Quarantine and testing strategies to ameliorate transmission due to travel during the COVID-19 pandemic: a modelling study

Abstract

A major policy tool used by governments during the COVID-19 pandemic has been the imposition of quarantine and testing requirements on international travel, extending even to the extreme approach of closing national borders. However, both approaches have far-reaching socioeconomic implications. Therefore, we evaluated the implications of quarantine and testing compared to the reductions achieved by border closure on in-country imminent transmission based on country-specific prevalence, daily incidence, vaccine coverage, immunity, age-demographics, and travel flow. We considered travel quarantines of 0–14 days with and without RT-PCR or antigen testing for COVID-19 in 31 European countries. Our analysis demonstrates that for the vast majority of origin-destination country pairs, there are combinations of short-duration quarantine and testing that are as effective as border closure. Furthermore, for most origin-destination country pairs, travel with testing and no quarantine will reduce imminent in-country transmission more than would border closure. We find that the duration of quarantine is predominantly influenced by country prevalence and quantity of travel. With higher prevalence in the origin country compared to the destination country, the minimum duration of quarantine increases from zero to beyond fourteen days (at which point border closure would likely be practical). Asymmetry in travel flow can also cause an increase or decrease of infections within the destination country, respectively resulting in longer and shorter quarantines. We apply the same framework to genetic variants of concern to limit their spread as a consequence of travel; the widespread variant of concern B.1.1.7 yields similar sufficient quarantine and testing regimes, whereas the lower-frequency, geographically heterogeneous 501Y.V2 variant requires longer, more specific quarantines. We show that adaptation of our analytical framework to the European Union traffic-light country risk stratification provides a simplified policy tool. Lastly, we examined the effect of travel quarantine and testing or border closure policy on hospitalization in the destination country. We find that hospitalization rates in the destination country are far more sensitive to changes in the vaccine coverage than on the duration of the travel quarantine or the country of origin. Our analysis provides rigorous guidelines enabling travel between most countries during early and late phases of pandemic disease.

Same storm, different boat: The global impact of COVID‐19 on palliative care

“…Throughout the world, a range of quarantine and social distancing measures have been implemented to curb the transmission of the virus. 13 The need for social distancing resulted in greater reliance on technology to create and maintain connections with patients, families, and each other. 14 The rapid transition to telehealth enabled many palliative care patients to receive ongoing, needed care; however, financial and socio-cultural inequities between and within developed and LMICs resulted in uneven access to palliative care services.…”

International Travel-Related Control Measures to contain The Covid-19 Pandemic: An update to a Cochrane Rapid Review

“…The study does not provide a specific effect measure for an air travel-related control measure Well 2021 (63) The study does not measure the specified interventions Wells 2021 (64) The study does not assess the impact of an air travel-related control measure Yang 2021 (65) No data for analysis Yokota 2021 (66) The study did not incorporate the specified study design Yousif 2020 (67) The study does not assess the impact of an air travel-related control measure Yue 2021 (68) The study does not measure the specified interventions Zhou 2021 (69) The study does not assess the impact of an air travel-related control measure Zhu 2021 (70) The study does not measure the specified interventions Zhu 2021 (71) The study does not measure the specified interventions…”