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The Trump administration’s decision to ban most foreign nationals who had been to China in the last two weeks from traveling to the United States amid an accelerating outbreak of a novel coronavirus there was preceded by calls for similar policies from conservative lawmakers and far-right supporters of the president. Public health experts, however, warn that the move could do more harm than good.

The administration’s public health emergency declaration also requires U.S. citizens returning from China to undergo some level of quarantine, depending on where they had been in China.

Before the announcement Friday, Sen. Tom Cotton (R-Ark.) had called for a ban on all commercial flights from China, and Rep. Paul Gosar (R-Ariz.) said the government should consider “implementing a temporary travel ban on travelers from China until the threat is resolved.”

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Beyond Capitol Hill, Mike Cernovich, a prominent conspiracy theorist and early Trump supporter, had agitated on Twitter for a Chinese travel ban, as has Michael Savage, another conspiracy theorist and a radio host with white nationalist beliefs. “QUARANTINE! STOP TRAVELERS FROM CHINA NOW!” he said on Twitter last week.

The ban comes on top of moves by major U.S. airlines halting flights to and from mainland China.

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The outbreak has sickened nearly 10,000 people, mostly in China, and killed more than 200. A few countries have responded by imposing full or limited travel bans. The Philippines, for instance, has banned travel from the city of Wuhan, the epicenter of the outbreak. Countries including the Bahamas, Mongolia, and Singapore have banned all travel from China.

Public health experts have warned that travel bans are not effective at stemming the spread of a virus and can make responding to an outbreak more challenging.

“From a public health perspective, there is limited effectiveness. And then there are a host of other reasons why they can actually be counterproductive,” said Catherine Worsnop, who studies international cooperation during global health emergencies at the University of Maryland.

The World Health Organization, which declared the outbreak a global health emergency this week, has recommended against any travel or trade restrictions in response to the outbreak. Member countries, however, do not have to comply with that guidance.

“Although travel restrictions may intuitively seem like the right thing to do, this is not something that WHO usually recommends,” said Tarik Jašarević, a WHO spokesperson. “This is because of the social disruption they cause and the intensive use of resources required,” he added.

Experts said travel bans could lead to a slew of downstream effects and risk complicating the public health response.

“There’s not only the financial toll on a country that is dealing with this outbreak, but this can discourage transparency, both in this outbreak and in the future,” Worsnop said.

Travel and trade restrictions can lead to dire economic consequences for countries involved, creating a disincentive for them to quickly disclose potential outbreaks to the WHO or other nations. They can hinder the sharing of information, make it harder to track cases and their contacts, and disrupt the medical supply chain, potentially fueling shortages of drugs and medical supplies in the areas hit hardest by the outbreak. They also send a punitive message, which could contribute to discrimination and stigmatization against Chinese nationals, experts warned.

Any effort and money spent crafting and enforcing travel and trade restrictions also take away already-stretched resources from public health measures that have been proven to be far more effective, experts said. Those measures include providing assistance to countries with weaker health systems, accelerating the development of a vaccine or rapid diagnostic test, and clearly communicating with the public about when and how to seek care.

But for politicians, those responses might not feel as tangible an action as enacting a travel ban. During the 2013-2014 Ebola outbreak, there was a flurry of calls for a U.S. ban on travel from the affected countries, including from Donald Trump, then a private citizen.

“People want their government to do something when these outbreaks are happening, and adopting a border restriction is a visible policy that people think works,” Worsnop said.

Enacting such a ban would go directly against the recommendation of the WHO, which has said countries must inform the organization of any travel restrictions they put in place.

“Adopting these restrictions undermines the cooperative approach we need to respond to this kind of outbreak, specifically by undermining the authority of the WHO, which has recommended against these restrictions,” Worsnop said.

Worsnop said she is hopeful that the WHO will be able to hold countries accountable for disregarding its guidance, including pressing countries for scientific justification for their travel policies and calling out governments that have gone against its recommendations.

“Unfortunately, [governments] face domestic and international pressures, and have faced few costs in the past for not following WHO recommendations,” she said.

  • I was thinking of subscribing to statnews, but this article made me change my mind.

    I had a feeling the author wants to write about this topic, found a WHO source. The fact that the author pick someone who just graduated 4 years ago from public policy and sold that to the readers as an expert makes me feel like she cannot find a credible veteran in this field who can collaborate WHO statement on this article.

    It feels like she just grab anyone to collaborate WHO’s statement. Hence an inexperience second source giving such naive narrative. It was really disappointing.

    Even the head of some medical bodies are advocating for the travel ban. Yet she grab a policy makers who just graduated from school 4 years ago and she sold it as an expert.

    It does tell something about the quality of this article and the author.

  • Putting the economy before health is disgusting. A travel ban is absolutely the right move, especially after China’s gross negligence during the critical early stages of the outbreak. China would do the same if this were occurring in another country.

    • I agree with you 100%!! Putting the almighty dollar ahead of our health is insane, and the excuse of “we don’t want people to get their feelings hurt and think we are discriminating” is another sad story!

  • Thinking of epidemics, we’ve had SARS, & MERS which were closely related, and should have given an idea of what to expect, although those apparently were more limited.

    China has also had Avian Flu pop up from time to time which was very limited.

    And, of course, we had the Mexican Swine Flu (which was highly related to the 1918 flu), which rapidly blasted around the globe, a couple of times.

    For an early response, it may be difficult to determine if the epidemic will follow the path of the Avian Flu that was extremely limited, vs SARS, vs MERS, vs the Swine Flu that wrecked havoc around the globe.

    What is too little response? What is too much response?

  • Politicizing a very serious outbreak is counter productive. China itself has imposed their own Strict travel bans in order to slow the spread of this virus. This was advised by experts in China to try and blunt the spread. Imposing worldwide travel bans may also slow the rate of spread and save lives. Calling this xenophobic is irresponsible and dangerous.
    I have relatives and friends in Wuhan and consider the current methods heroic after a slow response. This is worse than SARS and has the potential to develop into a worldwide pandemic. I have read the early models on this virus and they are quite alarming if they are true. So far, actual results are tracking at 4 times the mean for infections in Shanghai and Beijing. The death rates are much higher than reported based on various sources including people we know who work in Wuhan medical facilities. So rather than criticize anything Trump, how about you contribute to solutions. Your solution appears to be…let this spread everywhere because we will be able to fight it better and we can feel better about not discriminating against anyone.

    • Please give us more detail. It seems there’s something called a “quarantine certificate,” which allows someone to see a doctor in Wuhan. Without it, you stay home and hope for the best. Even with it, you might not see a doctor. This all adds up to case counts being way too low.

      Other question: how do the medical personnel avoid the illness?

  • Worsnop, be shameful on how naive or misleading you sounds.

    The US and the country who had the resources to deliver the cure and treatment had both the resources to implement the travel ban as well as the development of the cure.

    Just in case you are not paying attention on the news. Gilead is working with China on compassionate ground to use the medicine they develop for ebola. The antiviral proves effective on the Washington patient that had the coronavirus. Many individuals mask to Asia, especially China to help them combat the spread or coronavirus there.

    Should there be more infected people in the US, there will be mask shortage and this people cannot ship mask to China anymore.

    The most effective steps is isolate the place/country with infection, and then pour resources to that country to help them combat the epidemic. If countries act in this way, then their is no need to be secretive in the future seeing there will be help if they are transparent.

    It is own China local officials cover up that cause this to spread around the world. In any epidemic highly contagious, the most effective way to combat it is quarantine. That is how the ebola outbreak were, QUARANTINE.

    Worsnop, does you naive thinking that the other countries will have time to help China if it is widespread in their own background because they did not take steps to prevent it from spreading including travel ban.

    Some country also does not have the resource to battle this new coronavirus. Like some poor countries in Africa and Asia, and maybe Latin America included. The only steps they can take is to impose travel ban. Look at North Korea, it had to take steps to protect itself by closing its border to China, knowing it does not have the resources to successfully control this coronavirus.

    Each country have the right to protect its own citizen against introduction of costly epidemic.

    So Worsnop, I am not sure why you have a PHD in Public policy and think so naively. Hope you are not working for some government body on public policy, that will make me worried on what kind of policy you will be implementing.

    • Right now, there is no “cure”.

      It is my belief they could rapidly convert to an IgG treatment which might augment the treatment of the most severe cases, although if one waits to develop pneumonia before treating, it could be too late.

      Generic antivirals?

      There is a lot of work on a vaccine, but it likely won’t be available until this fall. There was previous work on SARS and MERS vaccines, but it was dropped as those disease died off. But, it would help provide a starting point.

      If one can limit the spread of the diease until this fall, then it would give time for an effective vaccine to be developed and distributed, and perhaps have more effective treatments too.

    • @Adams, in the news, there was something that Gilead develop for ebola. It was not tested and approved. It was used in the Washington patient on compassionate ground, case no. 1 in US. They said they see improvement after a day.

      It was supposed to be some antiviral medicine. I don’t think it is a vaccine.

      It was also on the news that Gilead is working with China to use the antiviral in China. It that really works, then maybe that can me use as one of the combination of medicine to help the patients survived.

    • @Henry
      Most of the new antivirals are reasonably broad spectrum. Although I suppose a careful analyis of mechanism should help determine the expected efficacy.

      It appears as if both Washington and Thailand have reported “success” with antivirals. Of course, those are just anecdotes, and one needs to do a random controlled study with many patients to determine efficacy (would the patients have recovered without treatment?)

      It looks like the Washington treatment was a new drug, Remdesivir that hasn’t been fully approved by the FDA, but has shown efficacy in animal studies against other Coronavirus strains. And, is likely going to have a full trial in China shortly.

      ===============

      As I had suggested earlier, we’re now seeing reports of:

      ” Chinese Abroad Become Targets of Suspicion Over Coronavirus
      Some businesses have sought to exclude Chinese people, particularly in places known to host tourists from China ”

      Enforcing the travel ban will help make the Chinese who are already here, or even longterm workers, or citizens safer.

  • This article is pure nonsense by so called experts. Prevention is worth an ounce of cure! A travel ban should be imposed by all countries until the situation is under control. If the situation was reversed, China would most definitely impose a ban. Here in Canada, we need to do the same. All travelers from China should be quarantined. It’s not the right time to travel to other countries! People need to feel confident and reassured as they go about their daily lives and Chinese Canadians wouldn’t be stigmatized and ridiculed if people believe the situation is being handled correctly by those in authority. Health and safety should always come before economy. The latter will bounce back. No such guarantee on health.

    • The situation wouldn’t be nearly as bad had China closed its borders to external travel earlier. Yet, there are China shills out there, starting with the WHO, who care not a whit for public health and safety if that conflicts with China’s objectives. Despicable, really.

  • Listen, I don’t believe that the authors of this story and the so-called experts cited actually believe what they are saying. Who would? This is just a wrong-headed attempt at anti-Trump politicking.

    The travel ban may not be totally effective at this point, mostly because the proverbial cat is already out of the bag, but it will buy time to develop a vaccine, test new drugs and combinations, and allow public health authorities to prepare.

  • Flights were leaving Wuhan well after the Chinese knew of the danger. That’s criminal. Countries around the world are dealing with the fallout.

    Hong Kong doctors voted overwhelmingly to strike if flights from China aren’t stopped. Yet, the WHO wants flights to continue. Why?

    • Because serve it own vested interested instead of the public interest.

      They where blame by the doctors on the large outbreak of Ebola years ago. They refuse to declare in was an epidemic until it was too late and infect many people.

      WHO was created in a time when internet and was not so prevalent. The world was not so connected as it is today and the travel of information was not as fact.

      WHO needs to be scarp and a new body independent of UN needs to be created. That body should solely be scientific and not deal with matter that does not pertain to them like economy and so forth…

      The more their is epidemic, the more WHO feels they can exercise their authority, so of course they will probably thrive on epidemic. It is useless for them to stop a disease on its bud.

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