Impact of Travel Ban Implementation on COVID-19 Spread in Singapore, Taiwan, Hong Kong and South Korea During the Early Phase of the Pandemic: a Comparative Study.
Abstract Introduction: Since January 2020, the COVID-19 pandemic has elicited imposition of some form of travel restrictions by almost all countries in the world. Most of which persist to this day even as some restrictions have been gradually eased. It remains unclear if the trade-off from the unprecedented disruption to air travel was well worth in the course of pandemic containment.Methods: A comparative analysis was conducted on Singapore, Taiwan, Hong Kong and South Korea’s COVID-19 response. Data on COVID-19 cases, travel-related and community interventions, socio-economic profile were consolidated. Trends on imported and local cases were analyzed using computations of moving averages, rate of change, particularly in response to distinct waves of travel-related interventions due to the outbreak in China, South Korea, Iran & Italy, and Europe.Findings: South Korea’s travel restrictions consistently lagged in terms of timeliness and magnitude. The first wave of travel restrictions against China was implemented 34 days after the outbreak in Wuhan, compared to 22-26 days taken by Singapore, Taiwan and Hong Kong. Restrictions against all countries came after 91 days, compared to 78-80 days for the other three countries. Taiwan and Hong Kong were the most efficient in adopting travel restrictions. Singapore’s belated measures and higher importation risk as compared to the other three Asian countries manifested in its deteriorating local transmission. The rate of change of imported cases fell by 1.08-1.43 across all four countries following the first wave of intervention against China, and by 0.22-0.52 in all countries except South Korea in the fifth wave against all international travellers. Conclusion: Travel restriction was effective in preventing COVID-19 case importation in early outbreak phase. However, evidence of its effect on local transmission was lacking. The impact of travel restrictions in containing epidemics cannot be disentangled from local non-pharmaceutical interventions concurrently implemented. Overall, measures should be complementary, with more emphasis on the latter to contain the outbreak effectively.