Effectiveness of international border control measures during the COVID-19 pandemic: a narrative synthesis of published systematic reviews

Abstract

The effectiveness of international border control measures during the COVID-19 pandemic is not well understood. Using a narrative synthesis approach to published systematic reviews, we synthesized the evidence from both modelling and observational studies on the effects of border control measures on domestic transmission of the virus. We find that symptomatic screening measures were not particularly effective, but that diagnostic-based screening methods were more effective at identifying infected travellers. Targeted travel restrictions levied against travellers from Wuhan were likely temporarily effective but insufficient to stop the exportation of the virus to the rest of the world. Quarantine of inbound travellers was also likely effective at reducing transmission, but only with relatively long quarantine periods, and came with important economic and social effects. There is little evidence that most travel restrictions, including border closure and those implemented to stop the introduction of new variants of concern, were particularly effective. Border control measures played an important role in former elimination locations but only when coupled with strong domestic public health measures. In future outbreaks, if border control measures are to be adopted, they should be seen as part of a broader strategy that includes other non-pharmaceutical interventions. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.

Detection of SARS-CoV-2 variants among travelers crossing the northern international border checkpoint in Duhok province, Iraq

“…These two variants were normally distributed when the normal plot of the residuals was examined, and the data were without outliers (Figure 1). [10,16]. Stressing this point, it has been reported that COVID-19 cases were found among travelers crossing Turkey to Iraq [11], without attempting to delineate the SARS-CoV-2 variants infecting them.…”

“…Another study reported 22 distinct mutations of SARS-CoV-2 spike protein regions between 2020 to 2021 in Iraq isolates, with the majority of the variants belonging to B.1.1.7 lineage [9]. Border gates are focal points of disease entry among neighboring states [10]. A recent study from the Kurdistan Region, Iraq reported the occurrence of COVID-19 cases among travelers crossing the Iraqi border from Turkey (August 21, 2020, to August 21, 2021), without any attempt to detect the SARS-CoV-2 variants [11].…”

Importation models for travel-related SARS-CoV-2 cases reported in Newfoundland and Labrador during the COVID-19 pandemic

“…Most evidence was due to modelling studies with a lack of ‘real world’ data (Burns et al, 2021), with inconsistent parameter estimates and assumptions, and that overlooked the impact of undetected cases outside of China (Grépin et al, 2021). Guidelines that recommended against the implementation of travel measures may have been made when considering travel measures in isolation, and might not be robust when considering the coordinated implementation of both travel measures and community non-pharmaceutical interventions as occurs for an elimination strategy (Grépin et al, 2023; Martignoni et al, 2023).…”

Lessons learned from the Alberta Border Testing Pilot Program

“…Due to the increased risk of COVID-19 case importation through international travel (5,6), many countries implemented border measures, including closing borders, screening programs, and post-arrival quarantine (7)(8)(9)(10). Border control measures were necessary to regulate the movement of individuals across international borders due to the need to contain the transmission of COVID-19, prevent the importation of new variants and conserve essential healthcare resources (11)(12)(13). Border closures and surveillance programs in response to a pandemic are complex (14,15) and their implementation and effectiveness are influenced by several factors (16,17).…”