In late November, the state of the COVID-19 pandemic shifted once more when South African scientists reported the discovery of a new SARS-CoV-2 variant named Omicron. When panic surrounding Omicron’s emergence set in, numerous countries instituted travel bans on South Africa and neighboring nations. As a medical student, I have begun to examine COVID-19 epidemiology and policy decisions more closely. Given that Omicron is already circulating globally and there was no evidence that Omicron emerged in South Africa, were these travel bans truly warranted and based on scientific evidence, or were they overly hasty? There is a tendency to view travel bans as an unambiguous strategy to seal the nation’s borders to unwanted exposures, but in practice, their usefulness is dependent on a variety of factors, including time of implementation relative to viral emergence. Importantly, the ramifications of the travel ban on South Africa are striking. These tradeoffs should have been considered more carefully before the implementation of the travel restrictions, because they might have changed the policy decision that was ultimately made. In 2019, the South African tourism sector contributed 3.7 percent of GDP and employed 4.7 percent of the total workforce. These new restrictions mean a significant loss of revenue from the tourism industry, and any establishments preparing for a wave of visitors over the holiday season must now attempt to stay afloat, return payments and merchandise, and let go of employees. Economic struggle will affect mental health and wellbeing in South Africa, as will the inability to travel home for the holidays. Harmful stigmas propagated with the ban are also troubling, with some South African speakers citing remnants of colonization in the ease with which restrictions are placed against African countries by Western countries. The genomic surveillance program also was a source of pride for South African scientists. In contrast, the travel ban reads like a punishment for having reported this discovery to the global community. Such a repercussion could discourage scientists from other nations from divulging similar discoveries. This is concerning because we cannot afford a decrease in reporting due to fears of punishment by the international community. These fears seem to be shared by the WHO, who on November 28th called for the South African borders to remain open, and for the discouragement of travel bans that are unnecessarily intrusive or not scientifically based. Less than a week after 23 countries instituted bans, evidence of community transmission was found in the U.S. and U.K., meaning that Omicron had been found in individuals there with no international travel. The scientific basis suggests that the global spread of Omicron was already underway at the time of its detection in South Africa, thus the bans are unlikely to be effective. In evaluating the benefits of travel bans overall, a study in Science assessed the travel restrictions placed on China in February 2020. The results showed that travel quarantine can only minimally reduce spread, unless combined with other proven strategies to reduce disease transmission. Another study in Emergency Medicine analyzed bans for other infectious diseases and concluded that there was limited evidence to support travel bans. This research challenges the confidence we have in travel bans and suggests that policymakers should focus on transmission-reducing practices, including social distancing, testing, and vaccinations, especially when the variant-of-concern is already circulating globally. The restrictions we implement at a policy level should not be taken lightly, and that their messaging has longitudinal effects we may not have fully considered. Given that the COVID-19 pandemic is not over, and that this may not be the last pandemic that we experience, decisions about policies must be backed by scientific evidence because their messaging and implementation has far-reaching effects. Source
