But what is clear now is that policy was more about politics and economics than public health.
Public health records, scientific study scores, and interviews with more than two dozen experts suggest that the policy of uninterrupted travel was not based on hard science. It was a political decision, reorganized as Health Advice, which emerged in the 1990s following a plague in India. By the time Kovid-19 appeared, it had become an article of faith.
“It’s part of the religion of global health: Travel and trade restrictions are bad,” Lawrence O. Gostin is a professor of global health law at Georgetown University who helped write global regulations known as the International Health Regulations. “I am one of the circles.”
Kovid-19 has broken that trust. Prior to the epidemic, some studies had found that travel restrictions were delayed, but did not stop, the spread of SARS, pandemic flu, and Ebola. Most, however, were based on mathematical models. No one had collected real-world data. The impact of travel restrictions on the spread of the latest coronaviruses is still not understood.
“Whoever is truthful is going to tell you that it’s a big fat ‘we don’t know’,” said Professor Keiji Fukuda, a former senior health officer at the World Health Organization, who teaches at the University of Hong Kong.
Not knowing is particularly troubling because the world is looking back to normalcy. For months, national leaders have implemented travel restrictions that vary in strictness and are often contradictory. Some closed their borders as well as imposed domestic lockdowns, others required testing and quarantine. Many regularly revised their lists of risky sites, sometimes replying to the tat when their citizens were denied entry.
Sanctions have deterred powerful countries such as the United States, whose citizens are no longer welcomed worldwide. Nevertheless, President Trump has called his travel restrictions “the biggest decision ever” and attacked the WHO’s initial advice on borders as “disastrous”.
Still, it soon becomes known, based on data and hard science, how much travel restrictions help, and if they do, which restrictions help the most. Experts who defended open borders at the onset of the epidemic now say countries should use prudent travel measures. The WHO now calls for a gradual reopening in which each country has its own risk.