Governments throughout the ages have found themselves needing to make difficult decisions in response to global outbreaks of infectious diseases.
Whether the threat is bubonic plague, influenza, Ebola, Zika, SARS, or today’s novel coronavirus, urgent decisions must be made in the face of uncertainty while balancing an array of often-competing priorities. These include public health objectives, legal obligations and economic consequences – overlaid with the domestic and international politics that inevitably surround epidemics of human and animal diseases.
In this complicated melee, some governments have been tempted to disguise political objectives as public health decisions – a sleight of hand that may compromise control of the disease outbreak. In this regard, the imposition of travel bans is perhaps the most commonly misused intervention.
Travel bans create a sense that a government is taking a strong stance to protect public health when in fact there is a growing body of evidence that they risk doing just the opposite. An expert group convened by the World Health Organisation (WHO) concluded travel bans were ineffective in curtailing the spread of infectious diseases like SARS and influenza. As a result, WHO has for many years advised against travel bans for the control of infectious diseases.
In this complicated melee, some governments have been tempted to disguise political objectives as public health decisions – a sleight of hand that may compromise control of the disease outbreak.
Similarly, many medical experts in universities and other organisations support the view that travel bans are counter-productive to disease control and, at best, briefly delay the onset of outbreaks.
Travel bans encourage travellers to hide their travel history or to take covert routes to evade bans, compromising border control procedures and the ability of border control officials to properly advise and follow up potentially infected travellers and those in contact with them.
The bans encourage countries to under-report their case numbers to avoid punitive travel sanctions – compromising global risk assessments and management. They impede the flow of the people, medicine and equipment necessary to control an outbreak at the source.
The economic damage resulting from travel bans is significant and they are capable of stigmatising entire races of people: in the case of coronavirus, those of Asian heritage.
Research has suggested that governments anticipating high domestic political benefits from imposing barriers during an outbreak will likely do so. The imposition of travel bans is particularly likely in democracies with weak health infrastructure – a combination of circumstances that creates significant risk for politicians eyeing re-election. These domestic considerations often outweigh governmental obligations to the International Health Regulations. These regulations clearly stipulate that states must impose the “least restrictive” measures necessary to safeguard public health.
Ultimately, of course, governments have found it is well-nigh impossible to extend their rule to the microbial world, travel bans or not.
As such, the last word should go to the Ministry of Health, which wisely states that the likelihood of an imported case of novel coronavirus in New Zealand is high, whereas the likelihood of a widespread outbreak remains low.