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Kurita J, Iwasaki Y. Effect of Long-Distance Domestic Travel Ban Policies in Japan on COVID-19 Outbreak Dynamics During Dominance of the Ancestral Strain: Ex Post Facto Retrospective Observation Study. Online J Public Health Inform 2024; 16:e44931. [PMID: 38648635 PMCID: PMC11037452 DOI: 10.2196/44931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 09/08/2023] [Accepted: 12/27/2023] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND In Japan, long-distance domestic travel was banned while the ancestral SARS-CoV-2 strain was dominant under the first declared state of emergency from March 2020 until the end of May 2020. Subsequently, the "Go To Travel" campaign travel subsidy policy was activated, allowing long-distance domestic travel, until the second state of emergency as of January 7, 2021. The effects of this long-distance domestic travel ban on SARS-CoV-2 infectivity have not been adequately evaluated. OBJECTIVE We evaluated the effects of the long-distance domestic travel ban in Japan on SARS-CoV-2 infectivity, considering climate conditions, mobility, and countermeasures such as the "Go To Travel" campaign and emergency status. METHODS We calculated the effective reproduction number R(t), representing infectivity, using the epidemic curve in Kagoshima prefecture based on the empirical distribution of the incubation period and procedurally delayed reporting from an earlier study. Kagoshima prefecture, in southern Japan, has several resorts, with an airport commonly used for transportation to Tokyo or Osaka. We regressed R(t) on the number of long-distance domestic travelers (based on the number of airport limousine bus users provided by the operating company), temperature, humidity, mobility, and countermeasures such as state of emergency declarations and the "Go To Travel" campaign in Kagoshima. The study period was June 20, 2020, through February 2021, before variant strains became dominant. A second state of emergency was not declared in Kagoshima prefecture but was declared in major cities such as Tokyo and Osaka. RESULTS Estimation results indicated a pattern of declining infectivity with reduced long-distance domestic travel volumes as measured by the number of airport limousine bus users. Moreover, infectivity was lower during the "Go To Travel" campaign and the second state of emergency. Regarding mobility, going to restaurants, shopping malls, and amusement venues was associated with increased infectivity. However, going to grocery stores and pharmacies was associated with decreased infectivity. Climate conditions showed no significant association with infectivity patterns. CONCLUSIONS The results of this retrospective analysis suggest that the volume of long-distance domestic travel might reduce SARS-CoV-2 infectivity. Infectivity was lower during the "Go To Travel" campaign period, during which long-distance domestic travel was promoted, compared to that outside this campaign period. These findings suggest that policies banning long-distance domestic travel had little legitimacy or rationale. Long-distance domestic travel with appropriate infection control measures might not increase SARS-CoV-2 infectivity in tourist areas. Even though this analysis was performed much later than the study period, if we had performed this study focusing on the period of April or May 2021, it would likely yield the same results. These findings might be helpful for government decision-making in considering restarting a "Go To Travel" campaign in light of evidence-based policy.
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Affiliation(s)
- Junko Kurita
- Department of Nursing, Faculty of Sports & Health Science, Daitobunka University, Higashimatsuyama-shi, Japan
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Kakulu RK, Kimaro EG, Mpolya EA. Effectiveness of Point of Entry Health Screening Measures among Travelers in the Detection and Containment of the International Spread of COVID-19: A Review of the Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:410. [PMID: 38673323 PMCID: PMC11049967 DOI: 10.3390/ijerph21040410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 04/28/2024]
Abstract
COVID-19 remains a communicable disease with the capacity to cause substantial damage to health and health systems. Enhanced health screening at points of entry (POEs) is a public health measure implemented to support early detection, prevention and response to communicable diseases, such as COVID-19. The purpose of this study was to review the available evidence on the effectiveness of POE health screening in the detection and containment of the COVID-19 pandemic. This study was registered under PROSPERO and followed PRISMA guidelines in which the literature between 2019 and 2022 was retrieved from Scopus, PubMed, Web of Science, Global Health, CINAHL, Embase, Google Scholar and international organizations. A total of 33,744 articles were screened for eligibility, from which 43 met the inclusion criteria. The modeling studies predicted POE screening able to detect COVID-19 in a range of 8.8% to 99.6%, while observational studies indicated a detection rate of 2% to 77.9%, including variants of concern depending on the screening method employed. The literature also indicated these measures can delay onset of the epidemic by 7 to 32 days. Based on our review findings, if POE screening measures are implemented in combination with other public health interventions such as rapid tests, they may help detect and reduce the spread of COVID-19.
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Affiliation(s)
- Remidius Kamuhabwa Kakulu
- Department of Health and Biomedical Sciences, School of Life Science and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), Arusha P.O. Box 447, Tanzania; (E.G.K.); (E.A.M.)
- Department of Preventive Services, Ministry of Health, Dodoma P.O. Box 743, Tanzania
| | - Esther Gwae Kimaro
- Department of Health and Biomedical Sciences, School of Life Science and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), Arusha P.O. Box 447, Tanzania; (E.G.K.); (E.A.M.)
| | - Emmanuel Abraham Mpolya
- Department of Health and Biomedical Sciences, School of Life Science and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), Arusha P.O. Box 447, Tanzania; (E.G.K.); (E.A.M.)
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow G12 8QQ, UK
- Center for Global Health (CGH), Perelman School of Medicine University of Pennsylvania, 240 John Morgan Bldg., 3620 Hamilton Walk, Philadelphia, PA 19104, USA
- Institute for Health Metrics and Evaluation (IHME), Population Health Building/Hans Rosling Center, 3980 15th Ave. NE, Seattle, WA 98195, USA
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Li Z, Yang B, Wang J, Wen Y, Xu J, Ling L, Wang T. Global border restrictions in 2020-2021: Adherence and the effectiveness in long-term COVID-19 epidemic control. Travel Med Infect Dis 2023; 52:102556. [PMID: 36805032 PMCID: PMC9946459 DOI: 10.1016/j.tmaid.2023.102556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/05/2022] [Accepted: 02/15/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Restrictions on international travel were widely applied to contain cross-border COVID-19 diffusion, while such applications varied globally, and little was known about their impacts on the long-term epidemic progression. METHODS We explored the global diversity in maintaining border policies classified to four levels (screening, quarantine, ban on regions and total border closure) using data of 185 countries and regions between 01 January 2020 to 31 December 2021. By using Ordinary least squares (OLS) regression and quantile regression (QR) models, we examined the relationship between total COVID-19 incidence and the cumulative duration of each policy level in 2020-2021, and the heterogeneity of such association across different transmission severity countries. RESULTS Firstly, "ban on regions" was the most durable policy applied in high-income countries, while in low-income countries, less stringent measures of screening and quarantine arrivals were applied the longest. Secondly, the cumulatively longer maintenance of the border quarantine was significantly associated with lower infections (log) in COVID-19 high-prevalent countries (75th QR, coefficient estimates [β] = -0.0038, 95% confidence interval: -0.0066 to -0.0010). By contrast, in medium and high transmission severity countries, those with longer duration of imposing bans on regions showed no suppressing effects but significantly higher COVID-19 incidence (OLS regression, β = 0.0028, 95% CI: 0.0009-0.0047; 75th QR, β = 0.0039, 95% CI: 0.0014-0.0063). No other significant results were found. CONCLUSION From the long-term perspective, inbound quarantine was effective in mitigating severe epidemics. However, in countries with medium or high COVID-19 prevalence, our findings of ban on regions highlighted its ineffectiveness in the long-term epidemic progression.
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Affiliation(s)
- Zhiyao Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, PR China; Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, Taiyuan, 030001, PR China
| | - Boran Yang
- Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, Taiyuan, 030001, PR China
| | - Jiale Wang
- Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, Taiyuan, 030001, PR China
| | - Yanchao Wen
- Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, Taiyuan, 030001, PR China
| | - Jianguo Xu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, PR China; Institute of Public Health, Nankai University, Tianjing, 300350, PR China
| | - Li Ling
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, PR China; Clinical research design division, Clinical research center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510080, PR China.
| | - Tong Wang
- Department of Health Statistics and Epidemiology, School of Public Health, Collaborative Innovation Center of Reverse Microbial Etiology, Shanxi Medical University, Taiyuan, 030001, PR China; Shanxi Provincial Key Laboratory of Major Infectious Disease Pandemic Response, Taiyuan, 030001, PR China.
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Miller MB, Ooi EE, Rhoads DD, Kulldorff M, Anderson DE, Lee H, Gupta S, Mel K. As Omicron Takes Hold and Other New Variants Arise, COVID-19 Testing Remains the Universally Agreed Tool to Effect Transition From Pandemic to Endemic State. Front Public Health 2022; 10:883066. [PMID: 35602143 PMCID: PMC9121917 DOI: 10.3389/fpubh.2022.883066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has caused more than 448 million cases and 6 million deaths worldwide to date. Omicron is now the dominant SARS-CoV-2 variant, making up more than 90% of cases in countries reporting sequencing data. As the pandemic continues into its third year, continued testing is a strategic and necessary tool for transitioning to an endemic state of COVID-19. Here, we address three critical topics pertaining to the transition from pandemic to endemic: defining the endemic state for COVID-19, highlighting the role of SARS-CoV-2 testing as endemicity is approached, and recommending parameters for SARS-CoV-2 testing once endemicity is reached. We argue for an approach that capitalizes on the current public health momentum to increase capacity for PCR-based testing and whole genome sequencing to monitor emerging infectious diseases. Strategic development and utilization of testing, including viral panels in addition to vaccination, can keep SARS-CoV-2 in a manageable endemic state and build a framework of preparedness for the next pandemic.
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Affiliation(s)
- Melissa B Miller
- Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Eng Eong Ooi
- Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore.,Viral Research and Experimental Medicine Centre, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Daniel D Rhoads
- Department of Pathology, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, United States.,Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, United States
| | - Martin Kulldorff
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Danielle E Anderson
- Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Hyukmin Lee
- Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sunetra Gupta
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Krajden Mel
- British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, BC, Canada
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