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Travel restrictions and SARS-CoV-2 transmission: an effective distance approach to estimate impact.

ABSTRACT: Objective:To estimate the effect of airline travel restrictions on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) importation. Methods:We extracted passenger volume data for the entire global airline network, as well as the dates of the implementation of travel restrictions and the observation of the first case of coronavirus disease (COVID-19) in each country or territory, from publicly available sources. We calculated effective distance between every airport and the city of Wuhan, China. We modelled the risk of SARS-CoV-2 importation by estimating survival probability, expressing median time of importation as a function of effective distance. We calculated the relative change in importation risk under three different hypothetical scenarios that all resulted in different passenger volumes. Findings:We identified 28 countries with imported cases of COVID-19 as at 26 February 2020. The arrival time of the virus at these countries ranged from 39 to 80 days since identification of the first case in Wuhan. Our analysis of relative change in risk indicated that strategies of reducing global passenger volume and imposing travel restrictions at a further 10 hub airports would be equally effective in reducing the risk of importation of SARS-CoV-2; however, this reduction is very limited with a close-to-zero median relative change in risk. Conclusion:The hypothetical variations in observed travel restrictions were not sufficient to prevent the global spread of SARS-CoV-2; further research should also consider travel by land and sea. Our study highlights the importance of strengthening local capacities for disease monitoring and control.

SUBMITTER: Shi S

PROVIDER: S-EPMC7411317 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Travel restrictions and SARS-CoV-2 transmission: an effective distance approach to estimate impact.

Shi Shoi S Tanaka Shiori S Ueno Ryo R Gilmour Stuart S Tanoue Yuta Y Kawashima Takayuki T Nomura Shuhei S Eguchi Akifumi A Miyata Hiroaki H Yoneoka Daisuke D

Bulletin of the World Health Organization 20200528 8

<h4>Objective</h4>To estimate the effect of airline travel restrictions on the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) importation.<h4>Methods</h4>We extracted passenger volume data for the entire global airline network, as well as the dates of the implementation of travel restrictions and the observation of the first case of coronavirus disease (COVID-19) in each country or territory, from publicly available sources. We calculated effective distance between every ai ...[more]

PMID: 32773897

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Project description:Rationale for the review: Air travel may be associated with viruses spread via infected passengers and potentially through in-flight transmission. Given the novelty of the SARS-CoV-2 virus, transmission associated with air travel is based on transmission dynamics of other respiratory viruses. Our objective was to provide a rapid summary and evaluation of relevant data on SARS-CoV-2 transmission aboard aircraft, report policy implications, and highlight research gaps requiring urgent attention.MethodsWe searched four electronic databases (1 February 2020 to 27 January 2021) and included studies on SARS-CoV-2 transmission aboard aircraft. We assessed study quality based on five criteria and reported important findings.Key findingsWe included 18 studies on in-flight SARS-CoV-2 transmission (130 unique flights) and two studies on wastewater from aircraft. The quality of evidence from most published studies was low. Two wastewater studies reported PCR-positive samples with high Cycle threshold values (33-39). Index case definition was heterogeneous across studies. The proportion of contacts traced ranged from 0.68% to 100%. Authors traced 2800/19729 passengers, 140/180 crew members, and 8/8 medical staff. Altogether, 273 index cases were reported, with 64 secondary cases. Three studies, each investigating one flight, reported no secondary cases. Secondary attack rate among studies following up > 80% of passengers and crew (including data on ten flights) varied between 0-8.2%. The studies reported on the possibility of SARS-CoV-2 transmission from asymptomatic, pre-symptomatic, and symptomatic individuals. Two studies performed viral cultures with ten positive results. Genomic sequencing and phylogenetic analysis were performed in individuals from four flights.ConclusionCurrent evidence suggests SARS-CoV-2 can be transmitted during aircraft travel, but published data do not permit any conclusive assessment of likelihood and extent. The variation in design and methodology restricts the comparison of findings across studies. Standardized guidelines for conducting and reporting future studies of transmission on aircraft should be developed.

Project description:ObjectivesTo evaluate the potential for long distance airborne transmission of SARS-CoV-2 in indoor community settings and to investigate factors that might influence transmission.DesignRapid systematic review and narrative synthesis.Data sourcesMedline, Embase, medRxiv, Arxiv, and WHO COVID-19 Research Database for studies published from 27 July 2020 to 19 January 2022; existing relevant rapid systematic review for studies published from 1 January 2020 to 27 July 2020; and citation analysis in Web of Science and Cocites.Eligibility criteria for study selectionObservational studies reporting on transmission events in indoor community (non-healthcare) settings in which long distance airborne transmission of SARS-CoV-2 was the most likely route. Studies such as those of household transmission where the main transmission route was likely to be close contact or fomite transmission were excluded.Data extraction and synthesisData extraction was done by one reviewer and independently checked by a second reviewer. Primary outcomes were SARS-CoV-2 infections through long distance airborne transmission (>2 m) and any modifying factors. Methodological quality of included studies was rated using the quality criteria checklist, and certainty of primary outcomes was determined using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. Narrative synthesis was themed by setting.Results22 reports relating to 18 studies were identified (methodological quality was high in three, medium in five, and low in 10); all the studies were outbreak investigations. Long distance airborne transmission was likely to have occurred for some or all transmission events in 16 studies and was unclear in two studies (GRADE: very low certainty). In the 16 studies, one or more factors plausibly increased the likelihood of long distance airborne transmission, particularly insufficient air replacement (very low certainty), directional air flow (very low certainty), and activities associated with increased emission of aerosols, such as singing or speaking loudly (very low certainty). In 13 studies, the primary cases were reported as being asymptomatic, presymptomatic, or around symptom onset at the time of transmission. Although some of the included studies were well conducted outbreak investigations, they remain at risk of bias owing to study design and do not always provide the level of detail needed to fully assess transmission routes.ConclusionThis rapid systematic review found evidence suggesting that long distance airborne transmission of SARS-CoV-2 might occur in indoor settings such as restaurants, workplaces, and venues for choirs, and identified factors such as insufficient air replacement that probably contributed to transmission. These results strengthen the need for mitigation measures in indoor settings, particularly the use of adequate ventilation.Systematic review registrationPROSPERO CRD42021236762.

Project description:Accessible urban nature is a key component of creating sustainable urban communities and promoting human health and well-being. To balance the economic, social, and environmental dimensions of sustainable development, the United Nations adopted several sustainable developmental goals (SDGs), such as SDG 11 for sustainable cities and communities, which aims to improve urban planning and management, including equitable access to urban nature. However, more information is still needed regarding how planners and managers can promote urban nature visitation and equitable access during health and environmental crises, such as the COVID-19 pandemic. The purpose of this study was to examine trends in urban nature visitation during the pandemic and then to determine if the effect of the pandemic on the frequency of urban nature site visitation varied by distance to home, using an innovative approach of analyzing both publicly available large-scale mobility data and a web-based survey of urban residents of Tel Aviv-Yafo, Israel. The mobility data results showed that there was a negative mean % difference in park visits compared to baseline during the first and third lockdowns, but an increase compared to baseline between lockdowns and even during the second lockdown. This suggests that urban residents had greater need to reconnect with urban nature during and after periods of intense stress. In addition, the survey results showed an increasing negative effect of distance on urban nature site visitation during the pandemic, specifically for urban nature sites located more than 1 km from home. Altogether, the mobility data and survey results suggest that people who lived within 1 km of their preferred urban nature site had disproportionate access to the benefits of urban nature during and after lockdowns than others. To effectively make social and ecological transitions toward urban sustainability, it is vital that cities promote urban nature accessibility during current and future environmental and health crises. Cities should collaborate with diverse stakeholders to create/maintain accessible urban nature sites nearby all sociodemographic groups, provide sustainability education and training to convey the benefits of urban nature, and pursue participatory solutions for understanding urban nature needs and preferences. In this manner, it will be possible to address the growing influence of proximity/travel distance and additional factors that affect urban nature visitation and ultimately, human health and urban sustainability.

Dataset Information

Travel restrictions and SARS-CoV-2 transmission: an effective distance approach to estimate impact.

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Travel restrictions and SARS-CoV-2 transmission: an effective distance approach to estimate impact.

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