and Morocco have banned all foreign visitors in response to the variant, while Australia has delayed opening its borders until Dec. 15.
Since the World Health Organization reported the existence of Omicron last week, the variant has been found in travelers in over 25 countries, including Australia, Britain, Sweden and the U.S., which announced its first Omicron case Wednesday. Dutch health authorities announced Tuesday that they identified the variant as many as 11 days earlier in Western Europe, at least five days before the first positive case found in South Africa, according to the Associated Press.
“By the time you detect one variant another is already circulating under the radar somewhere,” Dr. Kizzmekia Corbett, one of the leading scientists who helped design the genetic sequence for the Moderna vaccine, tweeted late last week. “So with a mix of surveillance lags, low vaccine uptake, inequitable vaccine access, we will be chasing variants endlessly.”
Dr. Anthony Fauci, the nation’s top infectious disease expert, offered a qualified defense of the travel ban on Wednesday, saying that while it could not prevent the emergence of Omicron in the U.S., it was “needed to buy some time to be able to prepare, understand what’s going on.”
“What is the nature of this infection? What is the nature of the transmissibility? And we wanted to make sure that we didn’t all of a sudden say, ‘It’s like anything else, don’t worry about it,’ and then all of a sudden, something unfolds in front of you that you’re really not prepared for,” Fauci said. “So we look at this as a temporary measure.
“I hope this gets sorted out and lifted before it has a significant impact,” he added.
Historically, travel bans have been criticized by international health groups. Early last year the WHO discouraged travel restrictions in response to the initial COVID-19 outbreak, framing it as bad policy. Bans, it said, disincentivize countries from working with one another, which is needed to monitor and follow trends in a pandemic.
“In general, evidence shows that restricting the movement of people and goods during public health emergencies is ineffective in most situations and may divert resources from other interventions,” the WHO argued in a February 2020 report. “Furthermore, restrictions may interrupt needed aid and technical support, may disrupt businesses, and may have negative social and economic effects on the affected countries.”
While travel bans can work temporarily in the early stages of an outbreak when a virus is localized and not much about it is known, Baral notes that their effectiveness goes down drastically once the virus has spread to multiple cities — mainly because the flow of goods and services never stops.
Emphasizing the Omicron variant’s potential danger, the WHO on Tuesday advised that anyone over the age of 60 should postpone travel plans.
Meanwhile, in South Africa, local leaders have repeatedly slammed the travel bans.
“The prohibition of travel is not informed by science, nor will it be effective in preventing the spread of this variant,” South African President Cyril Ramaphosa said in a speech on Sunday. “The only thing the prohibition on travel will do is to further damage the economies of the affected countries and undermine their ability to respond to and also to recover from the pandemic.”
Lazarus Chakwera, the president of Malawi and chairman of the Southern African Development Community (SADC), wrote in a Facebook post that the South African scientists who identified the variant should be thanked for their work and derided the travel bans as “Afrophobia.”
“We are all concerned about the new Covid variant and owe South Africa’s scientists our thanks for identifying it before anyone else did,” Chakwera wrote. “But the unilateral travel bans now imposed on SADC countries by the U.K., EU, U.S., Australia, and others are uncalled for. Covid measures must be based on science, not Afrophobia.”
Stanley Ress, an emeritus associate professor of medicine at the University of Cape Town, told Yahoo News that South Africans are largely feeling “angered and annoyed” by the world response.
“We need trust and transparency,” he said.
More than 5.2 million people have died globally from COVID-19 and nearly 800,000 in the U.S. alone, according to Johns Hopkins’s latest numbers. By comparison, about 90,000 have died in South Africa, at a significantly lower rate than in the U.S.
The White House has said readily available COVID-19 vaccines and boosters are the best way to prevent Omicron from spreading in the country. “This variant is a cause for concern, not a cause for panic,” Biden said Monday.
Baral, the Johns Hopkins epidemiologist, suggests focusing on the “unmet needs,” such as lack of education and access to resources, as a better way to lower infection rates.
“What drives infections drives variants,” he said. “So getting to the heart of those means not just shaming people into it or convincing them, but really looking at what are those unmet needs. And I think that applies domestically and around the world.”
Cover thumbnail photo illustration: Yahoo News; photos: Anna Moneymaker/Getty Images, Zhang Xiaoyu/Xinhua via Getty Images