LONDON — Border policies between nations have become a hot-button issue in recent years. As politicians argue about how easy it should or shouldn’t be to move between countries, a new report is stressing the need for strict controls at national borders because of one thing: COVID-19.
Researchers from University College London find border controls and quarantining must become common practice in order to stop future pandemics from spreading around the globe. Restricting entry to countries is essential for stopping COVID and further health crises, the study authors argue.
Comprehensive case finding, repeat testing to rule out false results, apps, and the use of GPS data to enable contact tracing and self-isolation will also be essential. Scientists add people should also receive financial support to make it easier to adhere to these regulations.
The report is based on a review of 118 studies covering the periods May 2019 to May 2020, June 2020, and January 2021, respectively. The review identified the best strategies for a successful FTTIS (find, test, trace, isolate, and support) to rapidly control outbreaks.
“Interrupting transmission of COVID-19 has depended on rapid isolation of infected individuals,” lead author Dr. Sheng-Chia Chung and the team writes in the journal BMJ Open.
“For this to happen, a complex set of co-ordinated elements must be implemented to find potential cases, either by identifying those who have symptoms or examination of individuals at risk, test to confirm the presence of infection, trace contacts, isolate those infected and their contacts and support those in isolation to reduce the risk that they will breach any restrictions.”
Healthcare workers need the most protections
Various elements of an FTTIS system have long been core elements of public health. However, COVID infections have specific characteristics, such as silent transmission and a “strong age gradient in disease severity,” that remain poorly understood. Researchers hope the study will improve the design and implementation of current systems.
Study authors systematically reviewed international studies which evaluated contact tracing, testing, self-isolation, and quarantine on COVID-19 management. Optimum strategies to control pandemics early on included border controls, restricted entry, and inbound traveler quarantines.
The study finds those most at risk, such as healthcare workers and care home residents, should be tested. Existing laboratory networks should also be repurposed and new testing sites created to meet demand. From there, pooled and repeated testing can help improve efficiency and minimize false negative results.
“We identified in our systematic review the core elements for an effective FTTIS system necessary to interrupt the spread of a novel infectious disease, as in the COVID-19 pandemic,” study authors write.
The researchers believe timely and adequate information reduces uncertainty and anxiety during widespread emergencies.
“Support for mental or physical health and livelihood is needed for individuals undergoing self-isolation/quarantine,” Dr. Chung’s team continues. “An integrated system with rolling-wave planning can best use effective FTTIS tools to respond to the fast-changing COVID-19 pandemic.”
Local and nation governments need to work seamlessly
The report notes all components need to be seamlessly integrated and health service data at local, regional, and national level — linked through real-time data sharing and dashboards. Regular press conferences by the central outbreak control team should update the public on the progress of the pandemic, changes in policies, and to correct misinformation. There should also be open and balanced discussions on public concerns, such as personal data privacy, protection, and curbs on personal freedoms for the public good.
“This comprehensive systematic review identified effective strategies for a successful FTTIS system to interrupt the spread of a novel infectious disease,” researchers conclude. “These include border controls, restricted entry, inbound traveler quarantine and screening for case finding; repeated testing to minimize false diagnoses and pooled testing in resource-limited circumstances; extended quarantine period and the use of digital tools for contact tracing and self-isolation. Our findings can inform policy in future pandemics,” conclude the researchers. And they “may inform countries considering implementing these measures.”
SWNS writer Mark Waghorn contributed to this report.