Britain could never eradicate Covid-19 — even if it banned all international travel, top experts believe.
Professor Paul Hunter, an infectious disease specialist based at the University of East Anglia, insisted closing the borders would not have stopped the crisis taking hold in the UK.
Research suggests the coronavirus was already spreading between Britons before it was formally recognised as a threat in February, by which time it would have been too late to crack down.
And imposing one now would ‘do nothing to affect the current epidemic’, according to Professor Hunter, other than potentially prevent localised outbreaks caused by a ‘patient zero’ who caught the virus while abroad.
Experts have admitted the disease will be around ‘forever’, even if a vaccine is found, because it is so established now. But disease is likely to become milder over time as people develop some immunity towards it.
Some scientists believe ‘Zero Covid’ — a strategy which aims for elimination of the coronavirus — can be achieved by limiting international travel. But ministers were told by scientific advisers early on that blocking travel was ‘really not worth trying to do’ unless the measures were ‘extremely draconian’.
Now Britons are allowed to go on holidays again but must quarantine for 14 days if they go to a country with high cases, such as Italy.
Lifting of travel bans was blamed for local outbreaks in the UK in the summer, such as a cluster of up to 30 cases in Cardiff linked to youngsters flying home from the party island of Zante, Greece, in August.
And one of the Government’s own top experts knows that banning travel does not work and only delays an inevitable crisis. Professor Jonathan Van Tam, who worked with the Government agency Public Health England (PHE), found that at least 90 per cent of air travel would need to stop in order to make a difference.
Britain could never eradicate Covid-19 — even if it banned all international travel, top experts believe. Pictured: A public health message on an arrival board at Heathrow Airport, July
The Government was adamant to keep travel corridors open, making it an outlier compared to the rest of the world. Pictured, passengers are welcomed back to Sydney from New Zealand in October after border rules in Australia were relaxed
A pre-departure rapid Covid-19 testing facility was launched at Heathrow Airport on Tuesday with the aim of boosting confidence in Britons to travel again
Several top scientists have backed a Zero Covid strategy, which aims to eliminate the virus in a region or country rather than just suppress it.
Professor Martin McKee, of London School of Hygiene and Tropical Medicine, says Zero Covid is ‘definitely’ possible in the UK.
He was the co-author of a paper published in the Lancet back in September, which concluded: ‘The argument is strong for countries adopting a so-called zero-Covid strategy, which aims to eliminate domestic transmission.’
DEATHS IN THE UK COMPARED TO COUNTRIES WHICH IMPOSED TRAVEL BANS
Population – 66million
Deaths – 44,347
Deaths per million – 647
Passengers from Hubei Province in China, certain areas of South Korea, Iran and later Italy, were asked to self-isolate for 14 days on arrival in February and March.
On 13 March, self-isolation advice for international arrivals was ended for those not displaying symptoms. The Government told anyone in the UK with symptoms they had to self isolate if they had a fever or continuous cough.
On 17 March, the Foreign Office warned UK nationals against all non-essential travel worldwide for 30 days, which was later extended to ‘indefinitely’.
Mandatory two-week quarantine rules were introduced in June for all travellers to the UK unless a country was on the exempt list, known as a ‘travel corridor’.
Population – 4.8million
Deaths – 25
Deaths per million – five
On March 19, New Zealand shut its borders to all non-citizens or permanent residents – except for spouses or children under 24.
Population – 25million
Deaths – 905
Deaths per million – 35
Australia followed New Zealand in closing its borders to all non-citizens or permanent residents on March 20, when it had recorded less than 1,000 cases.
Population – 8.8million
Deaths – 927
Deaths per million – 103
On March 17, Austria began turning away anyone from Italy, China’s Hubei Province, Iran, and South Korea, unless they had a medical certificate confirming negative test for SARS-CoV-2 in the last four days.
Population – 5.8million
Deaths – 688
Deaths per million – 118
Denmark closed its borders to all non-citizens 14 March, apart from travellers with ‘credible purpose’ such as non-citizen Danish residents.
Population – 5.4million
Deaths – 278
Deaths per million – 51
Norway introduced a nationwide travel ban on travellers entering the country on March 16, when cases reached the 400 mark.
A group of MPs and peers have since urged the Government to pursue a Zero Covid strategy in England — but have not suggested banning travel and instead ensuring a robust test and trace system.
Meanwhile, Independent SAGE – a self-appointed group of experts offering advice on policy – said Zero Covid would entail restricting foreign holidays and travel in an attempt to totally eliminate coronavirus, rather than just restricting it.
But some scientists say elimination of the coronavirus, which has been spreading for at least nine months now in Britain, is not possible, and that banning travel would not change that.
Professor Hunter told MailOnline border closures now would essentially be a waste of time because Covid-19 is so well established in the UK.
The Government is recording almost 20,000 cases per day, but surveillance schemes, which give a clearer idea of the outbreak size, say the true number of infections could be as high as 28,000 a day.
Professor Hunter said: ‘Closing our borders now whilst we have one of the highest attack rates in Europe will do nothing to affect the current epidemic.
‘There have been reports of people bringing back the infection after holidaying abroad this summer, and sometimes these have led to local clusters of secondary infection and this may well have contributed somewhat to the epidemic.’
But he said this will not have really driven the current surge because of how widespread the infection already is.
For example, England has a weekly infection rate of 205 cases per 100,000 — ten times higher than its own threshold of 20 cases per 100,000 for a country to be put on the ‘quarantine’ list. Italy’s is 140.
Even at the start of the crisis, Professor Hunter said: ‘I don’t think closing our borders would have done much at all.
‘Remember that in February we were all still not totally sure that Covid-19 would be the disaster it has become. By the time we realised it, it was too late, community transmission was happening and would progress whatever we did with our borders.
‘The thing about border closures is that they have to be so amazingly effective and implemented before any community transmission or they have to be combined with a really effective internal control lockdown strategy.’
Data shows countries that introduced travel bans have fared better in the coronavirus pandemic so far, suggesting the UK could have reduced deaths if it acted sooner.
Australia and New Zealand acted rapidly to close borders once cases were detected on their land. Their death tolls per million people (35 and five) are staggeringly lower than the UK, at 647.
In Europe, Norway and Denmark closed their borders to all non-citizens by March 13, within two weeks of recording their first cases of the virus. Both countries have recorded just 51 and 118 deaths per million people, respectively.
On March 15, Austria, with 103 deaths per million, started refusing entry to anyone without a medical certificate confirming they had tested negative for the virus within the last four days. Travellers who could not provide proof were placed in mandatory quarantine for 14 days.
But there are a number of other factors that help explain why some countries have come out the first wave of Covid-19 relatively unscathed, including lower population density, lower age demographics, better testing and health care infrastructure.
However, Professor Hunter noted that one of the Government’s own top experts – Professor Jonathan Van Tam – says travel bans are not worthwhile.
Professor Van-Tam, a leading face rolled out by No 10 in the battle against Covid-19, has previously shown a viral disease cannot be controlled with travel restrictions.
He and colleagues at PHE, which is being scrapped after reports ministers were frustrated with its performance during the pandemic, assessed the effectiveness of travel restrictions to contain influenza strains with pandemic potential.
Despite the study being based on flu transmission, experts believe the findings will apply to Covid-19, which is also spread via droplets from coughing and sneezing.
The review of 23 studies conducted in 2014 incorporated data collected during the 2009 pandemic, when some countries restricted travel as one of several strategies to crack down on swine flu – formally known as A(H1N1).
Although the review, published by the World Health Organization, showed some benefit of travel restrictions, Professor Van-Tam and colleagues concluded: ‘Overall [they] have only limited effectiveness in the prevention of influenza spread’.
This was particularly true in countries where the strain of virus was able to spread fast – when R0 ‘is at least 1.9’, the paper said.
Other countries have been stricter with their travel policies during the coronavirus crisis, including screening of arrivals and compulsory quarantining
Professor Jonathan Van Tam, who worked with the Government agency Public Health England (PHE), found in 2014 that at least 90 per cent of air travel would need to stop in order to make a difference. The Government expert said banning international travel does not stop a pandemic, it only delays an inevitable crisis.
The R0 — the reproduction number — is the average number of people an infected patient passes a disease on to. It can be drastically reduced with restrictions that cut social interaction, such as a lockdown.
For instance Covid-19, caused by the virus SARS-Cov-2, has a natural R rate of around 2.5. That’s around twice as high as flu, at 1.3, but nowhere near as high as measles, at around 12 to 18.
But the R rate dropped to below 1 with the Government’s blanket restrictions in March that limited social contact between people. It has risen to around 1.5 this October.
One systematic review looked at by Professor Van-Tam and colleagues found that extensive air travel restrictions – of more than 90 per cent – were ineffective if influenza strains had an RO of more than 2.4.
The study showed a country would have to stop almost all travel into its country if it wanted to try and reduce the magnitude of a pandemic.
But travel restrictions of any stringency would not prevent a pandemic in any given country and only delay the inevitable by up to three or four weeks, the study ruled.
In one review, it was estimated that introduction of a pandemic strain of influenza into the UK could be delayed by up to two months if there was a 99.9 per cent ban on air travel.
The size of the effect was considerably reduced, to just one or two weeks, if the level of restriction was lowered to 90 per cent.
For reference, before Covid-19 Britain would see around 11million people fly into airports in a summer month, according to the Government. Cutting it by 99.9 per cent would mean letting only 11,000 people in.
In January this year, before Covid-19 had took hold in Britain, there were 7million air passengers into the UK. This would have been only 7,000 with a significant travel ban.
Government data shows the number of travellers into the UK by air dropped by 99.9 per cent in April, May and June without the need to enforce a ban. But this did not save the UK from suffering one of the worst Covid-19 outbreaks in Europe.
Government data shows the number of travellers into the UK by air dropped by 99.9 per cent in April, May and June compared to 2019 without the need to enforce a ban. But this did not save the UK from suffering one of the worst Covid-19 outbreaks in Europe
How the UK’s death toll (per million people) compares to countries which banned travel in the early stages of the pandemic
How the UK’s cumulative cases (per million people) compares to countries which banned travel in the early stages of the pandemic
Despite New Zealand being hailed for its case elimination success in June, the country has since recorded a number of outbreaks. Professor Hunter told MailOnline cases would inevitably go up in New Zealand because of lockdown measures being lifted, allowing the virus room to spread in a population who have barely any immunity against it
One study in Professor Van-Tam’s review showed restricting air travel by 95 per cent could delay a pandemic in the US by two or three weeks if the virus originated in Hong Kong, which is situated just next door to where Covid-19 was found in China.
Several countries were quick to shut borders to some or all countries, including the US. But it did not stop coronavirus from popping up – the US has the one of the highest cases per capita in the world.
The review said international travel bans would have ‘minimal impact’ on reducing attack rates – the proportion of people who end up getting the virus in a disease-free population.
HOW CAN COVID-19 BE ELIMINATED AND WHO IS CALLING FOR IT?
Several scientists have backed a Zero Covid strategy, which aims to eliminate the virus in a region or country rather than just suppress it.
The fundamental parts of the approach include stricter checks on international travel or border closures.
It also includes a support system for people who are in isolation, more powers to local governments and councils to monitor local outbreaks, and a robust test and trace system.
Adopting a ‘zero-Covid’ strategy like in New Zealand should be considered by governments around the world, an international team said in September.
In a review published in the journal Lancet, a team of international experts outlined the key lessons learned from experiences of other countries in tackling the disease.
The authors wrote: ‘The argument is strong for countries adopting a so-called zero-Covid strategy, which aims to eliminate domestic transmission.
‘The New Zealand experience shows that this strategy is challenging but is an important aspiration, not least as the growing burden of so-called long Covid becomes apparent in people who have survived Covid-19 but continue to have symptoms for longer than expected.’
A group of MPs and urged the Government to pursue a Zero Covid strategy in England, but have not suggested banning travel.
The All-Party Parliamentary Group (APPG) on coronavirus, chaired by Lib Dem MP Layla Morgan, wrote to Boris Johnson with its recommendation in August.
Ms Morgan said the Government had ‘failed abysmally to put a clear strategy in place to eliminate coronavirus from the UK’.
Some elements of the Independent SAGE group’s recommendations for Zero Covid are already in place, such as encouraging people to socialise outdoors and to work from home.
But the appointed group of experts, who offer advice on policy, have said Zero Covid would entail Britain restricting foreign holidays and travel – which the British government have always been hesitant to do.
It would reduce by less than 0.02 per cent – the equivalent of only 162 diagnosed cases in the UK.
And it would not possible to reduce the attack rate if the flu strain had a high level of infectiousness, as does SARS-Cov-2.
In the review, Professor Van-Tam and his team said intensive travel bans would ‘clearly’ have negative economic impacts.
This has been the case for the aviation industry during the Covid-19 pandemic, in which non-essential travel came to a standstill due to lockdowns.
Thousands of workers have lost their jobs as a result of the travel industry shrinking, with firms from British Airways (12,000) to Ryanair (3,000) making cuts.
The findings could have directed the UK Government’s response to the coronavirus.
SAGE, which gives research to ministers in order to help them guide policy, told ministers in March the ban on travel was worthless unless it was extremely strict, Sir Patrick Vallance, the chief scientific adviser, revealed in May.
The Government was adamant to keep travel corridors open, making it an outlier compared to the rest of the world.
The Home Affairs committee has since conceded a lack of border measures earlier in the pandemic was a ‘serious mistake’.
Professor Hunter said eradication of a virus ‘probably only works in island countries that can really close all travel’.
The only country to have claimed ‘eliminated transmission’ of the coronavirus was New Zealand in June, which went three weeks without a case.
The island, home to 4.8million people, stopped flights on March 19 under Prime Minister Jacinda Ardern’s orders, less than a month after the first case was detected there on February 26.
But despite being hailed for its case elimination success, the country has since recorded a number of outbreaks.
Cases in the double figures were being diagnosed in August due to an outbreak in Auckland after no locally transmitted in cases across the country for more than three months. It was thought to be caused by a family returning from abroad.
A new outbreak is emerging now after 25 cases were diagnosed on October 21, the highest daily figure since April. The cases are linked to Russian and Ukraine fishing crews who had arrived on a charter flight from Moscow days earlier.
Professor Hunter told MailOnline cases would inevitably go up in New Zealand because of lockdown measures being lifted, allowing the virus room to spread in a population who have barely any immunity against it.
He added: ‘I think it is likely that the virus will be around for decades and infect people multiple times over their lifespan.
‘However, because of residual immunity from prior infections or immunization, the disease will become far less severe and probably start to resemble to common cold.
‘This probably was what happened with a couple of other betacoronaviruses, with the thrilling names of OC43 and HKU1.’
OC43 and HKU1 are strains of the coronavirus family which cause a large proportion of common colds. They were only discovered in the past 100 years.
The other known coronaviruses that infect humans are HCoV-229E, HCoV-NL63 and the more serious strains SARS-CoV-2, SARS-1, and MERS – which have caused epidemics in the past decade.
Dr Simon Clarke, associate professor of cellular microbiology at the University of Reading, also said: ‘If a working vaccine is available sooner rather than later, and New Zealanders can be immunised quickly and en masse, it will look like a great policy.
‘However, if vaccines aren’t available fast enough, New Zealand will increasingly be vulnerable to infection from abroad, and will have to maintain costly global isolation to protect its public.’
Other scientists who have waded in on the Zero Covid strategy say it has its clear disadvantages.
Dr Kathleen O’Reilly, assistant professor in infectious disease epidemiology at the London School of Hygiene and Tropical Medicine, told The i in July: ‘To provide advice to the Government that elimination should be the goal is commendable.
‘However, the Government also needs sound advice on whether elimination is feasible, and what the disadvantages might be.’
‘As a country we are barely six months into experiencing Covid-19, vaccines are being trialled but the safety and efficacy of the vaccines still need to be assessed.
‘It is still too early in this pandemic to know whether the UK could eliminate the virus.