Infectious Disease

The variants will proceed to unfold regardless of journey restrictions

February 05, 2021

3 min read

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Adalja and Marrazzo do not report any relevant financial information.

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Last week, President Joseph R. Biden Jr. signed an order suspending entry to the United States for non-citizens traveling within 14 days of their stay in South Africa.

Biden also reintroduced restrictions on travelers from Brazil, the United Kingdom – excluding overseas territories – Ireland and an area of ​​Europe with 26 countries to the US.

Amesh A. Adalja

Jeanne Marrazzo

In announcing the newly signed restrictions, the White House cited concerns about the variants of SARS-CoV-2 first detected in Brazil, South Africa and the UK, which raised concerns about the vaccine’s effectiveness.

Experts have discussed the usefulness of travel restrictions in controlling the spread of pathogens, stating that history has shown that they are ineffective and sometimes even counterproductive, although they acknowledge that sometimes they may be necessary.

Amesh A. Adalja, MD, A senior scientist at the Johns Hopkins Center for Health Security said it was important to remember that “despite travel restrictions, the variants are spreading across the United States and we shouldn’t get a false sense of security from doing these things.”

“I think a distinction has to be made between travel bans and travel restrictions,” Adalja told Healio. “For example, we have the test technology to make traveling relatively COVID-19-free. It just has to be implemented – at the gate.”

Jeanne Marrazzo, MD, MPH, FACP, FIDSA, The Director of the Department of Infectious Diseases and Endowed Chair of Infectious Diseases at the University of Alabama at the Birmingham School of Medicine said travel restrictions can and do work.

“Timing is everything, though,” said Marrazzo, who is also a member of the editorial board of Infectious Diseases News. The effectiveness of such restrictions depends on accurately identifying travelers who pose a real risk, she said.

“COVID-19 poses a particular challenge as at least half – and possibly more – of all transmissions come from people who are infected but do not know – either they have no symptoms or they do not recognize them as regards COVID,” said Marrazzo. “For this reason, it might be effective to apply travel bans broadly to a region that is believed to be the source of a particular problem.”

It is believed that the emerging variants are more transmissible and can bypass the immunity produced by natural infections or vaccinations.

Researchers have predicted that variant B.1.1.7, discovered in the UK, could be the dominant SARS-CoV-2 virus in the US by March. The variant spreads easier and faster than other variants, according to the CDC, and experts in the UK have reported that it may be linked to an increased risk of death, although more studies are needed to confirm this.

The B.1.351 variant, first identified in South Africa, is the most worrisome director of the National Institute of Allergy and Infectious Diseases Anthony S. Fauci, MD, and other experts have said. The variant first identified in Brazil is known as P.1. All three were discovered in the US, according to the CDC, although it is unclear how widespread they are.

According to Marrazzo, experts believe that the window of opportunity has closed to prevent variants from entering the US or spiraling out of control. She said travel bans could prevent even more variants from being imported, which could potentially arise in response to various pressures. “However, this is very theoretical at this point and the overall effect of such bans – including the human, social and economic implications – needs careful consideration,” she said.

Separately, Marrazzo said it was important that the US step up its efforts to monitor or not monitor emerging travel restrictions on variants.

“The only reason we even knew about strain B.1.1.7 is because the UK has one of the most aggressive and sophisticated approaches to sampling and sequencing – if not most – in the world. We don’t have anything in the US at the moment like in many other countries, ”said Marrazzo. “The only way to record the emergence of these and new variants is to set up a system that knows what to expect. If necessary, travel bans should be informed on the basis of this data.”

References:

CDC. New COVID-19 variants. https://www.cdc.gov/coronavirus/2019-ncov/transmission/variant.html. Accessed February 4, 2021.

The White House. Proclamation suspending the entry of certain other persons at risk for the transmission of coronavirus disease, both immigrants and non-immigrants. https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/25/proclamation-on-the-suspension-of-entry-as-immigrants-and-non-immigrants-of-certain- additional people at risk of spreading coronavirus disease. Accessed February 4, 2021.

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