COVID-19: International traffic and a perspective on numbers

The World Health Organisation has warned that restricting the movement of people and goods during public health emergencies is "ineffective in most situations and may divert resources from other interventions".

It says restrictions interrupt aid and technical support, disrupt businesses and can have negative economic effects, but that travel bans to affected areas or denial of entry to passengers coming from affected areas are "usually not effective in preventing the importation of cases".

Since the declaration by the organisation of a public health emergency of international concern in relation to COVID-19, 38 countries have reported additional health measures that significantly interfere with international traffic in relation to travel to and from China or other countries -- from denial of entry of passengers, visa restrictions or quarantine for returning travellers. And now, several countries that denied entry of travellers or which suspended flights to and from China or other affected countries are reporting cases of the virus.

"Travel measures that significantly interfere with international traffic may only be justified at the beginning of an outbreak, as they may allow countries to gain time, even if only a few days, to rapidly implement effective preparedness measures," WHO stated, adding that such restrictions must be based on "a careful risk assessment, be proportionate to the public health risk, be short in duration, and be reconsidered regularly as the situation evolves".

None of this suggests that the organisation has changed its policy of advising those who are unwell to self isolate -- an obvious and simple strategy, if not always practical.

The current coronavirus outbreak has not been named a pandemic. But acknowledging the fact that it costs less to prepare than it does to respond, many organisations are reviewing pandemic plans as a precaution, with daily briefings the norm for multinational companies, and attention now turning to network access for remote workers.

The numbers in perspective

There are about 1 billion cases of seasonal influenza every year, of which 3 to 5 million are severe, with 290,000 to 650,000 influenza-related respiratory deaths worldwide. Head of assistance at Traveller Assist, Danny Kaine, says it's important to keep perspective.

A qualified Critical Care Paramedic and a graduate of Harvard Medical School's Preventing the Next Pandemic' programme, Kaine was on the ground in Sierra Leone in 2014 during the outbreak of Ebola and has also coordinated several complex medical evacuations for Lassa fever and SARS patients.

"Over the years, I have also personally contracted West Nile virus, Zika and Malaria due to operating in complex regions, at short notice, for long periods of time...Coronavirus, while highly infectious, is reported to have a low fatality rate, with a mortality rate of only 2%, compared with SARS, which had a mortality rate of 9.6%, Lassa at 10-20% and Ebola at 50%."

The year 1918 saw the most devastating infectious disease event in recorded history, since which time three influenza pandemics have occurred - in 1957, 1968 and 2009 (H1N1).

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