It’s only this past fall when the U.S. began allowing non-residents who had been to Europe in the previous 14 days to enter the country by air. The March 2020 policy that was supposed to help keep Covid-19 out of the country somehow lasted more than a year and a half. This was replaced by a policy of requiring vaccination and testing, and requirements were just extended to land crossings for non-residents this month.
When the U.S. imposed travel bans on some African countries once the Omicron variant was detected this was supposed to ‘buy time’ for the government to be able to do something about the virus, before it entered and started spreading across the U.S. However,
- The Omicron variant turns out to have already been here and spreading when the ban was put into place
- The travel bans were porous, they applied only to non-U.S. resident foreigners, U.S. citizens could return with the virus
- The U.S. didn’t really have much of a plan to ‘do something’ with any time this might have bought anyway, even if the virus wasn’t already spreading here and even if it were strict enough to matter
Travel bans can make some sense for a country that has kept the virus out and has pursued a policy of containment. It’s debatable whether that’s the right strategy for a country to pursue, but it is a coherent one. The U.S. has never seriously entertained such a strategy, or been in a position to pursue such.
A vaccination requirement could make sense for entry for one of two reasons,
- When vaccines are sufficiently neutralizing, as mRNA vaccines were against earlier strains (we’re still vaccinating against the ancestral Wuhan strain). There’s some chance that variant-specific vaccines or boosters could restore this, and there’d be confidence that the person entering the country wouldn’t be spreading the virus. But it’s fairly non-sensical to require this when there’s no such requirement for everyone else already in the country.
- Because vaccines are highly effective against hospitalization, boosted individuals using mRNA vaccines are 90% less likely to be hospitalized from Omicron than unvaccinated individuals. If the concern was someone coming into the country who might become hospitalized in a situation where beds are scarce and health systems overwhelmed and every hospitalized case counts then this would be a logical requirement.
The first case is unsupported by current vaccines, and the second case is time-limited. Once hospitals are no longer overwhelmed a vaccine requirement makes little sense. There’s no more threat from unvaccinated foreigners than unvaccinated Texans.
Meanwhile a testing requirement as currently deployed makes far less sense.
- Antigen tests are accepted, and these show current infectiousness rather than detecting infection. Someone may be infected and spread the virus after they’ve arrived in the U.S. even though they tested negative.
- This is doubly true since tests are permitted any time the day prior to travel departure. A negative test might be about 48 hours old by the time someone arrives.
Now, if The U.S. testing policy actually kept infected people out of the country (it doesn’t), what would this be accomplishing?
- The virus is already spreading widely in the U.S., so this doesn’t ‘keep the virus out’
- Vaccines and boosters are already available, allowing most Americans to be protected against severe outcomes anyway
- Outstanding treatments are about to become more widely available
You might think we’re trying to keep out new variants but,
- That hasn’t worked thus far with the most serious variants
- With the level of infection in the U.S. it’s likely that residents already here are one of the main sources of creating new variants in the first place
Our current policies aren’t just failing, they have failed. But there’s a stickiness to current policy because lifting them creates a problem of optics. There’s can’t be a recognition that these policies have failed, except by a new administration that hasn’t already owned them. It took over a year and a half to even allow vaccinated Europeans testing negative for Covid into the country even when coming from a place where prevalence of the virus was lower than in the United States at a given time.
That’s why I’ve held out hope for the 2022 midterms creating the opportunity to end policies that don’t make sense for public health, as part of a political necessity to ‘declare victory’ over Covid-19.
But what does that look like in practice? It’s not clear whether lifting all restrictions that make little sense has to happen for this. For instance, Argentina just announced an end to testing for vaccinated residents entering the country. This half-measure still allows politicians to,
- Frame themselves as responsible, because they’re only lifting restrictions on vaccinated even though that vaccination requirement provides modest protection of others and doesn’t affect the aggregate course of the nation’s experience with the virus
- Differentiate between foreigners and non-foreigners, which entails both a distinction between voters and non-voters and perpetuates the ‘fear of foreigners’ that have characterized the pandemic.
We will start to see restrictions of various kinds lift this year – different restrictions and different times and in different places at different times. Even though most tests the Biden administration is sending out aren’t able to be used to meet the administration’s testing requirements to enter the country it seems unlikely they’d lift testing requirements at the same time as ramping up testing distribution. The idea that testing is both needed and not needed isn’t a great political narrative.
So I maintain hope that ‘sometime before the midterms’ will bring some relief. That will mean after the current virus wave has subsided, of course. And I’m cognizant that the administration won’t want to remind the country about promises we’d be over this come July 4th, and that bureaucratic rules tend to outlive even their logic-as-narrative. Although the U.K.’s recognition that travel testing served no useful purpose provides some hope that the U.S. will do the same, perhaps first for vaccinated citizens in order to draw on convenient narratives and continue to appear responsible.