Government AffairsOtherwise, governments will turn to default “shut borders” mode in absence of “scientific, calibrated approach”, says infectious diseases expert Dr Paul Tambyah.

Travel must work with medicine to prevent another lockdown

Dr Paul Tambyah: Travel must work with medicine to prevent being taken hostage in next pandemic.
Dr Paul Tambyah: Travel must work with medicine to prevent being taken hostage in next pandemic.

Governments will go to default “shut borders” mode in absence of “scientific, calibrated approach”, argues president-elect of International Society of Infectious Diseases.

The travel industry needs to take a more proactive approach to managing future pandemics because even if WHO declares an end to the Covid-19 pandemic by or towards the end of the third quarter, the next one is just around the corner and the industry cannot afford for the default response from governments to be “let’s shut down borders”.

Singapore-based infectious disease expert Dr Paul Tambyah said that unless the industry works with the medical fraternity to come up with a scientific, calibrated approach to give confidence to governments, that will become the default mode, given the success seen in countries like New Zealand and Australia that implemented sharp lockdowns over isolated cases.

In a recent podcast by WiT, National University of Singapore professor, Dr Tambyah, who is president-elect of the International Society of Infectious Diseases (ISID), said, “The travel industry has been relatively passive right now… they’re just taking what comes from the scientists, from the WHO, from the US CDC and various other agencies. But I think it’s reached the point where the travel industry has been hit so bad by this…

“The WHO, to this day on its website, says we do not recommend any travel restrictions. And nobody believes that.”

He said international agencies need to communicate with each other, suggesting that IATA gets together with WHO, which controls the yellow fever vaccination certificate, and work out a safe, digital version of the yellow book which has been around a long time and has been proven to work.

In March, he and several colleagues published an article urging for the use of the WHO International Certificate of Vaccination in the International Journal of Infectious Diseases.

“Vaccination requirements have been in place for a long time in many countries and regions, and the most notable of those is the yellow fever vaccination requirement. It’s mandatory under the International Health Regulations for travel from parts of Africa and Latin America to have a yellow fever vaccination certificate before they can leave those countries.”

Singapore in particular is vulnerable “and the reason is that the mosquito that spreads yellow fever is the same mosquito that spreads dengue. And dengue is widespread across Southeast Asia. So if yellow fever were to be introduced in Southeast Asia… it could be devastating.

“The death rate from yellow fever is really high, but that hasn’t happened. People thought it would happen 50 years ago, but with a good vaccine, and a good screening regime, we haven’t had that problem. So there is a precedent. We just need to look at the existing structures and the mechanisms that are already in place, and try and strengthen them, rather than try and present this as something new and something oppressive and whatnot.”

He said IATA and WHO could agree to look at all the different apps out there and say, “let’s have an internationally recognised app, and let’s get it monitored in in Beijing and in Washington or Seattle, or wherever it is, then it’s something that the whole world can trust, because people who don’t trust China will trust the US and people who don’t trust the US will trust China.

“It’s something that the international agencies need to get together on. And they need to take the lead — the trouble is that now everybody goes private and private is just a bit of a cowboy kind of world out there. It is a situation where you have to have an internationally recognised regulator step in.”

He said it was time for the travel industry to step up and fund its own research. “The industry has to really come up with its own set of questions that they need answered by the scientific community and obviously fund targeted research, and provide good solid data, which will allow governments to make decisions with confidence.

“…the travel industry depends on people moving from place A to place B, and if this cannot be done safely, and if the knee jerk response of governments and international agencies is just to shut the borders, then then you’re going to be held hostage to what’s going to happen.”

Unfortunately, “the way it’s been portrayed in the media is, if something new comes up, that’s potentially deadly, then you have to shut down… And because we don’t have that kind of calibrated or scientific approach which I think can happen, but it’s not going to happen yet because we haven’t got our act together as a scientific community integrated with the travel community…”

Other key takeaways from the interview:

• The role of vaccinations in opening borders: All eyes on the US

“Somebody needs to take the first step. The good news is the United States is slowly becoming the world thought leader again. And the US CDC just last week announced that if you are fully vaccinated, you don’t need to quarantine, if you’re returning from overseas, and you come back to the United States. And for domestic travel, you don’t need to quarantine either.

“So the rest of the world is going to watch and see what happens in the United States.”

• Do you have to get vaccinated before you can travel?

“Yes, that’s the sad reality. Governments will respond to this … right now, the vaccine is free in Singapore, and in many other countries. So it’s not a matter of whether you can afford it or not, it’s a matter of whether you get access to the queue. And it’s the same for example, with the pilgrimage in Saudi… everybody who goes there has to get meningitis vaccine and influenza vaccine. What countries do is that they organise mass vaccinations or campaigns and bulk purchase and discount so they try and mitigate the inequality or the discrepancy that will naturally arise when you put in a vaccine requirement.”

• How about families with kids – where the parents are vaccinated and the kids are not?

“This is going to be a huge problem. Both Pfizer and Madonna are pushing very aggressively to get the vaccines licensed for children. And until then It’s going to be really hard for families with children to travel because I don’t see how the authorities are going to make exceptions. The best hope, though, is that if the vaccination really gets rolled out, and if the numbers drop across the world, then the WHO can declare the pandemic over in the third quarter, maybe, and towards the end of the third quarter. And if that happens, it’s going to be very hard to put in very stringent restrictions on children.”

This is an abridged version of an article first published in Web in Travel.

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