Boyd Matt, Baker Michael G, Mansoor Osman D, Kvizhinadze Giorgi, Wilson Nick
Adapt Research Ltd, Wellington, New Zealand.
Department of Public Health, University of Otago, Wellington, New Zealand.
PLoS One. 2017 Jun 16;12(6):e0178732. doi: 10.1371/journal.pone.0178732. eCollection 2017.
Countries are well advised to prepare for future pandemic risks (e.g., pandemic influenza, novel emerging agents or synthetic bioweapons). These preparations do not typically include planning for complete border closure. Even though border closure may not be instituted in time, and can fail, there might still plausible chances of success for well organized island nations.
To estimate costs and benefits of complete border closure in response to new pandemic threats, at an initial proof-of-concept level. New Zealand was used as a case-study for an island country.
An Excel spreadsheet model was developed to estimate costs and benefits. Case-study specific epidemiological data was sourced from past influenza pandemics. Country-specific healthcare cost data, valuation of life, and lost tourism revenue were imputed (with lost trade also in scenario analyses).
For a new pandemic equivalent to the 1918 influenza pandemic (albeit with half the mortality rate, "Scenario A"), it was estimated that successful border closure for 26 weeks provided a net societal benefit (e.g., of NZ$11.0 billion, USD$7.3 billion). Even in the face of a complete end to trade, a net benefit was estimated for scenarios where the mortality rate was high (e.g., at 10 times the mortality impact of "Scenario A", or 2.75% of the country's population dying) giving a net benefit of NZ$54 billion (USD$36 billion). But for some other pandemic scenarios where trade ceased, border closure resulted in a net negative societal value (e.g., for "Scenario A" times three for 26 weeks of border closure-but not for only 12 weeks of closure when it would still be beneficial).
This "proof-of-concept" work indicates that more detailed cost-benefit analysis of border closure in very severe pandemic situations for some island nations is probably warranted, as this course of action might sometimes be worthwhile from a societal perspective.
各国应做好应对未来大流行风险（如大流行性流感、新型病原体或合成生物武器）的准备。这些准备工作通常不包括完全关闭边境的计划。尽管边境关闭可能无法及时实施，甚至可能失败，但对于组织良好的岛国来说，仍有可能取得成功。
在初步概念验证层面，评估针对新的大流行威胁完全关闭边境的成本和收益。以新西兰这个岛国为例进行研究。
开发了一个Excel电子表格模型来估算成本和收益。案例研究的特定流行病学数据来自过去的流感大流行。估算了各国特定的医疗保健成本数据、生命价值和旅游业收入损失（情景分析中还包括贸易损失）。
对于一场相当于1918年流感大流行（尽管死亡率减半，即“情景A”）的新大流行，估计成功关闭边境26周可带来净社会效益（例如110亿新西兰元，73亿美元）。即使贸易完全终止，在高死亡率情景下（例如死亡率为“情景A”的10倍，即该国人口的2.75%死亡）仍估计有净收益，达540亿新西兰元（360亿美元）。但在其他一些贸易停止的大流行情景中，边境关闭会导致社会净负价值（例如“情景A”的三倍，边境关闭26周时会出现这种情况，但仅关闭12周时仍有益）。
这项“概念验证”工作表明，对于一些岛国在非常严重的大流行情况下关闭边境进行更详细的成本效益分析可能是有必要的，因为从社会角度来看，这一行动有时可能是值得的。
