In an over the top piece Skift founder Rafat Ali wants us to examine travel’s role spreading the SARS-CoV-2 virus, and expresses concern about travel’s re-opening. He calls the U.S. ‘the failed states of America’.
And we have to examine the controversial and unmistakable role of our industry of travel — the movement and the gathering of humans — in this, especially as the reopening of travel is gaining momentum every day. We can’t just hurtle into reopening with fingers in our ears. After all, our industry’s output, the globe of travelers, has been the biggest vectors of spreading the virus around the world.
As horrible as the mistakes were in the U.S., it’s important to focus on the biggest ones including (but not limited to) the FDA refusing to allow tests other than the CDC’s, the CDC’s testing kits were faulty, moving coronavirus patients out of hospitals into nursing homes, failing to screening nursing home employees bringing the virus into that environment.
And it’s important to understand our failures in the proper perspective. The countries with the highest Covid-19 deaths per million population, in order: Andorra, Spain, Italy, UK, France, Sweden, Netherlands, Ireland, U.S., Switzerland. The U.S. is #9.
More importantly, for Mr. Ali’s piece, is to understand that there are two ways travel can spread the virus:
- Bringing infected people from one place to another.
- People picking up the virus while they’re traveling. But flying is far lower risk than you think and for the most part indoor super spreader gatherings have been turned off.
And fortuitously Europe’s CDC has just released guidance on re-opening travel that speaks to the role that travel can play bringing people from one place to another. The conclusion is that people traveling with the virus spread it from one place to another, but once that happens there’s little further risk – except to places that have crushed the virus completely.
- In places where the virus is already spreading, limits on travel don’t help. Bringing in a few extra cases doesn’t materially change the trajectory of the virus.
- If a country really has beaten the virus, then travel restrictions are a different matter. Travel could re-introduce the virus to a place where it isn’t already spreading.
- It’s generally desirable to limit travel from places with high concentrations of the virus to places with low concentration.
- Overall border closures aren’t helpful,
Based on evidence from modelling studies mainly related to influenza pandemics, border closures can delay the introduction of the virus into a country but only if they are almost complete and are rapidly implemented during the early phases of an epidemic, which is only feasible in specific contexts (e.g. for small, isolated, island nations) . Available evidence therefore does not support recommending border closures, which will cause significant secondary effects and societal and economic disruption in the EU.
There are prudent steps to take, according to Europe’s CDC. Tourism can mean dense gatherings – in airports, at resorts – and those contribute to spreading the virus. Large indoor gatherings are a bad idea. Even though physical distancing on planes of 5 to 6 feet isn’t going to be possible, some distancing (eg blocked middle seats) is better than no distancing.
Much of what’s being contemplated is theater rather than prophylactic, for instance “entry screening procedures are ineffective in preventing virus introduction. Emphasis should therefore be placed on discouraging symptomatic individuals from travelling.”
Past experience with entry screening using temperature control shows that it is a high-cost, low-efficiency measure. Current evidence, including evidence acquired in the early phases of the COVID-19 pandemic in Europe, indicates that entry screening is ineffective in preventing SARS-CoV-2 virus introductions.
In a recent review of the public health response by the US CDC, data from incoming passengers in selected US airports revealed that as of 21 April 2020, the screening of 268 000 returning travellers had detected 14 cases of COVID-19 (approximately 5/100 000 screened passengers) . However, based on existing knowledge of the disease evolution, a relatively large number of cases will be in the incubation phase while travelling. COVID-19 has an incubation period of 2−14 days, with 75% of cases developing symptoms in a period of between four and seven days.
These travellers will not be detected by exit or entry screening, even in a scenario assuming high sensitivity detection of symptomatic travellers. This scenario was modelled at the beginning of the outbreak in January 2020, with an estimated 75% of infected passengers exiting or entering the country without being detected .
Moreover, since then evidence has been accumulating to indicate that asymptomatic (or pre-symptomatic and mild) cases play a significant role in the transmission of COVID-19 . It is therefore impossible to rely on exit or entry screening to identify all those infected, as only a portion of them will probably be detected by the available screening tools.
Temperature checks, similarly, aren’t especially useful,
Although fever (body temperature >37.5 or 38°C) is one of the frequent symptoms of COVID-19, it is not consistently reported. In over 100 000 cases reported to ECDC’s European Surveillance System (TESSy) by 21 April 2020, only 48.7% reported having fever . In addition, fever is a symptom that can be temporarily masked by using antipyretic drugs.
Rapid testing on arrival, if scalable and accurate, could help but may be out of reach for most countries and airports.
Ultimately then what should be done? Ali thinks we should re-think all travel,
We have to critically examine our role in encouraging millions more Instagram selfies of a sunset on a beach, blithely, without acknowledging so many lives lost, so much disease spread, so many livelihoods destroyed. We have to examine the role of tourism promotion from here on, if it carries on without any sense of loss in it.
I think he strawmans the value of travel as mere ‘Instagram selfies’ without recognizing that travel has always brought with it good and bad, and that a continued pause on travel shuts the barn door after the horse is out.