Center for Systematic Reviews for Health Policy and Systems Research, American University of Beirut, P.O.Box 11-0236, Riad El-Solh, Beirut 1107 2020, Lebanon.
Clinical Research Institute, American University of Beirut Medical Center, Clinical Research Institute, P.O.Box 11-0236, Riad El-Solh, Beirut 1107 2020, Lebanon.
J Infect. 2021 Oct;83(4):413-423. doi: 10.1016/j.jinf.2021.07.017. Epub 2021 Jul 24.
To map travel policies implemented due to COVID-19 during 2020, and conduct a mixed-methods systematic review of health effects of such policies, and related contextual factors.
Policy mapping and systematic review. DATA SOURCES AND ELIGIBILITY CRITERIA: for the policy mapping, we searched websites of relevant government bodies and used data from the Oxford COVID-19 Government Response Tracker for a convenient sample of 31 countries across different regions. For the systematic review, we searched Medline (Ovid), PubMed, EMBASE, the Cochrane Central Register of Controlled Trials and COVID-19 specific databases. We included randomized controlled trial, non-randomized studies, modeling studies, and qualitative studies. Two independent reviewers selected studies, abstracted data and assessed risk of bias.
Most countries adopted a total border closure at the start of the pandemic. For the remainder of the year, partial border closure banning arrivals from some countries or regions was the most widely adopted measure, followed by mandatory quarantine and screening of travelers. The systematic search identified 69 eligible studies, including 50 modeling studies. Both observational and modeling evidence suggest that border closure may reduce the number of COVID-19 cases, disease spread across countries and between regions, and slow the progression of the outbreak. These effects are likely to be enhanced when implemented early, and when combined with measures reducing transmission rates in the community. Quarantine of travelers may decrease the number of COVID-19 cases but its effectiveness depends on compliance and enforcement and is more effective if followed by testing, especially when less than 14 day-quarantine is considered. Screening at departure and/or arrival is unlikely to detect a large proportion of cases or to delay an outbreak. Effectiveness of screening may be improved with increased sensitivity of screening tests, awareness of travelers, asymptomatic screening, and exit screening at country source. While four studies on contextual evidence found that the majority of the public is supportive of travel restrictions, they uncovered concerns about the unintended harms of those policies.
Most countries adopted full or partial border closure in response to COVID-19 in 2020. Evidence suggests positive effects on controlling the COVID-19 pandemic for border closure (particularly when implemented early), as well as quarantine of travelers (particularly with higher levels of compliance). While these positive effects are enhanced when implemented in combination with other public health measures, they are associated with concerns by the public regarding some unintended effects.
绘制 2020 年因 COVID-19 实施的旅行政策图，并对这些政策的健康影响及其相关背景因素进行混合方法系统评价。
政策图绘制和系统评价。
对于政策图绘制，我们搜索了相关政府机构的网站，并使用牛津 COVID-19 政府反应追踪器的数据，对来自不同地区的 31 个国家进行了方便的抽样。对于系统评价，我们检索了 Medline（Ovid）、PubMed、EMBASE、Cochrane 中央对照试验注册中心和 COVID-19 特定数据库。我们纳入了随机对照试验、非随机研究、建模研究和定性研究。两名独立评审员选择研究、提取数据并评估偏倚风险。
大多数国家在大流行开始时采取了全面边境关闭措施。在这一年的剩余时间里，部分边境关闭措施禁止来自某些国家或地区的入境，是最广泛采用的措施，其次是对旅行者进行强制检疫和筛查。系统检索确定了 69 项符合条件的研究，其中包括 50 项建模研究。观察性和建模证据均表明，边境关闭可能会减少 COVID-19 病例数量、减少国家间和地区间的疾病传播，并减缓疫情的发展。这些效果可能在早期实施时增强，并且与降低社区内传播率的措施相结合时增强。对旅行者进行检疫可能会减少 COVID-19 病例数量，但效果取决于遵守和执行情况，如果随后进行检测，则效果更好，尤其是当考虑少于 14 天的检疫时。出发和/或抵达时的筛查不太可能发现很大比例的病例或延迟疫情爆发。通过增加筛查测试的敏感性、旅行者的意识、无症状筛查以及在来源国进行出口筛查，可能会提高筛查的有效性。四项关于背景证据的研究发现，大多数公众支持旅行限制，但他们发现了对这些政策的意外影响的担忧。
2020 年，大多数国家针对 COVID-19 采取了全面或部分边境关闭措施。证据表明，边境关闭（特别是在早期实施时）以及对旅行者的检疫（特别是在遵守程度较高时）对控制 COVID-19 大流行具有积极影响。虽然这些积极影响在与其他公共卫生措施结合实施时会增强，但公众对一些意外影响表示关注。
