Can Omicron Finally Get the World to Cooperate on Pandemic Mobility Management?
The world is once again engaging in a mad scramble to close borders after news of the transmissibility of the Omicron variant of the SARS-CoV-2 virus and the concern with which the World Health Organization (WHO) and other public-health experts are taking this latest pandemic development. But just as with the initial response to COVID-19 and its subsequent Delta variant, the world risks mismanaging its public-health response with an uncoordinated, unevidenced, and single-minded focus on travel restrictions alone.
Since Omicron was first detected in Southern Africa in early November, dozens of countries, territories, and authorities across the globe have implemented new travel restrictions, according to the International Organization for Migration. Some countries (namely Israel, Japan, and Morocco) have banned all incoming travel. Others (including Pakistan, South Korea, the United Kingdom, and the United States) have banned arrivals from several countries, mostly in Southern Africa. Some (Australia, Singapore) have delayed plans to reopen, while others are reinstating health measures such as mask wearing, vaccine requirements, and digital surveillance. Yet once again this response has been unilateral and uncoordinated.
There is a sense of déjà vu in the way that countries have responded, imposing travel bans without coordination or planning that resulted in chaos and congestion in transport hubs and ports of entry—the antithesis of social distancing—and people stranded in airports, awaiting testing or more communications on quarantine and other restrictions. The designation of Omicron as a variant of concern occurred weeks after its global dispersal. And most countries now imposing travel restrictions are still allowing citizens and residents, among others, to return. Once again, Omicron-related travel restrictions are thus likely to be both leaky and too late—and unlikely to hold up to any cost-benefit analysis.
Can Travel Restrictions Quell Variants?
The role of travel restrictions in pandemic management has been hotly contested. Part of the problem has been a lack of clarity on their strategic purpose in different contexts and across different phases of the pandemic. The received wisdom, and WHO line, prior to the pandemic was that the costs of travel restrictions—including hampering the circulation of vital medical personnel—were so great as to outweigh their benefits. But COVID-19 changed all that. Some countries were able to use hardline border policies to contain the virus, in a so-called eradication strategy, although they had to confront painful tradeoffs in the process, including by barring returning citizens from traveling home. Elsewhere, travel curbs did slow global spread, largely by delaying the arrival of the virus in particular places by precious weeks or days, but they were often not lifted even when their purpose had largely evaporated.
The arrival of Delta and other variants threw a spanner in the works. A dominant variant will eventually outcompete all others, so just one case can be enough to seed its spread in a new country. For countries pursuing mitigation strategies to reduce the rate of spread, it was hard to spot the Delta variant in their midst, and thus by the time new travel restrictions were imposed it was already on a path to exponential growth; by November, Delta accounted for 100 percent of U.S. cases. And Delta’s transmissibility meant that even countries with the hardest of borders began to shift to mitigation; after hefty lockdowns, a rise in Delta cases prompted Australia to abandon its eradication strategy and make plans to open up.
The goal of not letting a single case of a new variant through still motivates decisions about travel restrictions. But few countries are in position to seal off borders in the way that China, Singapore, Australia, and New Zealand did in spring 2020, and all signs point to the Omicron variant already having spread its tentacles far and wide. Moreover, governments rightly want to permit nationals to return home, family reunification, and the entry of essential foreign workers.
The evidence is sorely lacking on the efficacy of travel measures in mitigating the spread of new variants, and we do not know enough about Omicron to predict how it will spread. But history suggests that travel restrictions will not ultimately prevent a dominant variant taking hold, and they will not offer a silver bullet without other, universal travel measures (such as vaccination requirements and testing) and public-health actions.
How Travel Restrictions Are Used Matters More than Ever
While more information is collected about the Omicron variant, short-term travel restrictions and flight bans can help reduce risk. But governments will need to proceed carefully to ensure that travel bans do not become sticky and outlast their public-health benefits, in part because their role as “pandemic theatrics” means the political cost of lifting them can be high. As a result, they should be time-limited, expire by default, and set clear benchmarks about the conditions under which they can be lifted.
And how travel restrictions are used will become more important than ever. As Canadian researcher Kelley Lee has argued, “we have to see borders not as a stop point, but more as a surveillance point,” meaning that what happens at the border becomes more important than ever. Countries could consider dropping “green lanes” that allow returning nationals to skip testing or vaccination requirements, or they could temporarily ramp up testing and/or quarantine and contact-tracing requirements for all travelers.
More importantly, there is real potential to use travel restrictions to better effect than in the early pandemic as a resource to delay the arrival of a new variant, including by updating vaccination sequencing, rolling out booster programs, ramping up testing and genomic sequencing capacity, and giving health-care systems and other public services time to prepare.
Towards Greater International Coordination
The risks posed by the Omicron variant are not easily solved unilaterally. Many rich countries are expanding and reiterating their commitments to COVAX and vaccine equity, acknowledging that shutting down can only do so much when the virus is surging untrammeled and countries with largely unvaccinated populations could become the petri dish for additional variants. The time is ripe for a more global approach, where governments move away from “shut the virus out” to “get on top of it everywhere.” Nearly two years into the global public-health crisis, Omicron could be the nudge needed to get on track.
One priority should be for countries and international organizations to join up action on global health vaccine equity and mobility management, instead of pursuing them as separate goals that end up working against one another. For instance, vaccine requirements for travel make sense, largely because they help create incentives for people to get vaccinated. But measures to verify health status can be exclusionary (especially if there is no option to test/quarantine instead of showing a vaccination record or if verification relies on complex digital systems). Instead of working on airtight systems to divide people into vaccinated and unvaccinated categories, governments could consider opportunities to create incentives for vaccination, for instance by offering access to vaccines in a consulate as part of a visa application process, or even allowing vaccination on arrival.
A bigger goal—as argued in a Migration Policy Institute report earlier this year on future scenarios for global mobility—would be pursuing global standards for international travel and pandemic management, including agreement on how to use time-limited border closures, categories of people eligible for exceptions, testing and screening procedures, and digital health record interoperability. Earlier this week, WHO convened a special session on the potential of revised international agreements on pandemic preparedness, and the IOM Council chose the pandemic’s consequences on mobility for its high-level discussion. The potential is growing for stronger international coordination on pandemics and mobility management.
The public-health and border management infrastructure evolving before our eyes will likely dictate how the next pandemic is handled, and thus it is important to put in place rules that are parsimonious, equitable, and risk-proportionate. Importantly, this approach would favor universal conditions that apply to all travelers (e.g., testing or vaccination) rather than country-based restrictions (e.g., bans on travel from particular regions) and include public and accessible benchmarks for both lifting restrictions and imposing new ones.
The Omicron variant is a clear reminder that international cooperation and long-term planning will be critical to a more equitable and sustainable system of global mobility and pandemic preparedness.