Lessons from COVID-19: Managing borders in the next global public-health crisis – World

0

Attachments

By Meghan Benton and Lawrence Huang

Executive Summary

The world has moved on from the COVID-19 pandemic, but it has yet to fully reckon with its unprecedented shutdown of the global mobility system. The number of government restrictions and conditions on cross-border mobility reached more than 100,000 by the end of 2020 and remained that high for the first two years of the crisis, severely limiting most forms of migration for an extended period. In 2020, international tourism dropped by three-quarters, legal migration to some countries halved, access to asylum was curtailed, and refugee resettlement stopped. This had catastrophic impacts on the global economy, triggering labor shortages and huge financial losses in industries such as tourism and education. It also left travelers stranded, families separated, and people unable to access protection even as humanitarian needs increased. And yet, when future public-health crises emerge, governments will likely once again face questions about how to manage mobility to reduce risk. Thus, it is critical to understand whether, when, and how travel measures can be an appropriate public-health response.

The decision to impose travel measures is rarely clear cut. Especially in the early stages of a public-health crisis, governments may not know whether a new virus will spread quickly, cause severe illness, or be easily treatable. This uncertainty means policymakers must walk a delicate line between under- and over-reaction. Travel measures were most effective during the COVID-19 crisis when they were imposed early, tightly, and/or alongside stringent domestic testing and isolation policies. In the best-case scenario, a combination of travel restrictions, quarantines, and domestic measures can prevent or limit a virus’s spread, as they did in the pandemic’s early stages in countries such as South Korea and Japan. But in most countries, the virus spread before borders closed, quickly exposing the folly of betting on travel measures as the sole or primary response mechanism. Travel measures may appear to be an easy lever for policymakers to respond to public-health risks, without the public backlash that often accompanies domestic lockdowns and restrictions, but such measures come with significant costs.

It is critical to understand whether, when, and how travel measures can be an appropriate public-health response.

Whether travel measures should be used during future public-health crises depends on the nature of the virus, but better coordination among governments will be essential. One tool in this regard could be risk analysis frameworks. During the COVID-19 pandemic, such frameworks were used only sporadically and largely retroactively (to explain rather than guide border management decisions), but when used more consistently they can help make decision-making more predictable and transparent. There is a flicker of opportunity to bring more standardization to such frameworks as governments revise the International Health Regulations, but moving toward a common global framework relies on governments revisiting—both domestically and internationally—difficult questions about their risk tolerances and how they rank different types of costs (public health, economic, or otherwise). This demands deeper reflection on the pandemic’s impacts on human mobility than is happening in global public-health governance: the pandemic treaty set to be discussed at the World Health Assembly in May 2024 has regrettably not focused on mobility at all. An easier win could be standardization at the regional level, starting with low-hanging fruit including agreeing on a set of common categories of essential movers and exemptions or on initial timelines for closures.

A great deal of mobility-related infrastructure, both physical and virtual, was built during the COVID-19 crisis, and it is important that governments do not jettison this entirely as countries move beyond the pandemic. Instead, they should seek to maintain systems that are dormant but prepared. Examples include maintaining digital health credential systems that emerged during the crisis and ensuring they are interoperable, so that any future vaccination, testing, or screening requirements can be implemented swiftly and standardized (if not globally, at least regionally). In addition, future architectural decisions about transport and borders could mainstream public-health considerations, for instance by improving ventilation and ensuring that check-in and security lines can be spaced out and that quarantine requirements could be implemented.

Arguably one of the most important lessons of the COVID-19 experience is that human behavior matters: the public needs to understand and be able to comply with rules put in place, and rules that are overly burdensome may lead some people to circumvent them. Throughout the pandemic, travel measures gave rise to negative spillover effects as people rushed home or as health checks compounded congestion in border checkpoints and transport hubs. As time went on, the shift from banning all travelers from certain countries to just those without vaccination or proof of a negative test result was a positive step as it helped get the world moving again. But these were still punitive and symbolic measures that had disproportionate effects on the most vulnerable as well as unintended consequences, such as pushing some people into irregular migration channels if they were unable to meet the heightened rules to move formally. And in some cases, such as vaccination and mask requirements, policies caused public backlash. A more sophisticated strategy would have mapped the risks posed by mobility and used carrots rather than sticks, such as offering vaccination to nonvaccinated people on arrival in a new country (instead of preventing them from moving) or expanding access to testing and health services, inclusive of irregular migrants.

Although migration has returned to the pre-pandemic norm, governments should not forget the costs of unplanned, long-lasting, and stringent travel restrictions. There is an urgent need for a full postmortem of how travel measures and mobility were used and their effectiveness, or lack thereof. Absent this reflection and a global consensus on how to use travel measures, at the very least governments should commit to ensuring future mobility measures are clear (well-communicated, predictable, and based on clear metrics); equitable (not overly burdensome to vulnerable groups); streamlined (used sparingly and lifted as quickly as possible, and certainly not maintained beyond domestic measures); and prepared (based on planning and building on COVID-19 digital and institutional infrastructure). These four principles can serve as guardrails for managing migration and borders during future public-health crises, in a way that balances health risks with the vital role mobility plays in societies and economies around the world.

link

Leave a Reply

Your email address will not be published. Required fields are marked *