An argument for ongoing travel quarantines
Wednesday, January 6, 2021
by Shlomiya Lightfoot
MIT, Cambridge, MA 02139
Disclaimer: The views, thoughts, and opinions expressed in this blog belong solely to the author, and do not necessarily represent the view of EndCoronaVirus.org or the Zero-Covid strategy.
Scientists are saying that more pandemics are on the way, but we can prevent future epidemic outbreaks from becoming pandemics.
Most of us are eager to get back to normal, or to the more just and hopeful world we are working to create. While necessary now to stop COVID-19, an indefinite continuance of the “social distancing” we’re supposed to be doing would be unacceptable. Aside from its deep economic consequences on individuals and the world, humans need to interact in person for their mental, physical, and spiritual health. Children need to play together, and they cannot be asked to keep distances from their playmates. All of us need to interact in sometimes large, overlapping communities.
But what about long-distance travel? Nearly a year ago we watched in horror as the novel coronavirus spread to one country and then the next through travel. Many countries implemented travel bans or mandatory travel quarantines; some of these, and some new ones, are still in place as the pandemic continues to develop.
Years ago, scientists predicted that increased global connectivity meant that illnesses arising in one location would rapidly spread around the world.[1] We have seen that prediction come true. Now scientists are telling us that this pandemic is just an early one of many.[2], [3], [4] Can we prevent future epidemics from becoming pandemics?
Back in the day, a traveler had in effect a two-week quarantine period for crossing the Atlantic, because that’s how long the boat ride took. Getting far from one’s home region was more time-consuming and difficult then, so people did it less and an illness incubation period would more likely be over before arrival. What if the world were to implement policies helping to ensure that new illnesses are not carried around the globe?
A two-week quarantine period for international, inter-regional, or transcontinental travel would make a huge difference in preventing future epidemics from becoming pandemics. Standing travel quarantine policies should be implemented, even when we are not in a pandemic. These can become as normal as other preventive measures we take, such as airport security and washing hands after using the bathroom. Having travel quarantine policies in place will also make it easier to adjust for particular events, such as increasing the quarantine time if a long-incubation illness emerges or testing for a particular illness.
Broad travel quarantines will be easier to sustain, more ethically acceptable, less politically loaded, and more effective, than travel bans or other restrictions. Careful investigation, modeling, and policy-making will be needed to decide what travel should be quarantined. Quarantines could be applied to air or ground travel. They could be applied between countries, continents, or other groupings. In some places multi-national zones would make most sense, while in theory very large countries could decide to designate internal zones. Groupings will likely change as information develops. Travel quarantines would reduce travel somewhat altogether, which is not necessarily a bad thing (certainly for the environment). They would also make remote participation continue to be more acceptable, now that people are getting more comfortable with phone and internet -based gatherings for everything from conferences to birthday parties to funerals.
A quarantine policy would affect some types of travel little, others substantially.
Inter-zone moves, permanently or for single years or semesters, would still take place, albeit with increased hassle. People could still conduct activities while in quarantine, whether working remotely or settling in to a new house (or packing up an old house). Travel to another zone to visit friends or family for a few months would be reduced but not eliminated. Systems could arise whereby the quarantine could be shared – someone needing to visit family could travel and see them immediately, as long as the family quarantine themselves (but they could be together with their visitor) after contact. Inter-zone travel for weeks or a month to visit or tour would be greatly reduced. Some of those trips could be expanded by combining – people traveling every year for three weeks could instead travel every other year for six weeks, particularly if vacation time policies become more flexible to accommodate.
Brief inter-zone travel, such as for a conference or a wedding, would be mostly eliminated. Remote participation would replace most of this travel, though people would also invent ways to make the travel they need worth doing, such as combining a once-in-two-years vacation with a relative’s wedding. Some working gatherings like meetings and workshops could be conducted as a quarantine unit themselves, such that the meeting would be long enough to count as quarantine or participants would have a briefer pre- or post-meeting quarantine. With conferences as quarantine units, if at the end of a meeting lasting the quarantine period no participant had come down with any concerning illness, we could assume that no one had come in with anything or passed it to anyone, so everyone would be released from quarantine. If anyone at the meeting came down with something concerning then all participants would need additional quarantine in case someone had caught it at any point during the conference. Exposure to ordinary illnesses is not the concern – as long as it could be established that the illness going around is just a common cold, for example, there would be no further concern. Most of the time no one will come into a meeting with a new dangerous pathogen, and everyone would be released from quarantine after the initial period.
Vacation cruises or travel to vacation resorts may be affected very little, particularly with policies in place to enable them. For example, people from the same zone could take vacation cruises together that don’t involve landing in another zone and mingling with locals; people from different zones could quarantine together as well, as long as they don’t return to their own zones before the time is over. In some instances locals could make livelihoods serving visitors and quarantining themselves (or themselves with their families) beforehand and afterwards. Further, the time a cruise ship takes to get somewhere would count as part of quarantine, such that cruises may simply need to add a day or two on ship before letting the passengers out to explore.
Travel for humanitarian work often takes place as longer trips (months or longer) and would still take place. The quarantine period could be used for training and team-building on the front end, and for de-briefing and write-ups on the back end. Shorter service trips might be replaced by more emphasis on local or intra-zone (such as intra-national) service or on longer trips, or on conducting activities without travel that support efforts by those abroad. Medical tourism would become more time-consuming, but it might otherwise not change dramatically. Some medical procedures could be conducted under quarantine, which would make the trip not much if at all longer than without quarantine policies.
With ongoing travel quarantines, quarantining would itself improve. Working remotely is becoming more possible. Policies and systems should be set up to maximize the feasibility and comfort of quarantining at home, and quarantined facilities would be created that are comfortable, enjoyable, and child-friendly. For some people traveling for vacation, if developed well the quarantine period could become part of the vacation. Like for conferences under quarantine, quarantining does not need to mean being alone, as long as the others are quarantining over the same dates. Large group quarantine is possible now, though a better ability to diagnose an illness as normal vs. novel would make it easier. This technology is within reach.
Today, many people think of travel as a fundamental right, at least a right of those who can afford it. But COVID-19 may be teaching us that fully exercising our rights, such as for socializing, shopping, travel, coughing where we wish, puts each of us at risk, and we may be recognizing our duty to the other members of our society. Growing numbers of people are already choosing to limit their airplane or car travel due to these activities’ environmental effects. That awareness can expand now that we know that global pandemics are at play. More broadly, we must consider how our values, such as health and rapid travel, play out in our new context of pandemic vulnerability. The costs of slowing travel can be viewed as part of a mix with other costs, such as to health and life and to personal freedoms of activity and movement in the event of the next pandemic. Put another way, costs to travel speed may be trading off with costs of pandemic vulnerability. Of course, how likely and how severe we think the next pandemic will be affects how we view the tradeoffs. Those predicting that they will be coming more frequently and could be much worse may wonder how many pandemics it will take us to decide that ongoing travel quarantines are necessary.
For political feasibility and equity, all or many countries will need to implement travel quarantines together. Otherwise, countries implementing quarantines would be putting their own tourism and other travel-based industries at disproportionate risk as interest would turn toward countries without quarantines. We all need to act like we’re in this together. That said, any country can stand up and show leadership in this area.
Permanent travel quarantines will disrupt some lives and industries. They will affect different communities in different ways. We must support affected individuals and communities as we make changes necessary to prevent future global disease outbreaks. The airline and tourism industries will be negatively affected, though opportunities for “quarantine hospitality” and intra-zone travel and tourism, as well as web-based tourism experiences, will develop and should be encouraged. Expatriates with family in other zones will have a harder time seeing their families, and people with limited vacation time or unable to work remotely will have a harder time taking themselves or their families to experience foreign cultures. Workplace vacation policies could expand or become more flexible to account for the additional time required for international travel, for example by allowing employees to save up vacation time over longer periods. Programs, such as through national consulates or culture groups, could subsidize increased vacation time for expatriates wishing to visit their families or bring their children to experience their native cultures. Any costs to companies of additional vacation time and flexibility may well be counterbalanced by the productivity gains by employees who no longer need to take time for travel and jet-lag adjustment, or sick time because of travel, for conferences or meetings that they will instead be joining remotely.
Pandemic-prevention tools with less effect on people’s lives might be better than travel quarantines, but they don’t exist yet. Rapid, accessible testing for infection in general, or perhaps even just for viral infection in general, improvements in contact tracing capabilities, or other developments that would allow us to get a better edge on new illnesses could negate the need for travel quarantines. Ongoing travel quarantines should be reconsidered with the development of other anti-pandemic capabilities. But months into COVID-19 we still lacked suitable, widely-distributed diagnostics even for this specific illness, and contact tracing is not at a level that it can be relied upon to prevent a pandemic. We are vulnerable now to hugely destructive pandemics, and travel quarantines are a tool we have now that can prevent them before other tools are available.
As we continue to struggle with COVID-19, and as we ponder and experiment with re-opening and future preparedness, ongoing travel quarantines should be part of the conversation.
[1] EM Rauch, Y Bar-Yam (2006) Long-range interaction and evolutionary stability in a predator-prey system, Physical Review E 73: 020903. https://tinyurl.com/y4roqzwd
[2] D Carrington, Guardian 2020. https://tinyurl.com/ybr67snn
[3] J Vidal, Sci Am 2020 https://tinyurl.com/y2f8j3t4
[4] KF Smith, M Goldberg, S Rosenthal, L Carlson, J Chen, C Chen, S Ramachandran, J. R. Soc. Interface.1120140950, https://doi.org/10.1098/rsif.2014.0950